Hasan Kaya - Academia.edu (original) (raw)
Papers by Hasan Kaya
The American Journal of Cardiology, 2010
Increased red blood cell distribution width (RDW) has been associated with adverse outcomes in he... more Increased red blood cell distribution width (RDW) has been associated with adverse outcomes in heart failure and stable coronary disease. We studied the association between baseline RDW and changes in RDW during hospital course with clinical outcomes in patients with acute myocardial infarction (AMI). Baseline RDW and RDW change during hospital course were determined in 1,709 patients with AMI who were followed for a median of 27 months (range 6 to 48). The relation between RDW and clinical outcomes after hospital discharge were tested using Cox regression models, adjusting for clinical variables, baseline hemoglobin, mean corpuscular volume, and left ventricular ejection fraction. Compared to patients in the first RDW quintile, the adjusted hazard ratios for death progressively increased with higher quintiles of RDW (second quintile 1.1, 95% confidence interval [CI] 0.6 to 2.1; third quintile 1.8, 95% CI 1.0 to 3.2; fourth quintile 2.0, 95% CI 1.1 to 3.4; fifth quintile 2.8, 95% CI 1.6 to 4.7, p for trend <0.0001). An increase in RDW during hospital course was also associated with subsequent mortality (adjusted hazard ratio 1.13 for 1-SD increase in RDW, 95% CI 1.02 to 1.25). Similar results were obtained for the end point of heart failure. The association between increased RDW and worse outcome was evident in patients with and without anemia. In conclusion, there is a graded, independent association between increased RDW and mortality after AMI. An increase in RDW during hospitalization also portends adverse clinical outcome.
Advances in Interventional Cardiology, 2015
Introduction: The thrombolysis in myocardial infarction (TIMI) risk score is calculated as the su... more Introduction: The thrombolysis in myocardial infarction (TIMI) risk score is calculated as the sum of independent predictors of mortality and ischemic events in ST elevation acute myocardial infarction (STEMI). Several studies show that the neutrophil to lymphocyte ratio (NLR) is a prognostic inflammatory marker. In preliminary studies, platelet to lymphocyte ratio (PLR) has been proposed as a pro-thrombotic marker. The relationship between NLR, PLR and TIMI risk score for STEMI has never been studied. Aim: To evaluate the association between TIMI-STEMI risk score and NLR, PLR and other biochemical indices in STEMI. Material and methods: In this retrospective study, we evaluated 390 patients who presented with STEMI within 12 h of symptom onset. Patients were grouped according to low and high TIMI risk scores. Results: We enrolled 390 patients (mean age 61.9 ±13.6 years; 73% were men). The NLR, platelet distribution width (PDW) and uric acid level (UA) were significantly associated with a high TIMI-STEMI risk score (p = 0.016, p = 0.008, p = 0.030, respectively), but PLR was not associated with a high TIMI-STEMI risk score. Left ventricular ejection fraction was an independent predictor of TIMI-STEMI risk score. A cutoff point of TIMI-STEMI score of > 4 predicted in-hospital mortality (sensitivity 75%, specificity 70%, p < 0.001). We found that NLR, PDW, and UA level were associated with TIMI-STEMI risk score. Conclusions: Neutrophil to lymphocyte ratio, PDW and UA level are convenient, inexpensive and reproducible biomarkers for STEMI prognosis before primary angioplasty when these indicators are combined with the TIMI-STEMI risk score. We believe that these significant findings can guide further clinical practice.
Abant Medical Journal, 2015
The utility of the serum albumin levels on admission for predicting angiographic no reflow after ... more The utility of the serum albumin levels on admission for predicting angiographic no reflow after primary percutaneous coronary intervention in patients with STsegment elevation myocardial infarction ST-Segment yükselmesi miyokard infarktüsülü hastalarda primer perkütan koroner girişim sonrası anjiyografik akışsızlık fenomenini öngürmede başvuru serum albümin düzeylerinin yararı
Dicle Medical Journal, 2014
![Research paper thumbnail of [A second percutaneous closure due to residual mitral paravalvular leak and successful treatment of device embolization]](https://attachments.academia-assets.com/100854337/thumbnails/1.jpg)
](Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2013
Paravalvular leak (PVL) is a common complication after surgical valve replacement. Most PVLs rema... more Paravalvular leak (PVL) is a common complication after surgical valve replacement. Most PVLs remain clinically silent; however, some may require reoperation due to symptomatic PVL. Surgical closure of PVL remains the most common therapy for these defects; however, redo surgery has some disadvantages, including a high recurrence rate as well as high morbidity and mortality rates. Percutaneous closure of PVLs has emerged as an alternative to surgical closure. A 42-year-old male patient underwent a second percutaneous closure due to residual mitral paravalvular leak. During the procedure, the closure device embolized in the descending aorta. The device was captured with a snare and successfully retrieved, and then PVL was successfully occluded with another device.
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 [Regional distribution of all-cause mortality and coronary disease incidence in Turkey: findings of Turkish Adult Risk Factor survey 2010]](https://attachments.academia-assets.com/100854342/thumbnails/1.jpg)
](Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2011
We analyzed the distribution of cumulative all-cause and cardiovascular mortality and incident co... more We analyzed the distribution of cumulative all-cause and cardiovascular mortality and incident coronary heart disease (CHD) across the seven geographic regions of Turkey and presented overall and coronary mortality findings of the 2010 survey of the Turkish Adult Risk Factor Study. A total of 1406 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath offices. Information on survivors was obtained from history, physical examination, and 12-lead electrocardiography. Of the surveyed participants, 686 were examined; information on health status was obtained in 577 subjects, and 32 participants (14 women, 18 men; mean age 72.3±15.6 years) were ascertained to have died. The total duration of follow-up was 2,520 person-years. Nineteen deaths were of coronary (n=16) or cerebrovascular (n=3) origin. Cumulative 20-year assessment of the entire cohort for the age bracket of 45-74 years disclosed a high coron...
The Anatolian Journal of Cardiology, 2015
Objective: In this study, we aimed to explore the association between platelet-to-lymphocyte rati... more Objective: In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). Methods: Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. Results: The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p<0.001). Also, PLR was positively correlated with Gensini score in CAD patients. A cutoff value of 111 for PLR predicted severe atherosclerosis with 61% sensitivity and 59% specificity. Pre-procedural PLR level was found to be independently associated with Gensini score, together with WBC, age, and low HDL level, in the multivariate analysis. Conclusion: Our study suggests that high PLR appears to be additive to conventional risk factors and commonly used biomarkers in predicting severe atherosclerosis.
![Research paper thumbnail of [Age at death in the Turkish Adult Risk Factor Study: temporal trend and regional distribution at 56,700 person-years' follow-up]](https://attachments.academia-assets.com/100854343/thumbnails/1.jpg)
](Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2009
We analyzed the temporal trend and regional distribution of age at all-cause death and the sex-sp... more We analyzed the temporal trend and regional distribution of age at all-cause death and the sex-specific and age-bracket defined coronary mortality in the 18-year follow-up of the Turkish Adult Risk Factor Study. The participants of the Turkish Adult Risk Factor Study who have been examined in even years were last surveyed in August 2008. A total of 1,582 individuals were surveyed, which constituted half of the alive participants of the overall cohort. Information on death was obtained from first-degree relatives and/or health personnel of local heath offices. Survivors were evaluated by history, physical examination, and 12-lead electrocardiography. The cumulative follow-up was 56,700 person-years. Of 1,582 participants, 868 (431 men, 437 women) were examined, in 604 subjects information was gathered, and 47 participants (26 men, 21 women) were ascertained to have died. Twenty-two deaths were classified as of coronary origin. Cumulative assessment of the entire cohort in the age bra...
Kosuyolu Kalp Dergisi, 2013
İmplante edilen kardiyoverter defi brilatörler primer ve sekonder korumada ani ölümü önlemek amac... more İmplante edilen kardiyoverter defi brilatörler primer ve sekonder korumada ani ölümü önlemek amacıyla yaygın olarak kullanılmaktadır. Bu cihazlar gerektiği zaman doğru akım şoku uygulayarak ventriküler taşikardi ve ventriküler fi brilasyon ataklarını sonlandırmaktadır. Ancak bu yararlı etkilerine rağmen uygunsuz şok implante edilen kardiyoverter defi brilatörlerin önemli bir yan etkisi olarak kalmaya devam etmektedir. Uygunsuz implante edilen kardiyoverter defi brilatör şokları hastalarda ağrı ve psikolojik yan etkilere neden olarak yaşam kalitesini bozmakta, hatta yeni aritmi gelişimini indükleyebilmektedir. Bu yazıda tremorun neden olduğu uygunsuz implante edilen kardiyoverter defi brilatör şoku alan bir olgu sunulmaktadır.
The Anatolian Journal of Cardiology, 2015
Objective: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric a... more Objective: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. Methods: The study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. The χ 2 and independentsamples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. Results: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p<0.004, p<0.001, p<0.001, respectively). In the multivariate analysis, serum UA level and PLR were found to be independent predictors of pre-PCI IRA patency. In the ROC curve analysis, PLR >190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. The sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. Conclusion: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in riskstratifying STEMI.
Turkiye Klinikleri Journal of Medical Sciences, 2010
Journal of the American College of Cardiology, 2013
Methylphenidate is a drug with central nervous stimulating action and with similar effects as amp... more Methylphenidate is a drug with central nervous stimulating action and with similar effects as amphetamines. A 14-year-old child was diagnosed with attention-deficit hyperactivity disorder (ADHD) 3 months before admission. He was started on methylphenidate (ConcertaÒ) 18 mg daily for a month. Six days before admission, methylphenidate dose was increased to 36 mg by the pediatric psychiatrist. Patient was admitted to our hospital suffering from sweating, palpitation, dyspnea and chest pain. There was no murmur on auscultation. ECG demonstrated tachycardia and bigeminal ventricular premature complexes. His temperature was 37.6 C , white blood cell and hemoglobin were in normal range, creatinine kinase, creatine kinase MB fraction levels were elevated, troponin I was 6.29 IU(upper limit of normal: 0.1), cRP was 24.2 mg/l with a sedimentation of 14 mm/h. Screening for infectious pathogens, immunological markers were all negative. Thyroid function tests were normal. Echocardiography showed a left ventricular ejection fraction (EF) of 50% without segmental wall motion abnormality. Methylphenidate was discontinued following hospitalization. Coronary angiography showed normal coronary arteries. Eight days after hospitalization, creatinine kinase and troponin I levels decreased to normal levels. Recovery was achieved completely. On follow up, transthoracic echocardiography was repeated and EF was noted to be 60%. The investigation yielded tentative diagnosis of temporary drug-induced myocarditis. Previously, Tollofsrud et al presented a case describing treated with methyphenidate 17 year old boy, who died from dilated cardiomyopathy (Tollofsrud C et al 2006). An adolescent with a normal baseline echocardiogram, who was administered up to 36 mg of methylphenidate for 3 months, was also reported in the literatüre to suffer from cardiac arrest with pulseless electrical activity, associated with methylphenidate (Daly MW et al). Cardiac adverse effects of methylphenidate have been shown to affect myocardial ultra-structure in rats (Henderson TA et al). Increase in adrenergic action that is believed to be cardiotoxic over time, is considered to cause cardiomyopathy. Clinicians should be aware that despite performing an exhaustive cardiac examination before methylphenidate treatment for ADHD, patients may still be under threat for a serious cardiac event. The risks and benefits of using methylphenidate and the other central nervous stimulators must be acknowledged by clinicians and shared with patients and parents.
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 = .002) while lymphocyte count was lower ( P = .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.
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2012
Objective: The aim of this study is to investigate the relationship between serum thyroid hormone... more Objective: The aim of this study is to investigate the relationship between serum thyroid hormone levels that are within the normal range and the presence and severity of coronary artery disease (CAD) in patients referred for coronary angiography. Methods: In this observational study, we enrolled 119 consecutive patients (77 men, mean age 60.7±13.8 years) who underwent coronary angiography. Blood samples were tested for thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) concentrations. Additionally, risk factors, clinical characteristics and angiographic results were obtained. The patients were separated into two groups according to the Gensini score as those with mild or severe atherosclerosis. Statistical analysis was performed using the Chi-square, Mann-Whitney U, correlation and logistic regression tests, and ROC analysis. Results: FT3 levels were significantly lower in subjects with CAD (4.0±0.7 vs. 4.6±0.6 pmol/L; p<0.001). Moreover, lower FT3 levels were found in patients with severe atherosclerosis (3.9±0.7 vs. 4.5±0.6 pmol/L; p<0.001). Logistic regression analysis demonstrated that the lower FT3 levels were associated with the presence (OR =0.266, 95% CI: 0.097-0.731, p=0.01) and severity (OR=0.238, 95% CI:0.083-0.685, p=0.008) of CAD. In the ROC analysis, a level of FT3 ≤4.2 pmol/L was found to predict the presence of CAD with 69% sensitivity and 71% specificity (AUC:0.744, 95% CI:0.653-0.834, p<0.001); and the severity of CAD with 75% sensitivity and 67% specificity (AUC:0.733, 95% CI:0.642-0.824, p<0.001). Conclusions: FT3 levels within the normal range were inversely correlated with the presence and severity of CAD. Moreover, lower FT3 concentrations were correlated with the Gensini score and independently predicted the presence and severity of CAD. Thus, the FT3 levels may be used as the indicator of increased risk for CAD.
Korean circulation journal, 2015
The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cas... more The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cases, CAE is associated with atherosclerosis; however, isolated CAE has a nonatherosclerotic mechanism. The association between atherosclerotic coronary artery disease and apelin has been examined in previous studies. However, the role of plasma apelin in isolated coronary artery ectasia has not been studied. In this study, we investigated the relationship between plasma apelin levels and isolated coronary artery ectasia. The study population included a total of 54 patients. Twenty-six patients had isolated CAE (53.6±8.1 years); 28 patients with normal coronary arteries (51.6±8.8 years) and with similar risk factors and demographic characteristics served as the control group. Apelin levels were measured using an enzyme-linked immunoassay kit. Apelin level in the CAE group was significantly lower (apelin=0.181±0.159 ng/mL) than that in the control group (apelin=0.646±0.578 ng/mL) (p=0.033)....
Turkiye Klinikleri Journal of Medical Sciences, 2015
Journal of Applied Ichthyology, 2014
ABSTRACT The aim of this study was to determine the effects of Tribulus terrestris extract (TT) o... more ABSTRACT The aim of this study was to determine the effects of Tribulus terrestris extract (TT) on growth performance, disease resistance and histopathological changes in intestine and liver tissues of Oreochromis mossambicus (Peters, 1852) first-feeding fry before and after exposure to Streptococcus iniae. Five isonitrogenous and isocaloric diets were formulated to contain 0 (control), 200, 400, 600, and 800 mg kg−1 TT. After feeding for 45 days, fish were infected with S. iniae and mortalities recorded. Final weight, weight gain and SGR of tilapia fry fed the 400 mg kg−1 TT diet were significantly greater than that of control diet. In the challenge experiment, the best survival rate was obtained with 400 mg kg−1 TT supplementation. Infection by S. iniae appeared to have a negative effect on histopathological findings and outcome than did TT-800 used alone. However, administration of TT (200 or 400 mg extract kg−1) resulted in overall improvement in the intestine and liver histopathology, emphasizing the protective potential of TT. The present study suggests the protective potential of TT in alleviating intestinal and hepatic damage that can occur after a S. iniae infection. It was concluded that 400 mg kg−1 TT can enhance growth and disease resistance during first–feeding of O. mossambicus fry. This suggests that TT may be an alternative to antibiotics in controlling streptococcal disease in tilapia culture.
Divan Edebiyatı Araştırmaları Dergisi, 2010
The American Journal of Cardiology, 2010
Increased red blood cell distribution width (RDW) has been associated with adverse outcomes in he... more Increased red blood cell distribution width (RDW) has been associated with adverse outcomes in heart failure and stable coronary disease. We studied the association between baseline RDW and changes in RDW during hospital course with clinical outcomes in patients with acute myocardial infarction (AMI). Baseline RDW and RDW change during hospital course were determined in 1,709 patients with AMI who were followed for a median of 27 months (range 6 to 48). The relation between RDW and clinical outcomes after hospital discharge were tested using Cox regression models, adjusting for clinical variables, baseline hemoglobin, mean corpuscular volume, and left ventricular ejection fraction. Compared to patients in the first RDW quintile, the adjusted hazard ratios for death progressively increased with higher quintiles of RDW (second quintile 1.1, 95% confidence interval [CI] 0.6 to 2.1; third quintile 1.8, 95% CI 1.0 to 3.2; fourth quintile 2.0, 95% CI 1.1 to 3.4; fifth quintile 2.8, 95% CI 1.6 to 4.7, p for trend &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). An increase in RDW during hospital course was also associated with subsequent mortality (adjusted hazard ratio 1.13 for 1-SD increase in RDW, 95% CI 1.02 to 1.25). Similar results were obtained for the end point of heart failure. The association between increased RDW and worse outcome was evident in patients with and without anemia. In conclusion, there is a graded, independent association between increased RDW and mortality after AMI. An increase in RDW during hospitalization also portends adverse clinical outcome.
Advances in Interventional Cardiology, 2015
Introduction: The thrombolysis in myocardial infarction (TIMI) risk score is calculated as the su... more Introduction: The thrombolysis in myocardial infarction (TIMI) risk score is calculated as the sum of independent predictors of mortality and ischemic events in ST elevation acute myocardial infarction (STEMI). Several studies show that the neutrophil to lymphocyte ratio (NLR) is a prognostic inflammatory marker. In preliminary studies, platelet to lymphocyte ratio (PLR) has been proposed as a pro-thrombotic marker. The relationship between NLR, PLR and TIMI risk score for STEMI has never been studied. Aim: To evaluate the association between TIMI-STEMI risk score and NLR, PLR and other biochemical indices in STEMI. Material and methods: In this retrospective study, we evaluated 390 patients who presented with STEMI within 12 h of symptom onset. Patients were grouped according to low and high TIMI risk scores. Results: We enrolled 390 patients (mean age 61.9 ±13.6 years; 73% were men). The NLR, platelet distribution width (PDW) and uric acid level (UA) were significantly associated with a high TIMI-STEMI risk score (p = 0.016, p = 0.008, p = 0.030, respectively), but PLR was not associated with a high TIMI-STEMI risk score. Left ventricular ejection fraction was an independent predictor of TIMI-STEMI risk score. A cutoff point of TIMI-STEMI score of > 4 predicted in-hospital mortality (sensitivity 75%, specificity 70%, p < 0.001). We found that NLR, PDW, and UA level were associated with TIMI-STEMI risk score. Conclusions: Neutrophil to lymphocyte ratio, PDW and UA level are convenient, inexpensive and reproducible biomarkers for STEMI prognosis before primary angioplasty when these indicators are combined with the TIMI-STEMI risk score. We believe that these significant findings can guide further clinical practice.
Abant Medical Journal, 2015
The utility of the serum albumin levels on admission for predicting angiographic no reflow after ... more The utility of the serum albumin levels on admission for predicting angiographic no reflow after primary percutaneous coronary intervention in patients with STsegment elevation myocardial infarction ST-Segment yükselmesi miyokard infarktüsülü hastalarda primer perkütan koroner girişim sonrası anjiyografik akışsızlık fenomenini öngürmede başvuru serum albümin düzeylerinin yararı
Dicle Medical Journal, 2014
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2013
Paravalvular leak (PVL) is a common complication after surgical valve replacement. Most PVLs rema... more Paravalvular leak (PVL) is a common complication after surgical valve replacement. Most PVLs remain clinically silent; however, some may require reoperation due to symptomatic PVL. Surgical closure of PVL remains the most common therapy for these defects; however, redo surgery has some disadvantages, including a high recurrence rate as well as high morbidity and mortality rates. Percutaneous closure of PVLs has emerged as an alternative to surgical closure. A 42-year-old male patient underwent a second percutaneous closure due to residual mitral paravalvular leak. During the procedure, the closure device embolized in the descending aorta. The device was captured with a snare and successfully retrieved, and then PVL was successfully occluded with another device.
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...
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2011
We analyzed the distribution of cumulative all-cause and cardiovascular mortality and incident co... more We analyzed the distribution of cumulative all-cause and cardiovascular mortality and incident coronary heart disease (CHD) across the seven geographic regions of Turkey and presented overall and coronary mortality findings of the 2010 survey of the Turkish Adult Risk Factor Study. A total of 1406 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath offices. Information on survivors was obtained from history, physical examination, and 12-lead electrocardiography. Of the surveyed participants, 686 were examined; information on health status was obtained in 577 subjects, and 32 participants (14 women, 18 men; mean age 72.3±15.6 years) were ascertained to have died. The total duration of follow-up was 2,520 person-years. Nineteen deaths were of coronary (n=16) or cerebrovascular (n=3) origin. Cumulative 20-year assessment of the entire cohort for the age bracket of 45-74 years disclosed a high coron...
The Anatolian Journal of Cardiology, 2015
Objective: In this study, we aimed to explore the association between platelet-to-lymphocyte rati... more Objective: In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). Methods: Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. Results: The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p<0.001). Also, PLR was positively correlated with Gensini score in CAD patients. A cutoff value of 111 for PLR predicted severe atherosclerosis with 61% sensitivity and 59% specificity. Pre-procedural PLR level was found to be independently associated with Gensini score, together with WBC, age, and low HDL level, in the multivariate analysis. Conclusion: Our study suggests that high PLR appears to be additive to conventional risk factors and commonly used biomarkers in predicting severe atherosclerosis.
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2009
We analyzed the temporal trend and regional distribution of age at all-cause death and the sex-sp... more We analyzed the temporal trend and regional distribution of age at all-cause death and the sex-specific and age-bracket defined coronary mortality in the 18-year follow-up of the Turkish Adult Risk Factor Study. The participants of the Turkish Adult Risk Factor Study who have been examined in even years were last surveyed in August 2008. A total of 1,582 individuals were surveyed, which constituted half of the alive participants of the overall cohort. Information on death was obtained from first-degree relatives and/or health personnel of local heath offices. Survivors were evaluated by history, physical examination, and 12-lead electrocardiography. The cumulative follow-up was 56,700 person-years. Of 1,582 participants, 868 (431 men, 437 women) were examined, in 604 subjects information was gathered, and 47 participants (26 men, 21 women) were ascertained to have died. Twenty-two deaths were classified as of coronary origin. Cumulative assessment of the entire cohort in the age bra...
Kosuyolu Kalp Dergisi, 2013
İmplante edilen kardiyoverter defi brilatörler primer ve sekonder korumada ani ölümü önlemek amac... more İmplante edilen kardiyoverter defi brilatörler primer ve sekonder korumada ani ölümü önlemek amacıyla yaygın olarak kullanılmaktadır. Bu cihazlar gerektiği zaman doğru akım şoku uygulayarak ventriküler taşikardi ve ventriküler fi brilasyon ataklarını sonlandırmaktadır. Ancak bu yararlı etkilerine rağmen uygunsuz şok implante edilen kardiyoverter defi brilatörlerin önemli bir yan etkisi olarak kalmaya devam etmektedir. Uygunsuz implante edilen kardiyoverter defi brilatör şokları hastalarda ağrı ve psikolojik yan etkilere neden olarak yaşam kalitesini bozmakta, hatta yeni aritmi gelişimini indükleyebilmektedir. Bu yazıda tremorun neden olduğu uygunsuz implante edilen kardiyoverter defi brilatör şoku alan bir olgu sunulmaktadır.
The Anatolian Journal of Cardiology, 2015
Objective: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric a... more Objective: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. Methods: The study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. The χ 2 and independentsamples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. Results: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p<0.004, p<0.001, p<0.001, respectively). In the multivariate analysis, serum UA level and PLR were found to be independent predictors of pre-PCI IRA patency. In the ROC curve analysis, PLR >190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. The sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. Conclusion: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in riskstratifying STEMI.
Turkiye Klinikleri Journal of Medical Sciences, 2010
Journal of the American College of Cardiology, 2013
Methylphenidate is a drug with central nervous stimulating action and with similar effects as amp... more Methylphenidate is a drug with central nervous stimulating action and with similar effects as amphetamines. A 14-year-old child was diagnosed with attention-deficit hyperactivity disorder (ADHD) 3 months before admission. He was started on methylphenidate (ConcertaÒ) 18 mg daily for a month. Six days before admission, methylphenidate dose was increased to 36 mg by the pediatric psychiatrist. Patient was admitted to our hospital suffering from sweating, palpitation, dyspnea and chest pain. There was no murmur on auscultation. ECG demonstrated tachycardia and bigeminal ventricular premature complexes. His temperature was 37.6 C , white blood cell and hemoglobin were in normal range, creatinine kinase, creatine kinase MB fraction levels were elevated, troponin I was 6.29 IU(upper limit of normal: 0.1), cRP was 24.2 mg/l with a sedimentation of 14 mm/h. Screening for infectious pathogens, immunological markers were all negative. Thyroid function tests were normal. Echocardiography showed a left ventricular ejection fraction (EF) of 50% without segmental wall motion abnormality. Methylphenidate was discontinued following hospitalization. Coronary angiography showed normal coronary arteries. Eight days after hospitalization, creatinine kinase and troponin I levels decreased to normal levels. Recovery was achieved completely. On follow up, transthoracic echocardiography was repeated and EF was noted to be 60%. The investigation yielded tentative diagnosis of temporary drug-induced myocarditis. Previously, Tollofsrud et al presented a case describing treated with methyphenidate 17 year old boy, who died from dilated cardiomyopathy (Tollofsrud C et al 2006). An adolescent with a normal baseline echocardiogram, who was administered up to 36 mg of methylphenidate for 3 months, was also reported in the literatüre to suffer from cardiac arrest with pulseless electrical activity, associated with methylphenidate (Daly MW et al). Cardiac adverse effects of methylphenidate have been shown to affect myocardial ultra-structure in rats (Henderson TA et al). Increase in adrenergic action that is believed to be cardiotoxic over time, is considered to cause cardiomyopathy. Clinicians should be aware that despite performing an exhaustive cardiac examination before methylphenidate treatment for ADHD, patients may still be under threat for a serious cardiac event. The risks and benefits of using methylphenidate and the other central nervous stimulators must be acknowledged by clinicians and shared with patients and parents.
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 = .002) while lymphocyte count was lower ( P = .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.
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2012
Objective: The aim of this study is to investigate the relationship between serum thyroid hormone... more Objective: The aim of this study is to investigate the relationship between serum thyroid hormone levels that are within the normal range and the presence and severity of coronary artery disease (CAD) in patients referred for coronary angiography. Methods: In this observational study, we enrolled 119 consecutive patients (77 men, mean age 60.7±13.8 years) who underwent coronary angiography. Blood samples were tested for thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) concentrations. Additionally, risk factors, clinical characteristics and angiographic results were obtained. The patients were separated into two groups according to the Gensini score as those with mild or severe atherosclerosis. Statistical analysis was performed using the Chi-square, Mann-Whitney U, correlation and logistic regression tests, and ROC analysis. Results: FT3 levels were significantly lower in subjects with CAD (4.0±0.7 vs. 4.6±0.6 pmol/L; p<0.001). Moreover, lower FT3 levels were found in patients with severe atherosclerosis (3.9±0.7 vs. 4.5±0.6 pmol/L; p<0.001). Logistic regression analysis demonstrated that the lower FT3 levels were associated with the presence (OR =0.266, 95% CI: 0.097-0.731, p=0.01) and severity (OR=0.238, 95% CI:0.083-0.685, p=0.008) of CAD. In the ROC analysis, a level of FT3 ≤4.2 pmol/L was found to predict the presence of CAD with 69% sensitivity and 71% specificity (AUC:0.744, 95% CI:0.653-0.834, p<0.001); and the severity of CAD with 75% sensitivity and 67% specificity (AUC:0.733, 95% CI:0.642-0.824, p<0.001). Conclusions: FT3 levels within the normal range were inversely correlated with the presence and severity of CAD. Moreover, lower FT3 concentrations were correlated with the Gensini score and independently predicted the presence and severity of CAD. Thus, the FT3 levels may be used as the indicator of increased risk for CAD.
Korean circulation journal, 2015
The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cas... more The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cases, CAE is associated with atherosclerosis; however, isolated CAE has a nonatherosclerotic mechanism. The association between atherosclerotic coronary artery disease and apelin has been examined in previous studies. However, the role of plasma apelin in isolated coronary artery ectasia has not been studied. In this study, we investigated the relationship between plasma apelin levels and isolated coronary artery ectasia. The study population included a total of 54 patients. Twenty-six patients had isolated CAE (53.6±8.1 years); 28 patients with normal coronary arteries (51.6±8.8 years) and with similar risk factors and demographic characteristics served as the control group. Apelin levels were measured using an enzyme-linked immunoassay kit. Apelin level in the CAE group was significantly lower (apelin=0.181±0.159 ng/mL) than that in the control group (apelin=0.646±0.578 ng/mL) (p=0.033)....
Turkiye Klinikleri Journal of Medical Sciences, 2015
Journal of Applied Ichthyology, 2014
ABSTRACT The aim of this study was to determine the effects of Tribulus terrestris extract (TT) o... more ABSTRACT The aim of this study was to determine the effects of Tribulus terrestris extract (TT) on growth performance, disease resistance and histopathological changes in intestine and liver tissues of Oreochromis mossambicus (Peters, 1852) first-feeding fry before and after exposure to Streptococcus iniae. Five isonitrogenous and isocaloric diets were formulated to contain 0 (control), 200, 400, 600, and 800 mg kg−1 TT. After feeding for 45 days, fish were infected with S. iniae and mortalities recorded. Final weight, weight gain and SGR of tilapia fry fed the 400 mg kg−1 TT diet were significantly greater than that of control diet. In the challenge experiment, the best survival rate was obtained with 400 mg kg−1 TT supplementation. Infection by S. iniae appeared to have a negative effect on histopathological findings and outcome than did TT-800 used alone. However, administration of TT (200 or 400 mg extract kg−1) resulted in overall improvement in the intestine and liver histopathology, emphasizing the protective potential of TT. The present study suggests the protective potential of TT in alleviating intestinal and hepatic damage that can occur after a S. iniae infection. It was concluded that 400 mg kg−1 TT can enhance growth and disease resistance during first–feeding of O. mossambicus fry. This suggests that TT may be an alternative to antibiotics in controlling streptococcal disease in tilapia culture.
Divan Edebiyatı Araştırmaları Dergisi, 2010