Ilhan Avcı - Academia.edu (original) (raw)

Papers by Ilhan Avcı

Research paper thumbnail of Contribution of platelets indices in the development of contrast-induced nephropathy

Blood Coagulation & Fibrinolysis, 2014

Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a ... more Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor clinical outcome. The underlying mechanism of the CIN development remains unclear and seems to be multifactorial. The potential link between platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) with CIN is unknown. Herein, we aimed to investigate the correlation between MPV and PDW levels with the development of CIN. The incidence of CIN (20.5%) was prospectively evaluated in 430 patients with diagnosis of acute coronary syndrome. Initial creatinine (1.13 ± 0.25 vs. 1.05 ± 0.27 mg/dl, P = 0.01) and PDW (40.1 ± 20.2 vs. 34.5 ± 19.9%, P = 0.02) levels and the total volume of contrast media used (121 ± 61 vs. 94 ± 42 ml, P = 0.01) were higher in patients who developed CIN. MPV was similar between the two groups (P = 0.80). In a univariate regression analysis, age, increased creatinine, uric acid, phosphate, PDW levels and higher total volume of contrast media used were significantly correlated with CIN incidence. However, in a multivariate analysis, only total volume of CM used [odds ratio (OR) 1.011, 95% confidence interval (CI) 1.006-1.016; P = 0.01], increased age (OR 1.026, 95% CI 1.00-1.052; P = 0.05) and increased PDW levels (OR 1.009, 95% CI 1.00-1.022; P = 0.04) remained as the independent predictors of CIN. Among platelet indices, PDW, but not MPV, was associated with CIN development. The clinical significance of such link remains unclear, but may indicate involvement of platelet activation in CIN pathogenesis.

Research paper thumbnail of Usefulness of Serum Omentin-1 Levels for the Prediction of Adverse Cardiac Events in Patients with Hypertrophic Cardiomyopathy

Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2018

To investigate the association between serum omentin-1 levels and adverse cardiac events in patie... more To investigate the association between serum omentin-1 levels and adverse cardiac events in patients with hypertrophic cardiomyopathy (HCM). This prospective, observational study included 87 patients with HCM and 50 age- and sex-matched control subjects. Serum omentin-1 and brain natriuretic peptide (BNP) levels were measured in all subjects, using enzyme-linked immunosorbent assay and electrochemiluminescence, respectively. Patients with HCM were divided into 2 groups according to their omentin levels, i.e., low: ≤291 ng/mL (n = 48) and high: > 291 ng/mL (n = 39). Cardiac mortality, hospitalization due to heart failure, and implantable cardioverter-defibrillator (ICD) implantation were considered adverse cardiac events. Statistical analysis included uni- and multivariant logistic regression, receiver-operating characteristic (ROC) analysis, and the Kaplan-Meier method. Serum omentin-1 levels were significantly lower in the obstructive (253.9 ± 41.3 ng/mL) and nonobstructive (301...

Research paper thumbnail of An unexpected complication of acute pancreatitis: Intra-cardiac thrombus

The American Journal of Emergency Medicine, 2016

Left atrial thrombus after acute pancreatitis (AP) is a rare clinical statement. Because of induc... more Left atrial thrombus after acute pancreatitis (AP) is a rare clinical statement. Because of induction of systemic prothrombotic process by AP; some patients with underlying risk factors may develop an intra-cardiac thrombus. We present a 53years-old-woman with moderate mitral stenosis and atrial fibrillation. However the patient was under warfarin treatment, she developed a big left atrial big thrombus which was originated from left atrial appendage after she was suffered from AP.

Research paper thumbnail of Higher copeptin levels are associated with worse outcome in patients with hypertrophic cardiomyopathy

Clinical Cardiology, 2016

Correlation of increased copeptin levels with various cardiovascular diseases has been described.... more Correlation of increased copeptin levels with various cardiovascular diseases has been described. The clinical use of copeptin levels in patients with hypertrophic cardiomyopathy (HCM) has not been investigated before. In this study, we aimed to investigate the prognostic value of copeptin levels in patients with hypertrophic cardiomyopathy (HCM). HCM was defined as presence of left ventricular wall thickness ≥15 mm in a subject without any concomitant disease that may cause left ventricular hypertrophy. Levels of copeptin and plasma N-terminal probrain natriuretic peptide (NT-proBNP) were evaluated prospectively in 24 obstructive HCM patients, 36 nonobstructive HCM patients, and 36 age- and sex-matched control subjects. Blood samples were collected in the morning between 7 and 9 am after overnight fasting. Patients were followed for 24 months. Hospitalization with diagnosis of heart failure/arrhythmia, implantable cardioverter-defibrillator implantation, and cardiac mortality were accepted as adverse cardiac events. Copeptin and NT-proBNP levels were higher in the HCM group compared with controls (14.1 vs 8.4 pmol/L, P < 0.01; and 383 vs 44 pg/mL, P < 0.01, respectively). Copeptin and NT-proBNP levels were higher in the obstructive HCM subgroup compared with the nonobstructive HCM subgroup (18.3 vs 13.1 pmol/L, P < 0.01; and 717 vs 223 pg/mL, P < 0.01, respectively). In multivariable logistic regression analysis, copeptin and NT-proBNP levels remained as independent predictors of heart failure (P < 0.01 for both) and adverse cardiac events (P < 0.01 for both). Copeptin and NT-proBNP levels were significantly higher in patients with obstructive HCM, and higher levels were associated with worse outcome.

Research paper thumbnail of Artmış eritrosit dağılım genişliği kararlı koroner arter hastalarında yetersiz koroner kollateral dolaşımı ile ilişkilidir

Artmıs Eritrosit Dagılım Genisligi Kararlı Koroner Arter Hastalarında Yetersiz Koroner Kollateral Dolasımı Ile Iliskilidir, 2015

Research paper thumbnail of Bölgesel debi süreklilik eğrilerinin elde edilmesi

Itudergisi D, Apr 14, 2010

... Bölgesel debi süreklilik eğrilerinin elde edilmesi Bahattin YANIK*, İlhan AVCI İTÜ ... fonksi... more ... Bölgesel debi süreklilik eğrilerinin elde edilmesi Bahattin YANIK*, İlhan AVCI İTÜ ... fonksiyonudur. Bu tür santrallerin enerji ihtiyacının fazla olduğu za-manlarda talebi karşılamak üzere enerji üretimi-ni artırma yeteneği bulunmamaktadır. ...

Research paper thumbnail of Higher CHA2DS2-VASc Score Is Associated With Increased Mortality in Acute Pulmonary Embolism

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 11, 2016

CHA2DS2-VASc score has been validated in risk prediction for stroke and thromboembolism in patien... more CHA2DS2-VASc score has been validated in risk prediction for stroke and thromboembolism in patients with atrial fibrillation (AF). Association of CHA2DS2-VASc score with higher risk of venous thromboembolism and pulmonary embolism (PE) has also been shown. In this study, we investigated the long-term prognostic value of CHA2DS2-VASc score in patients with acute pulmonary embolism (APE). Consecutive patients with APE presenting to our emergency department were retrospectively recruited. Patients with AF and who died secondary to causes other than PE were excluded from the study. The CHA2DS2-VASc score and pulmonary embolism severity index (PESI) were calculated. Two hundred seventy seven participants were included in the study. The mortality rate was 18.7%. Twenty-two cases died within 30 days, and 30 cases died during the follow-up period (median: 13 months). The mean CHA2DS2-VASc score was significantly higher in dead patients compared to survivors (3.61 ± 1.35 vs 1.95 ± 1.52, P &l...

Research paper thumbnail of Increased level of red cell distribution width is associated with poor coronary collateral circulation in patients with stable coronary artery disease

Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2015

Previous studies have shown the association between various hematological parameters and cardiova... more Previous studies have shown the association between various hematological parameters and cardiovascular diseases, and their prognostic value. In this study, we compared red cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and mean platelet volume (MPV) measurements among patients with poor coronary collateral circulation (CCC) and well-developed CCC. 326 patients with stable coronary artery disease (CAD) were evaluated retrospectively. CCC was graded by using the Rentrop classification. The poor CCC group included patients with Rentrop 0-1 CCC, and the good CCC group included Rentrop 2-3 CCC. There were 171 subjects (84% male; mean age 56.6±10.4 years) in the poor CCC group, and 155 subjects (89% male; mean age 57.6±9.7 years) in the good CCC group. The total number of vessels with >95% stenosis (1.1±0.5 vs. 1.0±0.4; p=0.64) and Gensini scores (84.4±38.8 vs. 83.3±37.4; p=0.83) was not higher in the poor CCC group compared to the good CCC group. RDW was significant...

Research paper thumbnail of Impact of coronary collateral circulation and severity of coronary artery disease in the development of postoperative atrial fibrillation

Interactive cardiovascular and thoracic surgery, 2014

Atrial fibrillation (AF) after cardiac surgery has been reported to be approximately 30%, making ... more Atrial fibrillation (AF) after cardiac surgery has been reported to be approximately 30%, making it one of the most important causes of morbidity and mortality post surgery. Although various clinical and laboratory predictors and underlying mechanisms progressing to postoperative AF have been proposed, the role of ischaemia in pathogenesis is doubtful. In this study, the association of coronary collateral circulation (CCC) and severity of coronary artery disease (CAD) with the development of postoperative AF was investigated. A total of 597 patients who underwent on-pump coronary artery bypass surgery were included in the study. Pre-, peri- and postoperative variables were recorded in a computerized database. CCC and severity of CAD were documented for each patient according to Rentrop classification and Gensini score. Postoperative AF was observed in 96 patients (16.1%). Advanced age, female gender, presence of hypertension and low haematocrit level were significantly associated wi...

Research paper thumbnail of PP-095 Low Vitamin D Status is Associated with Resistant Hypertension

The American Journal of Cardiology, 2015

Research paper thumbnail of Wpływ aktywności fosfatazy zasadowej w surowicy na wieńcowe krążenie oboczne

Kardiologia Polska, 2014

Background: Serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor for m... more Background: Serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor for myocardial infarction and stroke via its promotion of vascular calcification. Aim: To investigate for the first time the correlation between serum ALP level and coronary collateral circulation (CCC) development. Methods: A total of 356 patients with stable angina pectoris were evaluated retrospectively. Patients were classified according to ALP level and CCC grade. Rentrop 0-1 flow was defined as impaired CCC. Serum ALP > 129 mg/dL in men and > 104 mg/dL in women was defined as elevated ALP. All groups were compared statistically according to clinical, laboratory and demographic features. Results: Impaired CCC was observed in 53.7% of the patients. The mean ALP level was 102.8 ± 57.9 mg/dL, and elevated ALP levels were obtained in 19.4% of cases. There was a significant correlation between ALP and CCC grade, and impaired CCC was associated with relatively higher ALP values (65.2% vs. 50.9%, p = 0.03). Multivariate regression analysis also showed a significant correlation between elevated ALP level and impaired CCC (OR 1.85, with a 95% CI 1.056-3.264; p = 0.03). Conclusions: Serum ALP is a widely avaliable unfavourable prognostic parameter in coronary heart disease. Elevated ALP levels were associated with inadequate CCC, which supports the previously reported literature concerning the negative prognostic value of ALP levels in cardiovascular settings.

Research paper thumbnail of Wpływ stężenia fosfatazy zasadowej w surowicy na patofizjologiczny mechanizm nefropatii kontrastowej

Kardiologia Polska, 2014

Contrast-induced nephropathy (CIN) accounts for 10% of all causes of hospital-acquired renal fail... more Contrast-induced nephropathy (CIN) accounts for 10% of all causes of hospital-acquired renal failure. It leadsto a prolonged in-hospital stay, and represents a powerful predictor of poor early and late outcomes. More than half of casesare observed after cardiovascular procedures. To determine the predictive value of the serum alkaline phosphatase (ALP) level in the development of CIN, something which has not been assessed before. We prospectively evaluated a total of 430 patients with acute coronary syndrome. Patients were classified according to the development of CIN and both groups were compared statistically according to clinical, laboratory and demographic features, including the serum ALP level. CIN was observed in 20.5% of patients. Advanced age, male gender, elevated creatinine, uric acid and phosphate levels, and low glomerular filtration rate were correlated with the development of CIN. Correlation analysis also showed a significant association between the ALP level and the development of CIN (126.1 ± 144.9 vs. 97.2 ± 46.9, p = 0.004). Univariate regression analysis also showed the impact of ALP on the development of CIN (OR 1.004, 95% CI 1.001–1.007, p = 0.02). Conclusions: Our outcomes indicate a possible active role of ALP in the mechanism of CIN. An elevated ALP level may predict the development of CIN.

Research paper thumbnail of Lower vitamin D level is associated with poor coronary collateral circulation

Scandinavian Cardiovascular Journal, 2014

Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-... more Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-sectional associations between lower vitamin D levels and cardiovascular diseases have been reported, but the relationship between vitamin D levels and collateral arteries in stable coronary artery disease (CAD) has not been reported before. Two hundred and fourteen patients with above 95% stenosis in at least one epicardial coronary artery were consecutively recruited after coronary angiography (CAG) during the winter season. The coronary collateral circulation (CCC) was graded using Rentrop classification. Poor CCC group included patients with Rentrop Grade 0-1 CCC and control group included patients with Rentrop Grade 2-3 CCC. Vitamin D and PTH levels were measured on the day of CAG. In the poor CCC group, vitamin D levels were lower (34 ± 25 pmol/L vs. 49 ± 33 pmol/L; p = 0.01) and the prevalence of vitamin D deficiency (< 37 pmol/L) was higher (67% vs. 43%; p = 0.01) compared to the controls. PTH levels, calcium, and phosphate levels were not significantly different between the groups. Female gender, lower HDL cholesterol, and lower vitamin D levels were independently correlated with poor CCC in the study population. Lower vitamin D levels may be associated with poor collateral development in patients with stable CAD.

Research paper thumbnail of Lower Blood Vitamin D Levels Are Associated With an Increased Incidence of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Canadian Journal of Cardiology, 2014

Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assesse... more Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assessed the correlation between vitamin D levels and contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG). Vitamin D and parathyroid hormone (PTH) levels were assessed before CAG in 403 patients. Estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault equation. Patients with eGFR < 60 mL/min/1.73 m(2) were hydrated with 0.9%-saline at 1 mL/kg/h for 12 hours before and after CAG. CIN was defined as serum creatinine increase of > 0.5 mg/dL or > 25% within 48-72 hours after CAG. CIN developed in 74 participants. Baseline eGFR, blood urea and creatinine in CIN (+) and (-) groups were not significantly different (P = 0.14, P = 0.07, and P = 0.61, respectively). Total volume of contrast medium (CM) was higher in the CIN (+) group (132 ± 64 mL vs 90 ± 41 mL; P = 0.01). Vitamin D levels were lower (median 8.5 [range, 0.5-26.6] ng/mL vs 14.9 [range, 1.9-93.5] ng/mL; P = 0.01) and PTH levels were higher (median 73.9 [range, 22-530] pg/mL vs 44.2 [range, 5-361] pg/mL; P = 0.01) in the CIN (+) group. Multivariate logistic regression analysis revealed that lower vitamin D levels (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.11-1.26; P = 0.01) and increased CM volume (OR, 1.01; 95% CI, 1.008-1.017; P = 0.01) were independently correlated with CIN. In patients who had undergone percutaneous coronary intervention, lower levels of vitamin D were independently associated with CIN development. Lower vitamin D levels, implying possible vitamin D deficiency, are associated with a higher incidence of CIN.

Research paper thumbnail of Contribution of platelets indices in the development of contrast-induced nephropathy

Blood Coagulation & Fibrinolysis, 2014

Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a ... more Contrast-induced nephropathy (CIN) accounts for 10% of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor clinical outcome. The underlying mechanism of the CIN development remains unclear and seems to be multifactorial. The potential link between platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) with CIN is unknown. Herein, we aimed to investigate the correlation between MPV and PDW levels with the development of CIN. The incidence of CIN (20.5%) was prospectively evaluated in 430 patients with diagnosis of acute coronary syndrome. Initial creatinine (1.13 ± 0.25 vs. 1.05 ± 0.27 mg/dl, P = 0.01) and PDW (40.1 ± 20.2 vs. 34.5 ± 19.9%, P = 0.02) levels and the total volume of contrast media used (121 ± 61 vs. 94 ± 42 ml, P = 0.01) were higher in patients who developed CIN. MPV was similar between the two groups (P = 0.80). In a univariate regression analysis, age, increased creatinine, uric acid, phosphate, PDW levels and higher total volume of contrast media used were significantly correlated with CIN incidence. However, in a multivariate analysis, only total volume of CM used [odds ratio (OR) 1.011, 95% confidence interval (CI) 1.006-1.016; P = 0.01], increased age (OR 1.026, 95% CI 1.00-1.052; P = 0.05) and increased PDW levels (OR 1.009, 95% CI 1.00-1.022; P = 0.04) remained as the independent predictors of CIN. Among platelet indices, PDW, but not MPV, was associated with CIN development. The clinical significance of such link remains unclear, but may indicate involvement of platelet activation in CIN pathogenesis.

Research paper thumbnail of Usefulness of Serum Omentin-1 Levels for the Prediction of Adverse Cardiac Events in Patients with Hypertrophic Cardiomyopathy

Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2018

To investigate the association between serum omentin-1 levels and adverse cardiac events in patie... more To investigate the association between serum omentin-1 levels and adverse cardiac events in patients with hypertrophic cardiomyopathy (HCM). This prospective, observational study included 87 patients with HCM and 50 age- and sex-matched control subjects. Serum omentin-1 and brain natriuretic peptide (BNP) levels were measured in all subjects, using enzyme-linked immunosorbent assay and electrochemiluminescence, respectively. Patients with HCM were divided into 2 groups according to their omentin levels, i.e., low: ≤291 ng/mL (n = 48) and high: > 291 ng/mL (n = 39). Cardiac mortality, hospitalization due to heart failure, and implantable cardioverter-defibrillator (ICD) implantation were considered adverse cardiac events. Statistical analysis included uni- and multivariant logistic regression, receiver-operating characteristic (ROC) analysis, and the Kaplan-Meier method. Serum omentin-1 levels were significantly lower in the obstructive (253.9 ± 41.3 ng/mL) and nonobstructive (301...

Research paper thumbnail of An unexpected complication of acute pancreatitis: Intra-cardiac thrombus

The American Journal of Emergency Medicine, 2016

Left atrial thrombus after acute pancreatitis (AP) is a rare clinical statement. Because of induc... more Left atrial thrombus after acute pancreatitis (AP) is a rare clinical statement. Because of induction of systemic prothrombotic process by AP; some patients with underlying risk factors may develop an intra-cardiac thrombus. We present a 53years-old-woman with moderate mitral stenosis and atrial fibrillation. However the patient was under warfarin treatment, she developed a big left atrial big thrombus which was originated from left atrial appendage after she was suffered from AP.

Research paper thumbnail of Higher copeptin levels are associated with worse outcome in patients with hypertrophic cardiomyopathy

Clinical Cardiology, 2016

Correlation of increased copeptin levels with various cardiovascular diseases has been described.... more Correlation of increased copeptin levels with various cardiovascular diseases has been described. The clinical use of copeptin levels in patients with hypertrophic cardiomyopathy (HCM) has not been investigated before. In this study, we aimed to investigate the prognostic value of copeptin levels in patients with hypertrophic cardiomyopathy (HCM). HCM was defined as presence of left ventricular wall thickness ≥15 mm in a subject without any concomitant disease that may cause left ventricular hypertrophy. Levels of copeptin and plasma N-terminal probrain natriuretic peptide (NT-proBNP) were evaluated prospectively in 24 obstructive HCM patients, 36 nonobstructive HCM patients, and 36 age- and sex-matched control subjects. Blood samples were collected in the morning between 7 and 9 am after overnight fasting. Patients were followed for 24 months. Hospitalization with diagnosis of heart failure/arrhythmia, implantable cardioverter-defibrillator implantation, and cardiac mortality were accepted as adverse cardiac events. Copeptin and NT-proBNP levels were higher in the HCM group compared with controls (14.1 vs 8.4 pmol/L, P < 0.01; and 383 vs 44 pg/mL, P < 0.01, respectively). Copeptin and NT-proBNP levels were higher in the obstructive HCM subgroup compared with the nonobstructive HCM subgroup (18.3 vs 13.1 pmol/L, P < 0.01; and 717 vs 223 pg/mL, P < 0.01, respectively). In multivariable logistic regression analysis, copeptin and NT-proBNP levels remained as independent predictors of heart failure (P < 0.01 for both) and adverse cardiac events (P < 0.01 for both). Copeptin and NT-proBNP levels were significantly higher in patients with obstructive HCM, and higher levels were associated with worse outcome.

Research paper thumbnail of Artmış eritrosit dağılım genişliği kararlı koroner arter hastalarında yetersiz koroner kollateral dolaşımı ile ilişkilidir

Artmıs Eritrosit Dagılım Genisligi Kararlı Koroner Arter Hastalarında Yetersiz Koroner Kollateral Dolasımı Ile Iliskilidir, 2015

Research paper thumbnail of Bölgesel debi süreklilik eğrilerinin elde edilmesi

Itudergisi D, Apr 14, 2010

... Bölgesel debi süreklilik eğrilerinin elde edilmesi Bahattin YANIK*, İlhan AVCI İTÜ ... fonksi... more ... Bölgesel debi süreklilik eğrilerinin elde edilmesi Bahattin YANIK*, İlhan AVCI İTÜ ... fonksiyonudur. Bu tür santrallerin enerji ihtiyacının fazla olduğu za-manlarda talebi karşılamak üzere enerji üretimi-ni artırma yeteneği bulunmamaktadır. ...

Research paper thumbnail of Higher CHA2DS2-VASc Score Is Associated With Increased Mortality in Acute Pulmonary Embolism

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 11, 2016

CHA2DS2-VASc score has been validated in risk prediction for stroke and thromboembolism in patien... more CHA2DS2-VASc score has been validated in risk prediction for stroke and thromboembolism in patients with atrial fibrillation (AF). Association of CHA2DS2-VASc score with higher risk of venous thromboembolism and pulmonary embolism (PE) has also been shown. In this study, we investigated the long-term prognostic value of CHA2DS2-VASc score in patients with acute pulmonary embolism (APE). Consecutive patients with APE presenting to our emergency department were retrospectively recruited. Patients with AF and who died secondary to causes other than PE were excluded from the study. The CHA2DS2-VASc score and pulmonary embolism severity index (PESI) were calculated. Two hundred seventy seven participants were included in the study. The mortality rate was 18.7%. Twenty-two cases died within 30 days, and 30 cases died during the follow-up period (median: 13 months). The mean CHA2DS2-VASc score was significantly higher in dead patients compared to survivors (3.61 ± 1.35 vs 1.95 ± 1.52, P &l...

Research paper thumbnail of Increased level of red cell distribution width is associated with poor coronary collateral circulation in patients with stable coronary artery disease

Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2015

Previous studies have shown the association between various hematological parameters and cardiova... more Previous studies have shown the association between various hematological parameters and cardiovascular diseases, and their prognostic value. In this study, we compared red cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and mean platelet volume (MPV) measurements among patients with poor coronary collateral circulation (CCC) and well-developed CCC. 326 patients with stable coronary artery disease (CAD) were evaluated retrospectively. CCC was graded by using the Rentrop classification. The poor CCC group included patients with Rentrop 0-1 CCC, and the good CCC group included Rentrop 2-3 CCC. There were 171 subjects (84% male; mean age 56.6±10.4 years) in the poor CCC group, and 155 subjects (89% male; mean age 57.6±9.7 years) in the good CCC group. The total number of vessels with >95% stenosis (1.1±0.5 vs. 1.0±0.4; p=0.64) and Gensini scores (84.4±38.8 vs. 83.3±37.4; p=0.83) was not higher in the poor CCC group compared to the good CCC group. RDW was significant...

Research paper thumbnail of Impact of coronary collateral circulation and severity of coronary artery disease in the development of postoperative atrial fibrillation

Interactive cardiovascular and thoracic surgery, 2014

Atrial fibrillation (AF) after cardiac surgery has been reported to be approximately 30%, making ... more Atrial fibrillation (AF) after cardiac surgery has been reported to be approximately 30%, making it one of the most important causes of morbidity and mortality post surgery. Although various clinical and laboratory predictors and underlying mechanisms progressing to postoperative AF have been proposed, the role of ischaemia in pathogenesis is doubtful. In this study, the association of coronary collateral circulation (CCC) and severity of coronary artery disease (CAD) with the development of postoperative AF was investigated. A total of 597 patients who underwent on-pump coronary artery bypass surgery were included in the study. Pre-, peri- and postoperative variables were recorded in a computerized database. CCC and severity of CAD were documented for each patient according to Rentrop classification and Gensini score. Postoperative AF was observed in 96 patients (16.1%). Advanced age, female gender, presence of hypertension and low haematocrit level were significantly associated wi...

Research paper thumbnail of PP-095 Low Vitamin D Status is Associated with Resistant Hypertension

The American Journal of Cardiology, 2015

Research paper thumbnail of Wpływ aktywności fosfatazy zasadowej w surowicy na wieńcowe krążenie oboczne

Kardiologia Polska, 2014

Background: Serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor for m... more Background: Serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor for myocardial infarction and stroke via its promotion of vascular calcification. Aim: To investigate for the first time the correlation between serum ALP level and coronary collateral circulation (CCC) development. Methods: A total of 356 patients with stable angina pectoris were evaluated retrospectively. Patients were classified according to ALP level and CCC grade. Rentrop 0-1 flow was defined as impaired CCC. Serum ALP > 129 mg/dL in men and > 104 mg/dL in women was defined as elevated ALP. All groups were compared statistically according to clinical, laboratory and demographic features. Results: Impaired CCC was observed in 53.7% of the patients. The mean ALP level was 102.8 ± 57.9 mg/dL, and elevated ALP levels were obtained in 19.4% of cases. There was a significant correlation between ALP and CCC grade, and impaired CCC was associated with relatively higher ALP values (65.2% vs. 50.9%, p = 0.03). Multivariate regression analysis also showed a significant correlation between elevated ALP level and impaired CCC (OR 1.85, with a 95% CI 1.056-3.264; p = 0.03). Conclusions: Serum ALP is a widely avaliable unfavourable prognostic parameter in coronary heart disease. Elevated ALP levels were associated with inadequate CCC, which supports the previously reported literature concerning the negative prognostic value of ALP levels in cardiovascular settings.

Research paper thumbnail of Wpływ stężenia fosfatazy zasadowej w surowicy na patofizjologiczny mechanizm nefropatii kontrastowej

Kardiologia Polska, 2014

Contrast-induced nephropathy (CIN) accounts for 10% of all causes of hospital-acquired renal fail... more Contrast-induced nephropathy (CIN) accounts for 10% of all causes of hospital-acquired renal failure. It leadsto a prolonged in-hospital stay, and represents a powerful predictor of poor early and late outcomes. More than half of casesare observed after cardiovascular procedures. To determine the predictive value of the serum alkaline phosphatase (ALP) level in the development of CIN, something which has not been assessed before. We prospectively evaluated a total of 430 patients with acute coronary syndrome. Patients were classified according to the development of CIN and both groups were compared statistically according to clinical, laboratory and demographic features, including the serum ALP level. CIN was observed in 20.5% of patients. Advanced age, male gender, elevated creatinine, uric acid and phosphate levels, and low glomerular filtration rate were correlated with the development of CIN. Correlation analysis also showed a significant association between the ALP level and the development of CIN (126.1 ± 144.9 vs. 97.2 ± 46.9, p = 0.004). Univariate regression analysis also showed the impact of ALP on the development of CIN (OR 1.004, 95% CI 1.001–1.007, p = 0.02). Conclusions: Our outcomes indicate a possible active role of ALP in the mechanism of CIN. An elevated ALP level may predict the development of CIN.

Research paper thumbnail of Lower vitamin D level is associated with poor coronary collateral circulation

Scandinavian Cardiovascular Journal, 2014

Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-... more Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-sectional associations between lower vitamin D levels and cardiovascular diseases have been reported, but the relationship between vitamin D levels and collateral arteries in stable coronary artery disease (CAD) has not been reported before. Two hundred and fourteen patients with above 95% stenosis in at least one epicardial coronary artery were consecutively recruited after coronary angiography (CAG) during the winter season. The coronary collateral circulation (CCC) was graded using Rentrop classification. Poor CCC group included patients with Rentrop Grade 0-1 CCC and control group included patients with Rentrop Grade 2-3 CCC. Vitamin D and PTH levels were measured on the day of CAG. In the poor CCC group, vitamin D levels were lower (34 ± 25 pmol/L vs. 49 ± 33 pmol/L; p = 0.01) and the prevalence of vitamin D deficiency (< 37 pmol/L) was higher (67% vs. 43%; p = 0.01) compared to the controls. PTH levels, calcium, and phosphate levels were not significantly different between the groups. Female gender, lower HDL cholesterol, and lower vitamin D levels were independently correlated with poor CCC in the study population. Lower vitamin D levels may be associated with poor collateral development in patients with stable CAD.

Research paper thumbnail of Lower Blood Vitamin D Levels Are Associated With an Increased Incidence of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Canadian Journal of Cardiology, 2014

Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assesse... more Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assessed the correlation between vitamin D levels and contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG). Vitamin D and parathyroid hormone (PTH) levels were assessed before CAG in 403 patients. Estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault equation. Patients with eGFR < 60 mL/min/1.73 m(2) were hydrated with 0.9%-saline at 1 mL/kg/h for 12 hours before and after CAG. CIN was defined as serum creatinine increase of > 0.5 mg/dL or > 25% within 48-72 hours after CAG. CIN developed in 74 participants. Baseline eGFR, blood urea and creatinine in CIN (+) and (-) groups were not significantly different (P = 0.14, P = 0.07, and P = 0.61, respectively). Total volume of contrast medium (CM) was higher in the CIN (+) group (132 ± 64 mL vs 90 ± 41 mL; P = 0.01). Vitamin D levels were lower (median 8.5 [range, 0.5-26.6] ng/mL vs 14.9 [range, 1.9-93.5] ng/mL; P = 0.01) and PTH levels were higher (median 73.9 [range, 22-530] pg/mL vs 44.2 [range, 5-361] pg/mL; P = 0.01) in the CIN (+) group. Multivariate logistic regression analysis revealed that lower vitamin D levels (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.11-1.26; P = 0.01) and increased CM volume (OR, 1.01; 95% CI, 1.008-1.017; P = 0.01) were independently correlated with CIN. In patients who had undergone percutaneous coronary intervention, lower levels of vitamin D were independently associated with CIN development. Lower vitamin D levels, implying possible vitamin D deficiency, are associated with a higher incidence of CIN.