Halit Acet - Academia.edu (original) (raw)

Papers by Halit Acet

Research paper thumbnail of The clinical significance of anticardiolipin antibody levels in patients with acute myocardial infarction: a regional study

Advances in Interventional Cardiology, 2013

Introduction: Acute myocardial infarction (AMI) will probably remain the most important cause of ... more Introduction: Acute myocardial infarction (AMI) will probably remain the most important cause of death over the next decades. Traditional risk factors of atherosclerosis could not exactly explain the development of acute coronary events such as AMI. Antiphospholipid antibody syndrome is a disorder characterized by the development of arterial and venous thrombosis. Aim: In this study, we investigated the relations between acute myocardial infarction and anti-phospholipid antibody syndrome in our population representing Aegean Region people characteristics. Material and methods: One hundred patients with acute myocardial infarction were consecutively included in the study (group I) and one hundred age and sex matched people with similar risk factors were enrolled in the study as a control group (group II). Anticardiolipin antibody (aCL) IgM and IgG levels were measured in the two groups. Levels of aCL IgG ≥ 48 U/ml and/or aCL IgM ≥ 44 U/ml were accepted as positive and significant. Results: In patients with acute myocardial infarction, 5 patients (5%) had positive IgM levels and 8 patients (8%) were found to have positive IgG levels. All cases in the control group had negative aCL IgM and IgG antibody levels. These results were accepted as significant for both aCL antibodies between patients and controls (p < 0.001). Conclusions: We concluded that aCL antibody levels are also higher in a small proportion of patients with acute myocardial infarction than controls in our region, also, and these results suggest that there may be an immune stimulus in the pathogenesis of acute coronary events.

Research paper thumbnail of The relationship of TIMI risk index with SYNTAX and Gensini risk scores in predicting the extent and severity of coronary artery disease in patients with STEMI undergoing primary percutaneous coronary intervention

Therapeutic advances in cardiovascular disease, Jan 16, 2015

The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and... more The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) have been reported in patients with coronary artery disease (CAD). In this study, we sought to evaluate the association between TRI and the extent and severity of CAD evaluated by SYNTAX score (SS) and Gensini score in patients with ST elevation myocardial infarction (STEMI). A total of 290 patients with STEMI were included in the study. GRS and TRI were calculated on admission using specified variables. The extent and severity of CAD were evaluated using the SS and Gensini scores. The patients were divided into low (TRI ⩽19), intermediate (TRI 19-30), and high (TRI ⩾30) risk groups. A Pearson correlation analysis was used for the relationship between TRI, GRS, Gensini score and SS. There were significant differences in the mean age (p < 0.001), admission heart rate (p < 0.001), admission systolic blood pressure (p ...

Research paper thumbnail of Evaluation of Platelet to Lymphocyte Ratio to Predict No-Reflow in Patients With Acute Myocardial Infarction

Results: There was no statistical difference between two groups in terms of demographic character... more Results: There was no statistical difference between two groups in terms of demographic characteristicts even the age was higher in C-shape ). In C-shape patients, the frequency of proximal and mid region lesions were found more than distal lesions (p¼0.014) but there was no differences in S-shape patients. TFC in patient group with S-shape were significantly higher than patient group with C shape when both groups were compared in terms of TFCs. The two groups lesion regions were compared each other and there were no difference between vascular diameters. Conclusıons: The frequency of lesion was higher in the proximal and mid sections of C shape RCA. TFCs were significantly higher in patients with S-shape group than patients C shape group when they were compared in terms of TFCs.

Research paper thumbnail of Assessment of Platelet to Lymphocyte Ratio to Predict Stent Thrombosis in Patients with ST Elevation Myocardial Infarction

Introductıon: Atrial septostomy (AS) is a complex technique used during interventions such as; mi... more Introductıon: Atrial septostomy (AS) is a complex technique used during interventions such as; mitral balloon valvotomy, electrophysiological procedures, left atrial appendage closure and MitraClip. Cardiac perforation occurs in 1-5% of cases even in experienced hands. In daily practice, although AS is performed with the guidance of fluoroscopy, it is necessary to use transesophageal echocardiography (TEE) in some interventions (MitraClip, for some cases with mitral balloon valvotomy). Here, we present, to our knowledge, outcomes of the largest series of TEE-guided AS in our country. Method: Our study included the results of 39 AS procedures (mean age 55.6AE10.2) by TEE-guided. AS was performed for mitral balloon valvotomy in 17 patients and for MitraClip in 22 patients. Atrial septal puncture was only performed when tenting was confirmed in all of the bicaval, short axis aortic and 4 chamber views. Results: While AS was successful in 37 (95%) of our patients, cardiac tamponade developed in one patient (%2). In this patient, the septum was rigid and the Mullin's sheath/needle combination was constantly directed towards the cranial region of the septum. After trying for a long period of time, cardiac tamponade developed, and pericardial fluid beginning from the right atrium and rapidly spreading to other regions was detected. In the meantime, the hemodynamics quickly worsened and the patient underwent immediate pericardiocentesis and was referred to surgery. In another patient, the septum was very thick (1.5 cm) and the Mullin's sheath/needle combination constantly slipped towards the cranial region of the septum during AS. In this patient, tenting was obtained only once with TEE. Since the level was as not appropriate for MitraClip procedure, puncture was not performed. In one of the cases where AS was performed successfully, a mobile thrombus attached to the atrial septum was detected after the removing of the catheter from the septum. Since the patient was high risk for surgery, he was treated with anticoagulants and on the 5th day after imaging the thrombus was resolved without any complications. Conclusıon: During the AS, cardiac perforation is more common particularly in patients with a large aortic root, in those with very large or unlikely very small atrium, in thoracic vertebral deformities, congenital heart diseases, massive pericardial effusions and in those with previously underwent ASD closure. Although there is not sufficient information in literature about TEE-guided AS, there are some reports that have mentioned the reduction of complications with the TEE-guided AS procedure. But, others have reported reductions only in the duration of fluoroscopy without the reduction of complications and an easier more specific region targeting method for AS. Our findings suggest that TEE-guided AS may reduce the need of fluoroscopy and the duration of AS, however, this method can not absolutely prevent cardiac tamponade.

Research paper thumbnail of The Association between Neutrophil/Lymphocyte Ratio and Functional Capacity in Patients with Idiopathic Dilated Cardiomyopathy

Aim: In recent literature only two data exist whether the CHADS2 and CHA2DS2-VASc scores can be u... more Aim: In recent literature only two data exist whether the CHADS2 and CHA2DS2-VASc scores can be used for the risk assessment of new-onset atrial fibrillation (AF) or AF after coronary artery bypass graft (CABG) surgery. Methods: We retrospectively analyzed 133 consecutive patients (42 patients with AF after CABG surgery and 91 patients without AF) who were undergoing CABG between January 2011 and January 2013 at our department. Complete medical records were retrospectively collected to investigate, congestive heart failure, hypertension, age ! 75 years, diabetes, previous stroke (CHADS2) and CHA2DS2-vascular disease, age 65-74 years, sex category (CHA2DS2-VASc) scores. The primary end point of this study was the development of AF after CABG surgery in hospital. Results: Only age (67.6+9.7 vs 62.4+10.6 years, p¼0.008) was significantly higher in AF group. Mean CHADS2 and CHA2DS2-VASc scores were 1.53+0.97 and 3.23+1.25 respectively. CHADS2 (1.62+0.91 vs 1.48+1.00, p¼0.34) and CHA2DS2-VASc (3.43+1.17 vs 3.13+1.28, p¼0.22) scores were higher in AF group but it was not statistically significant. When patients divided into two groups according to CHADS2 and CHA2DS2-VASc scores at the cuttof point of 2, no significant difference was detected in AF rate (31.9% vs 30.0%, p¼0.55 and 34.4% vs 24.3%, p¼0.18 respectively). In univariate and multivariate analysis only age was independent predictor of AF after CABG surgery . Conclusıon: CHADS2 and CHA2DS2-VASc scores were not independent predictors of AF after CABG surgery. Further prospective, randomized, controlled trials are necessary to make healthier interpretations on this issue.

Research paper thumbnail of The Relationship between RDW and the GRACE Risk Score with in Hospital Death in Non-ST Elevation Myocardial Infarction and Unstable Angina Pectoris

Objective: Red cell distribution width (RDW), is an independent predictor of mortality in patient... more Objective: Red cell distribution width (RDW), is an independent predictor of mortality in patients with cardiovascular disease. This study evaluated the relationship between RDW and Calculation of the Global Registry of Acute Coronary Events (GRACE) risk score with in-hospital death in patients with unstable angina pectoris (UAP) and non-ST elevation myocardial infarction (NSTEMI). Methods: We prospectively enrolled 193 patients with UAP/NSTEMI (mean age 63.6AE12.6 years; 110 men, 83 women) in this study. Admission RDW was measured and the study population was classified on the basis of RDW tertiles. A high RDW was defined as a value in the upper third tertile and a low RDW was defined as in the lower two tertiles. GRACE risk score was calculated upon first arrival to the coronary care unit and classified low, medium and high risk tertiles. The patients were followed for clinical outcomes during the hospital stay. Results: Higher RDW values were associated with increased in-hospital mortality. Inhospital mortality rate was 9.5% in the high RDW group versus 0% in the low RDW group (p¼0.001). There was a significant correlation between RDW and GRACE risk score in terms of in-hospital death (p<0.001), in-hospital death or myocardial infarction (p<0.001), discharge to 6 month death (p<0.001) and discharge to 6 month death or myocardial infarction (p<0.001). In multivariate logistic regression analysis, the RDW (odds ratio: 1.513, 95% confidence interval: 1.116-2.051, p¼0.008), female gender and left ventricular ejection fraction were found to be independent predictors of high GRACE

Research paper thumbnail of The importance of hematologic indices in the risk stratification of patients with acute decompensated systolic heart failure

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2015

In patients with heart failure, a variety of hemogram parameters are known to be of prognostic si... more In patients with heart failure, a variety of hemogram parameters are known to be of prognostic significance. This study aimed to investigate which of these parameters is/are useful in predicting one-year all-cause mortality in patients with acute decompensated heart failure (ADHF). Patients who were hospitalized between September 2012-March 2013 in our hospital with systolic-ADHF with ejection fraction ≤40%, symptoms, and findings of congestion were enrolled retrospectively in the study. The study population was divided into two groups based on one-year-mortality. 119 patients with ADHF (mean-age 67±14 years; 55% male) were enrolled in the study. One-year-mortality occurred in 29% of patients. Hemoglobin levels, platelet, basophil and lymphocyte counts were significantly lower, while red-cell distribution width (RDW) was found to be significantly higher in the one-year-mortality group. Neutrophil, monocyte, and eosinophil counts were similar in the two groups. Furthermore, lower est...

Research paper thumbnail of An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER-2 study design

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2015

Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is r... more Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). First results are expected in June 2015. Data about major cardiovascul...

Research paper thumbnail of Relationship Between Hematologic Indices and Global Registry of Acute Coronary Events Risk Score in Patients With ST-Segment Elevation Myocardial Infarction

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 8, 2014

The aim of this study was to evaluate the relationship between hematologic indices and the Global... more The aim of this study was to evaluate the relationship between hematologic indices and the Global Registry of Acute Coronary Events (GRACE) score in patients with ST-segment elevation myocardial infarction (STEMI). A total of 800 patients who consecutively and retrospectively presented with STEMI within 12 hours of symptom onset. After accounting for exclusion criteria, a total of 379 patients remained in the study. We enrolled 379 patients with STEMI (mean age 61.7 ± 13.6 years; men 73%). Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW), and monocyte count were associated with increased worse GRACE risk score (P = .008, P = .012, P = .005, P = .022, respectively). In multivariate linear regression analysis, NLR, PLR, RDW, and monocyte count were found to be independent predictors of GRACE risk score. We demonstrate for the first time that PLR, RDW, and monocyte were associated with the GRACE score in patients with STEMI.

Research paper thumbnail of Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

Case Reports in Vascular Medicine, 2014

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamb... more Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient's symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

Research paper thumbnail of A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

Advances in Interventional Cardiology, 2014

Introduction: Previous studies have reported a relationship between serum bilirubin levels and co... more Introduction: Previous studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (TB) levels and pre-primary percutaneous coronary intervention (PCI) with patency of IRA flow in STEMI patients has not been investigated.

Research paper thumbnail of Evaluation of fluid status related parameters in hemodialysis and peritoneal dialysis patients: Clinical usefulness of bioimpedance analysis

Medicina, 2014

m e d i c i n a 5 0 ( 2 0 1 4 ) 2 6 9 -2 7 4 a b s t r a c t Background and objective: Fluid over... more m e d i c i n a 5 0 ( 2 0 1 4 ) 2 6 9 -2 7 4 a b s t r a c t Background and objective: Fluid overload is a common and serious problem that leads to severe complications in dialysis patients. We aimed to compare hydration status as measured with bioimpedance analysis (BIA) method in hemodialysis (HD) and peritoneal dialysis (PD) patients, as well as investigating the association between blood pressure, left ventricular mass index (LVMI) and hydration status.

Research paper thumbnail of Relation of epicardial fat thickness and brachial flow-mediated vasodilation with coronary artery disease

Journal of Cardiology, 2013

Objective: The purpose of this study is to investigate the presence of a statistical association ... more Objective: The purpose of this study is to investigate the presence of a statistical association between epicardial fat thickness (EFT) and coronary artery disease (CAD) and between flow-mediated vasodilation (FMD) and CAD. Methods: We measured the EFT and FMD in 64 subjects with suspected stable angina pectoris. The patients were separated into two groups according to their coronary angiography results: 34 patients with CAD and 30 patients with normal coronary arteries (NCA). Results: EFT was significantly higher in the patients with CAD than the NCA group (6.43 ± 0.90 mm vs. 5.35 ± 0.75 mm, p < 0.001) while FMD was significantly lower in the patients with CAD than those in the NCA group (6.41 ± 2.51% vs. 8.33 ± 3.45%, p = 0.015). No significant correlation was found between EFT and FMD. After adjustment for EFT, FMD, age, sex, ejection fraction, glucose, and low-density lipoprotein cholesterol through multivariate logistic regression analysis, EFT (odds ratio: 6.325, 95% confidence interval 2.289-17.476, p < 0.001) and age (odds ratio: 1.093, 95% confidence interval 1.008-1.185, p = 0.032) remained significant predictors of CAD. A cut-off value of EFT ≥ 5.8 mm predicted the presence of CAD with 77% sensitivity and 70% specificity. Conclusion: An echocardiographic EFT assessment is independently associated with the presence of CAD. Thus, EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.

Research paper thumbnail of New inflammatory predictors for non-valvular atrial fibrillation: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio

The International Journal of Cardiovascular Imaging, 2014

The objective of this study was to investigate the relationship of echocardiographic epicardial f... more The objective of this study was to investigate the relationship of echocardiographic epicardial fat thickness (EFT) and neutrophil to lymphocyte ratio (NLR) with different types of non-valvular atrial fibrillation (AF) in a clinical setting. A total of 197 consecutive patients were enrolled in the study. Seventy-one patients had paroxysmal non-valvular AF, 63 patients had persistent/permanent nonvalvular AF, and 63 patients had sinus rhythm (control group). EFT was measured with echocardiography, while NLR was measured by dividing neutrophil count by lymphocyte count. EFT was significantly higher in patients with paroxysmal non-valvular AF compared with those in the sinus rhythm group (6.6 ± 0.7 vs. 5.0 ± 0.9 mm, p \ 0.001). Persistent/permanent non-valvular AF patients had a significantly larger EFT compared with those with paroxysmal AF (8.3 ± 1.1 vs. 6.6 ± 0.7 mm, p \ 0.001). EFT had a significant relationship with paroxysmal nonvalvular AF (odds ratio 4.672, 95 % CI 2.329-9.371, p \ 0.001) and persistent/permanent non-valvular AF (OR 24.276,, p \ 0.001). NLR was significantly higher in those with paroxysmal non-valvular AF compared with those in the sinus rhythm group (2.5 ± 0.6 vs. 1.8 ± 0.4, p \ 0.001). Persistent/permanent non-valvular AF patients had a significantly larger NLR when compared with paroxysmal non-valvular AF patients (3.4 ± 0.6, vs. 2.5 ± 0.6, p \ 0.001). NLR ([2.1) had a significant relationship with non-valvular AF (OR 11.313, 95 % CI 3.025-42.306, b 2.426, p \ 0.001). EFT and NLR are highly associated with types of non-valvular AF independent of traditional risk factors. EFT measured by echocardiography and NLR appears to be related to the duration and severity of AF.

Research paper thumbnail of The Utility of the Platelet-Lymphocyte Ratio for Predicting No Reflow in Patients With ST-Segment Elevation Myocardial Infarction

Clinical and Applied Thrombosis/Hemostasis, 2014

The aim of the study was to evaluate the utility of the preprocedural platelet-lymphocyte ratio (... more The aim of the study was to evaluate the utility of the preprocedural platelet-lymphocyte ratio (PLR) for predicting no reflow in patients undergoing primary percutaneous intervention (PCI) for the treatment of ST-segment elevation myocardial infarction. The thrombolysis in myocardial infarction (TIMI) flow grades of 287 patients treated with primary PCI were assessed retrospectively. Patients were divided into 3 tertiles based upon preprocedural PLR. Pre-and postprocedural TIMI flow grades were evaluated. No reflow developed in 6, 14, and 43 patients in the lower, middle, and higher tertiles, respectively (P < .001). After multivariate analysis, PLR remained a significant predictor of no reflow together with neutrophil-lymphocyte ratio (NLR). A cutoff value of 160 for PLR and 5.9 for NLR predicted no reflow with sensitivities and specificities of 75% and 71% and 74% and 70%, respectively. In conclusion, high preprocedural PLR and NLR levels are significant and independent predictors of no reflow in patients undergoing primary PCI.

Research paper thumbnail of Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease

Clinical and Applied Thrombosis/Hemostasis, 2014

Objectives: Pulmonary hypertension (PH) is composed of a heterogeneous group of disorders marked ... more Objectives: Pulmonary hypertension (PH) is composed of a heterogeneous group of disorders marked by increased pulmonary artery resistance leading to right heart failure, with high mortality. Evidence is increasing to propose that inflammation plays a significant role in the pathophysiological mechanism. Increased prevalence of PH in patients with systemic inflammatory diseases is already known. Herein, we sought to evaluate the association between neutrophil to lymphocyte ratio (N/L ratio) and pulmonary arterial hypertension (PAH).

Research paper thumbnail of Association of Neutrophil-Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis

Clinical and Applied Thrombosis/Hemostasis, 2013

The aim of the study is to investigate the association between the severity of rheumatic mitral v... more The aim of the study is to investigate the association between the severity of rheumatic mitral valvular disease (RMVD) and the neutrophil-lymphocyte ratio (NLR). A total of 227 patients were enrolled in the study and divided into 3 groups. Patients in group 1 had rheumatic mitral stenosis (RMS), those in group 2 had RMVD without stenosis, and those in group 3 served as the control group. Group 1 was further divided into 2 groups, severe mitral stenosis (MS) and mild to moderate MS. The NLR was significantly higher in patients with severe MS when compared to those with mild to moderate MS (P ¼ .002) while lymphocyte count was lower (P ¼ .034). Using a cutoff level of 2.56, the NLR predicted severe RMS with a sensitivity of 75% and specificity of 74%. In conclusion, as an inexpensive, simple, and accessible marker of inflammation, the NLR may be useful in predicting the presence and severity of MS in patients with RMVD.

Research paper thumbnail of Platelet to lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2014

Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS).... more Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS). Recent studies have shown that the plateletto-lymphocyte ratio (PLR) is associated with several malignancies; however, there are not enough data in cardiovascular diseases. Therefore, the aim of this study was to explore the association between PLR and in-hospital mortality in patients with ACS. Methods: We retrospectively collected patients with ACS undergoing coronary angiography. Total and differential leukocyte counts were measured by an automated hematology analyzer. Results: This study is single-centered and observational. In total, 587 patients with a mean age of 61.8±13.1 years (68.4% male) were enrolled in the study. Patients were divided into 3 tertiles based on PLR levels. In-hospital mortality was significantly higher among patients in the upper PLR tertile when compared with the middle and lower PLR tertile groups [29 (14.8%) vs. 17 (8.7%) and 2 (1.0%); p<0.001]. In the multiple logistic regression analysis, a high level of PLR was an independent predictor of in-hospital mortality, together with age, total leukocyte count, and creatinine. Using a cutoff point of 142, the PLR predicted in-hospital mortality with a sensitivity of 69% and specificity of 63%. Conclusion: Different from other inflammatory markers and assays, PLR is an inexpensive and readily available biomarker that may be useful for cardiac risk stratification in patients with ACS. (Anadolu Kardiyol Derg 2015; 15(0): 000-000)

Research paper thumbnail of Relationship Between Red Cell Distribution Width and Stroke in Patients With Stable Chronic Heart Failure: A Propensity Score Matching Analysis

Clinical and Applied Thrombosis/Hemostasis, 2013

The aim of this study was to evaluate the relationship between red cell distribution width (RDW) ... more The aim of this study was to evaluate the relationship between red cell distribution width (RDW) and Global Registry of Acute Coronary Events (GRACE) risk score in patients with unstable angina pectoris (UAP) and non-ST elevation myocardial infarction (NSTEMI). We retrospectively enrolled 193 patients with UAP/NSTEMI (mean age 63.6 + 12.6 years; men 57%) in this study.

Research paper thumbnail of The clinical significance of anticardiolipin antibody levels in patients with acute myocardial infarction: a regional study

Advances in Interventional Cardiology, 2013

Introduction: Acute myocardial infarction (AMI) will probably remain the most important cause of ... more Introduction: Acute myocardial infarction (AMI) will probably remain the most important cause of death over the next decades. Traditional risk factors of atherosclerosis could not exactly explain the development of acute coronary events such as AMI. Antiphospholipid antibody syndrome is a disorder characterized by the development of arterial and venous thrombosis. Aim: In this study, we investigated the relations between acute myocardial infarction and anti-phospholipid antibody syndrome in our population representing Aegean Region people characteristics. Material and methods: One hundred patients with acute myocardial infarction were consecutively included in the study (group I) and one hundred age and sex matched people with similar risk factors were enrolled in the study as a control group (group II). Anticardiolipin antibody (aCL) IgM and IgG levels were measured in the two groups. Levels of aCL IgG ≥ 48 U/ml and/or aCL IgM ≥ 44 U/ml were accepted as positive and significant. Results: In patients with acute myocardial infarction, 5 patients (5%) had positive IgM levels and 8 patients (8%) were found to have positive IgG levels. All cases in the control group had negative aCL IgM and IgG antibody levels. These results were accepted as significant for both aCL antibodies between patients and controls (p < 0.001). Conclusions: We concluded that aCL antibody levels are also higher in a small proportion of patients with acute myocardial infarction than controls in our region, also, and these results suggest that there may be an immune stimulus in the pathogenesis of acute coronary events.

Research paper thumbnail of The relationship of TIMI risk index with SYNTAX and Gensini risk scores in predicting the extent and severity of coronary artery disease in patients with STEMI undergoing primary percutaneous coronary intervention

Therapeutic advances in cardiovascular disease, Jan 16, 2015

The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and... more The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) have been reported in patients with coronary artery disease (CAD). In this study, we sought to evaluate the association between TRI and the extent and severity of CAD evaluated by SYNTAX score (SS) and Gensini score in patients with ST elevation myocardial infarction (STEMI). A total of 290 patients with STEMI were included in the study. GRS and TRI were calculated on admission using specified variables. The extent and severity of CAD were evaluated using the SS and Gensini scores. The patients were divided into low (TRI ⩽19), intermediate (TRI 19-30), and high (TRI ⩾30) risk groups. A Pearson correlation analysis was used for the relationship between TRI, GRS, Gensini score and SS. There were significant differences in the mean age (p < 0.001), admission heart rate (p < 0.001), admission systolic blood pressure (p ...

Research paper thumbnail of Evaluation of Platelet to Lymphocyte Ratio to Predict No-Reflow in Patients With Acute Myocardial Infarction

Results: There was no statistical difference between two groups in terms of demographic character... more Results: There was no statistical difference between two groups in terms of demographic characteristicts even the age was higher in C-shape ). In C-shape patients, the frequency of proximal and mid region lesions were found more than distal lesions (p¼0.014) but there was no differences in S-shape patients. TFC in patient group with S-shape were significantly higher than patient group with C shape when both groups were compared in terms of TFCs. The two groups lesion regions were compared each other and there were no difference between vascular diameters. Conclusıons: The frequency of lesion was higher in the proximal and mid sections of C shape RCA. TFCs were significantly higher in patients with S-shape group than patients C shape group when they were compared in terms of TFCs.

Research paper thumbnail of Assessment of Platelet to Lymphocyte Ratio to Predict Stent Thrombosis in Patients with ST Elevation Myocardial Infarction

Introductıon: Atrial septostomy (AS) is a complex technique used during interventions such as; mi... more Introductıon: Atrial septostomy (AS) is a complex technique used during interventions such as; mitral balloon valvotomy, electrophysiological procedures, left atrial appendage closure and MitraClip. Cardiac perforation occurs in 1-5% of cases even in experienced hands. In daily practice, although AS is performed with the guidance of fluoroscopy, it is necessary to use transesophageal echocardiography (TEE) in some interventions (MitraClip, for some cases with mitral balloon valvotomy). Here, we present, to our knowledge, outcomes of the largest series of TEE-guided AS in our country. Method: Our study included the results of 39 AS procedures (mean age 55.6AE10.2) by TEE-guided. AS was performed for mitral balloon valvotomy in 17 patients and for MitraClip in 22 patients. Atrial septal puncture was only performed when tenting was confirmed in all of the bicaval, short axis aortic and 4 chamber views. Results: While AS was successful in 37 (95%) of our patients, cardiac tamponade developed in one patient (%2). In this patient, the septum was rigid and the Mullin's sheath/needle combination was constantly directed towards the cranial region of the septum. After trying for a long period of time, cardiac tamponade developed, and pericardial fluid beginning from the right atrium and rapidly spreading to other regions was detected. In the meantime, the hemodynamics quickly worsened and the patient underwent immediate pericardiocentesis and was referred to surgery. In another patient, the septum was very thick (1.5 cm) and the Mullin's sheath/needle combination constantly slipped towards the cranial region of the septum during AS. In this patient, tenting was obtained only once with TEE. Since the level was as not appropriate for MitraClip procedure, puncture was not performed. In one of the cases where AS was performed successfully, a mobile thrombus attached to the atrial septum was detected after the removing of the catheter from the septum. Since the patient was high risk for surgery, he was treated with anticoagulants and on the 5th day after imaging the thrombus was resolved without any complications. Conclusıon: During the AS, cardiac perforation is more common particularly in patients with a large aortic root, in those with very large or unlikely very small atrium, in thoracic vertebral deformities, congenital heart diseases, massive pericardial effusions and in those with previously underwent ASD closure. Although there is not sufficient information in literature about TEE-guided AS, there are some reports that have mentioned the reduction of complications with the TEE-guided AS procedure. But, others have reported reductions only in the duration of fluoroscopy without the reduction of complications and an easier more specific region targeting method for AS. Our findings suggest that TEE-guided AS may reduce the need of fluoroscopy and the duration of AS, however, this method can not absolutely prevent cardiac tamponade.

Research paper thumbnail of The Association between Neutrophil/Lymphocyte Ratio and Functional Capacity in Patients with Idiopathic Dilated Cardiomyopathy

Aim: In recent literature only two data exist whether the CHADS2 and CHA2DS2-VASc scores can be u... more Aim: In recent literature only two data exist whether the CHADS2 and CHA2DS2-VASc scores can be used for the risk assessment of new-onset atrial fibrillation (AF) or AF after coronary artery bypass graft (CABG) surgery. Methods: We retrospectively analyzed 133 consecutive patients (42 patients with AF after CABG surgery and 91 patients without AF) who were undergoing CABG between January 2011 and January 2013 at our department. Complete medical records were retrospectively collected to investigate, congestive heart failure, hypertension, age ! 75 years, diabetes, previous stroke (CHADS2) and CHA2DS2-vascular disease, age 65-74 years, sex category (CHA2DS2-VASc) scores. The primary end point of this study was the development of AF after CABG surgery in hospital. Results: Only age (67.6+9.7 vs 62.4+10.6 years, p¼0.008) was significantly higher in AF group. Mean CHADS2 and CHA2DS2-VASc scores were 1.53+0.97 and 3.23+1.25 respectively. CHADS2 (1.62+0.91 vs 1.48+1.00, p¼0.34) and CHA2DS2-VASc (3.43+1.17 vs 3.13+1.28, p¼0.22) scores were higher in AF group but it was not statistically significant. When patients divided into two groups according to CHADS2 and CHA2DS2-VASc scores at the cuttof point of 2, no significant difference was detected in AF rate (31.9% vs 30.0%, p¼0.55 and 34.4% vs 24.3%, p¼0.18 respectively). In univariate and multivariate analysis only age was independent predictor of AF after CABG surgery . Conclusıon: CHADS2 and CHA2DS2-VASc scores were not independent predictors of AF after CABG surgery. Further prospective, randomized, controlled trials are necessary to make healthier interpretations on this issue.

Research paper thumbnail of The Relationship between RDW and the GRACE Risk Score with in Hospital Death in Non-ST Elevation Myocardial Infarction and Unstable Angina Pectoris

Objective: Red cell distribution width (RDW), is an independent predictor of mortality in patient... more Objective: Red cell distribution width (RDW), is an independent predictor of mortality in patients with cardiovascular disease. This study evaluated the relationship between RDW and Calculation of the Global Registry of Acute Coronary Events (GRACE) risk score with in-hospital death in patients with unstable angina pectoris (UAP) and non-ST elevation myocardial infarction (NSTEMI). Methods: We prospectively enrolled 193 patients with UAP/NSTEMI (mean age 63.6AE12.6 years; 110 men, 83 women) in this study. Admission RDW was measured and the study population was classified on the basis of RDW tertiles. A high RDW was defined as a value in the upper third tertile and a low RDW was defined as in the lower two tertiles. GRACE risk score was calculated upon first arrival to the coronary care unit and classified low, medium and high risk tertiles. The patients were followed for clinical outcomes during the hospital stay. Results: Higher RDW values were associated with increased in-hospital mortality. Inhospital mortality rate was 9.5% in the high RDW group versus 0% in the low RDW group (p¼0.001). There was a significant correlation between RDW and GRACE risk score in terms of in-hospital death (p<0.001), in-hospital death or myocardial infarction (p<0.001), discharge to 6 month death (p<0.001) and discharge to 6 month death or myocardial infarction (p<0.001). In multivariate logistic regression analysis, the RDW (odds ratio: 1.513, 95% confidence interval: 1.116-2.051, p¼0.008), female gender and left ventricular ejection fraction were found to be independent predictors of high GRACE

Research paper thumbnail of The importance of hematologic indices in the risk stratification of patients with acute decompensated systolic heart failure

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2015

In patients with heart failure, a variety of hemogram parameters are known to be of prognostic si... more In patients with heart failure, a variety of hemogram parameters are known to be of prognostic significance. This study aimed to investigate which of these parameters is/are useful in predicting one-year all-cause mortality in patients with acute decompensated heart failure (ADHF). Patients who were hospitalized between September 2012-March 2013 in our hospital with systolic-ADHF with ejection fraction ≤40%, symptoms, and findings of congestion were enrolled retrospectively in the study. The study population was divided into two groups based on one-year-mortality. 119 patients with ADHF (mean-age 67±14 years; 55% male) were enrolled in the study. One-year-mortality occurred in 29% of patients. Hemoglobin levels, platelet, basophil and lymphocyte counts were significantly lower, while red-cell distribution width (RDW) was found to be significantly higher in the one-year-mortality group. Neutrophil, monocyte, and eosinophil counts were similar in the two groups. Furthermore, lower est...

Research paper thumbnail of An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER-2 study design

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2015

Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is r... more Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). First results are expected in June 2015. Data about major cardiovascul...

Research paper thumbnail of Relationship Between Hematologic Indices and Global Registry of Acute Coronary Events Risk Score in Patients With ST-Segment Elevation Myocardial Infarction

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 8, 2014

The aim of this study was to evaluate the relationship between hematologic indices and the Global... more The aim of this study was to evaluate the relationship between hematologic indices and the Global Registry of Acute Coronary Events (GRACE) score in patients with ST-segment elevation myocardial infarction (STEMI). A total of 800 patients who consecutively and retrospectively presented with STEMI within 12 hours of symptom onset. After accounting for exclusion criteria, a total of 379 patients remained in the study. We enrolled 379 patients with STEMI (mean age 61.7 ± 13.6 years; men 73%). Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW), and monocyte count were associated with increased worse GRACE risk score (P = .008, P = .012, P = .005, P = .022, respectively). In multivariate linear regression analysis, NLR, PLR, RDW, and monocyte count were found to be independent predictors of GRACE risk score. We demonstrate for the first time that PLR, RDW, and monocyte were associated with the GRACE score in patients with STEMI.

Research paper thumbnail of Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

Case Reports in Vascular Medicine, 2014

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamb... more Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient's symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

Research paper thumbnail of A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

Advances in Interventional Cardiology, 2014

Introduction: Previous studies have reported a relationship between serum bilirubin levels and co... more Introduction: Previous studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (TB) levels and pre-primary percutaneous coronary intervention (PCI) with patency of IRA flow in STEMI patients has not been investigated.

Research paper thumbnail of Evaluation of fluid status related parameters in hemodialysis and peritoneal dialysis patients: Clinical usefulness of bioimpedance analysis

Medicina, 2014

m e d i c i n a 5 0 ( 2 0 1 4 ) 2 6 9 -2 7 4 a b s t r a c t Background and objective: Fluid over... more m e d i c i n a 5 0 ( 2 0 1 4 ) 2 6 9 -2 7 4 a b s t r a c t Background and objective: Fluid overload is a common and serious problem that leads to severe complications in dialysis patients. We aimed to compare hydration status as measured with bioimpedance analysis (BIA) method in hemodialysis (HD) and peritoneal dialysis (PD) patients, as well as investigating the association between blood pressure, left ventricular mass index (LVMI) and hydration status.

Research paper thumbnail of Relation of epicardial fat thickness and brachial flow-mediated vasodilation with coronary artery disease

Journal of Cardiology, 2013

Objective: The purpose of this study is to investigate the presence of a statistical association ... more Objective: The purpose of this study is to investigate the presence of a statistical association between epicardial fat thickness (EFT) and coronary artery disease (CAD) and between flow-mediated vasodilation (FMD) and CAD. Methods: We measured the EFT and FMD in 64 subjects with suspected stable angina pectoris. The patients were separated into two groups according to their coronary angiography results: 34 patients with CAD and 30 patients with normal coronary arteries (NCA). Results: EFT was significantly higher in the patients with CAD than the NCA group (6.43 ± 0.90 mm vs. 5.35 ± 0.75 mm, p < 0.001) while FMD was significantly lower in the patients with CAD than those in the NCA group (6.41 ± 2.51% vs. 8.33 ± 3.45%, p = 0.015). No significant correlation was found between EFT and FMD. After adjustment for EFT, FMD, age, sex, ejection fraction, glucose, and low-density lipoprotein cholesterol through multivariate logistic regression analysis, EFT (odds ratio: 6.325, 95% confidence interval 2.289-17.476, p < 0.001) and age (odds ratio: 1.093, 95% confidence interval 1.008-1.185, p = 0.032) remained significant predictors of CAD. A cut-off value of EFT ≥ 5.8 mm predicted the presence of CAD with 77% sensitivity and 70% specificity. Conclusion: An echocardiographic EFT assessment is independently associated with the presence of CAD. Thus, EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.

Research paper thumbnail of New inflammatory predictors for non-valvular atrial fibrillation: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio

The International Journal of Cardiovascular Imaging, 2014

The objective of this study was to investigate the relationship of echocardiographic epicardial f... more The objective of this study was to investigate the relationship of echocardiographic epicardial fat thickness (EFT) and neutrophil to lymphocyte ratio (NLR) with different types of non-valvular atrial fibrillation (AF) in a clinical setting. A total of 197 consecutive patients were enrolled in the study. Seventy-one patients had paroxysmal non-valvular AF, 63 patients had persistent/permanent nonvalvular AF, and 63 patients had sinus rhythm (control group). EFT was measured with echocardiography, while NLR was measured by dividing neutrophil count by lymphocyte count. EFT was significantly higher in patients with paroxysmal non-valvular AF compared with those in the sinus rhythm group (6.6 ± 0.7 vs. 5.0 ± 0.9 mm, p \ 0.001). Persistent/permanent non-valvular AF patients had a significantly larger EFT compared with those with paroxysmal AF (8.3 ± 1.1 vs. 6.6 ± 0.7 mm, p \ 0.001). EFT had a significant relationship with paroxysmal nonvalvular AF (odds ratio 4.672, 95 % CI 2.329-9.371, p \ 0.001) and persistent/permanent non-valvular AF (OR 24.276,, p \ 0.001). NLR was significantly higher in those with paroxysmal non-valvular AF compared with those in the sinus rhythm group (2.5 ± 0.6 vs. 1.8 ± 0.4, p \ 0.001). Persistent/permanent non-valvular AF patients had a significantly larger NLR when compared with paroxysmal non-valvular AF patients (3.4 ± 0.6, vs. 2.5 ± 0.6, p \ 0.001). NLR ([2.1) had a significant relationship with non-valvular AF (OR 11.313, 95 % CI 3.025-42.306, b 2.426, p \ 0.001). EFT and NLR are highly associated with types of non-valvular AF independent of traditional risk factors. EFT measured by echocardiography and NLR appears to be related to the duration and severity of AF.

Research paper thumbnail of The Utility of the Platelet-Lymphocyte Ratio for Predicting No Reflow in Patients With ST-Segment Elevation Myocardial Infarction

Clinical and Applied Thrombosis/Hemostasis, 2014

The aim of the study was to evaluate the utility of the preprocedural platelet-lymphocyte ratio (... more The aim of the study was to evaluate the utility of the preprocedural platelet-lymphocyte ratio (PLR) for predicting no reflow in patients undergoing primary percutaneous intervention (PCI) for the treatment of ST-segment elevation myocardial infarction. The thrombolysis in myocardial infarction (TIMI) flow grades of 287 patients treated with primary PCI were assessed retrospectively. Patients were divided into 3 tertiles based upon preprocedural PLR. Pre-and postprocedural TIMI flow grades were evaluated. No reflow developed in 6, 14, and 43 patients in the lower, middle, and higher tertiles, respectively (P < .001). After multivariate analysis, PLR remained a significant predictor of no reflow together with neutrophil-lymphocyte ratio (NLR). A cutoff value of 160 for PLR and 5.9 for NLR predicted no reflow with sensitivities and specificities of 75% and 71% and 74% and 70%, respectively. In conclusion, high preprocedural PLR and NLR levels are significant and independent predictors of no reflow in patients undergoing primary PCI.

Research paper thumbnail of Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease

Clinical and Applied Thrombosis/Hemostasis, 2014

Objectives: Pulmonary hypertension (PH) is composed of a heterogeneous group of disorders marked ... more Objectives: Pulmonary hypertension (PH) is composed of a heterogeneous group of disorders marked by increased pulmonary artery resistance leading to right heart failure, with high mortality. Evidence is increasing to propose that inflammation plays a significant role in the pathophysiological mechanism. Increased prevalence of PH in patients with systemic inflammatory diseases is already known. Herein, we sought to evaluate the association between neutrophil to lymphocyte ratio (N/L ratio) and pulmonary arterial hypertension (PAH).

Research paper thumbnail of Association of Neutrophil-Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis

Clinical and Applied Thrombosis/Hemostasis, 2013

The aim of the study is to investigate the association between the severity of rheumatic mitral v... more The aim of the study is to investigate the association between the severity of rheumatic mitral valvular disease (RMVD) and the neutrophil-lymphocyte ratio (NLR). A total of 227 patients were enrolled in the study and divided into 3 groups. Patients in group 1 had rheumatic mitral stenosis (RMS), those in group 2 had RMVD without stenosis, and those in group 3 served as the control group. Group 1 was further divided into 2 groups, severe mitral stenosis (MS) and mild to moderate MS. The NLR was significantly higher in patients with severe MS when compared to those with mild to moderate MS (P ¼ .002) while lymphocyte count was lower (P ¼ .034). Using a cutoff level of 2.56, the NLR predicted severe RMS with a sensitivity of 75% and specificity of 74%. In conclusion, as an inexpensive, simple, and accessible marker of inflammation, the NLR may be useful in predicting the presence and severity of MS in patients with RMVD.

Research paper thumbnail of Platelet to lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2014

Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS).... more Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS). Recent studies have shown that the plateletto-lymphocyte ratio (PLR) is associated with several malignancies; however, there are not enough data in cardiovascular diseases. Therefore, the aim of this study was to explore the association between PLR and in-hospital mortality in patients with ACS. Methods: We retrospectively collected patients with ACS undergoing coronary angiography. Total and differential leukocyte counts were measured by an automated hematology analyzer. Results: This study is single-centered and observational. In total, 587 patients with a mean age of 61.8±13.1 years (68.4% male) were enrolled in the study. Patients were divided into 3 tertiles based on PLR levels. In-hospital mortality was significantly higher among patients in the upper PLR tertile when compared with the middle and lower PLR tertile groups [29 (14.8%) vs. 17 (8.7%) and 2 (1.0%); p<0.001]. In the multiple logistic regression analysis, a high level of PLR was an independent predictor of in-hospital mortality, together with age, total leukocyte count, and creatinine. Using a cutoff point of 142, the PLR predicted in-hospital mortality with a sensitivity of 69% and specificity of 63%. Conclusion: Different from other inflammatory markers and assays, PLR is an inexpensive and readily available biomarker that may be useful for cardiac risk stratification in patients with ACS. (Anadolu Kardiyol Derg 2015; 15(0): 000-000)

Research paper thumbnail of Relationship Between Red Cell Distribution Width and Stroke in Patients With Stable Chronic Heart Failure: A Propensity Score Matching Analysis

Clinical and Applied Thrombosis/Hemostasis, 2013

The aim of this study was to evaluate the relationship between red cell distribution width (RDW) ... more The aim of this study was to evaluate the relationship between red cell distribution width (RDW) and Global Registry of Acute Coronary Events (GRACE) risk score in patients with unstable angina pectoris (UAP) and non-ST elevation myocardial infarction (NSTEMI). We retrospectively enrolled 193 patients with UAP/NSTEMI (mean age 63.6 + 12.6 years; men 57%) in this study.