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Papers by Serkan Kahraman

European Urology Supplements, 2005

Nephrology Dialysis Transplantation, 2005

Background. Abnormal mineral metabolism is associated with increased cardiovascular morbidity and... more Background. Abnormal mineral metabolism is associated with increased cardiovascular morbidity and mortality. The exact pathogenesis linking mineral metabolism to cardiovascular risk is unknown. This study was undertaken to investigate the association between serum phosphate and/or Ca  PO 4 product with serum levels of soluble E-selectin (sE-selectin), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 and the degree of carotid artery atherosclerosis in patients on haemodialysis. Methods. Seventy-three patients (46 male, 27 female; mean age 48±13 years, on haemodialysis for 82±80 months) were included in the study. All patients were stable, had no evidence of vascular disease and/or active infection. Consecutive 6 months clinical and laboratory data were obtained for each patient from their medical records and mean values were used for analysis. Serum levels of soluble adhesion molecules were assayed by ELISA. All subjects underwent a detailed evaluation of the carotid arteries. Results. The percentage of patients who met all three targets of NKF-K/DOQI for phosphate, calcium and Ca  PO 4 product was 27.1%, whereas those who did not achieve the target in one, two or three parameters was 28.1, 17.7 and 14.6%, respectively. The sICAM-1 levels were significantly higher in patients who had hyperphosphataemia (serum phosphate >5.5 mg/dl; P ¼ 0.044) and hypercalcaemia (serum calcium >9.5 mg/dl; P ¼ 0.014), both sE-selectin and sICAM-1 levels were significantly higher in patients with Ca  PO 4 product levels above 55 mg 2 /dl 2 (P ¼ 0.002 and P ¼ 0.000, respectively). Soluble E-selectin and sICAM levels demonstrated a nearlinear increase in parallel to the degree of deviation from mineral metabolism targets. Soluble E-selectin and sICAM levels were correlated with serum phosphate and Ca  PO 4 product, but there were no correlations between adhesion molecules and carotid measurements. Conclusion. These findings suggest that in stable haemodialysis patients abnormal bone mineral metabolism was associated with increased soluble adhesion molecules. These alterations in adhesion molecules may favour the development of cardiovascular changes and contribute to high cardiovascular morbidity and mortality in patients with abnormal mineral metabolism.

Journal of the American College of Cardiology, 2013

Background: Postdilatation after stent implantation in stable patients has been recommended to ac... more Background: Postdilatation after stent implantation in stable patients has been recommended to achieve better angiographic results, but its effect in primary percutaneous coronary intervention (PCI) is less clear. Objective: Our objective was to determine whether postdilatation has an effect on clinical outcomes in STEMI. Our objective was to determine whether postdilatation has an effect on clinical outcomes in STEMI. Methods: This study was a single-center retrospective, observational study including patients who presented with STEMI and were treated with primary PCI between January 2008 and March 2013. Patients with STEMI who were treated with primary PCI were included. Patients with non-ST-elevation myocardial infarction, bypass graft occlusion, or who were not treated with primary PCI were excluded. The patients were divided into two groups: 1) patients who did not undergo postdilatation after stent implantation (Group 1) and 2) patients who underwent postdilatation (Group 2). The patient demographics, risk factors, clinical presentation, procedural properties, and major adverse cardiac events (MACE), including target lesion revascularization, target vessel failure, and cardiac death at the hospital or during follow-up, were compared between the two groups. Conclusıon: In total, 227 patients underwent primary PCI for STEMI and were treated with at least one stent. A total of 218 patients were included (Group 1¼ 57, Group 2 ¼161). The follow-up time was 79.68 AE58.89 weeks in Group 1 and 141.30 AE 87.07 weeks in Group 2 (p<0.001). The patient demographics, risk factors, clinical presentation and procedural properties were all similar except for the increased use of predilatation (75.4% vs. 94.4%, p<0.001) and intracoronary nitroglycerine in Group 2 (50.9% vs. 71.4%, p<0.05). The mean final TIMI coronary flow was better in Group 1 (2.89 AE 0.31 vs. 2.61 AE 0.66, p<0.05). The MACE rate both in hospital and during follow-up did not differ between Groups 1 and 2. Conclusion: Although stent postdilatation is negatively correlated with the final TIMI flow grade, it does not appear to be correlated with worse long-term clinical outcomes.

American Journal of Hypertension, 2004

European Urology Supplements, 2005

Nephrology Dialysis Transplantation, 2005

Background. Abnormal mineral metabolism is associated with increased cardiovascular morbidity and... more Background. Abnormal mineral metabolism is associated with increased cardiovascular morbidity and mortality. The exact pathogenesis linking mineral metabolism to cardiovascular risk is unknown. This study was undertaken to investigate the association between serum phosphate and/or Ca  PO 4 product with serum levels of soluble E-selectin (sE-selectin), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 and the degree of carotid artery atherosclerosis in patients on haemodialysis. Methods. Seventy-three patients (46 male, 27 female; mean age 48±13 years, on haemodialysis for 82±80 months) were included in the study. All patients were stable, had no evidence of vascular disease and/or active infection. Consecutive 6 months clinical and laboratory data were obtained for each patient from their medical records and mean values were used for analysis. Serum levels of soluble adhesion molecules were assayed by ELISA. All subjects underwent a detailed evaluation of the carotid arteries. Results. The percentage of patients who met all three targets of NKF-K/DOQI for phosphate, calcium and Ca  PO 4 product was 27.1%, whereas those who did not achieve the target in one, two or three parameters was 28.1, 17.7 and 14.6%, respectively. The sICAM-1 levels were significantly higher in patients who had hyperphosphataemia (serum phosphate >5.5 mg/dl; P ¼ 0.044) and hypercalcaemia (serum calcium >9.5 mg/dl; P ¼ 0.014), both sE-selectin and sICAM-1 levels were significantly higher in patients with Ca  PO 4 product levels above 55 mg 2 /dl 2 (P ¼ 0.002 and P ¼ 0.000, respectively). Soluble E-selectin and sICAM levels demonstrated a nearlinear increase in parallel to the degree of deviation from mineral metabolism targets. Soluble E-selectin and sICAM levels were correlated with serum phosphate and Ca  PO 4 product, but there were no correlations between adhesion molecules and carotid measurements. Conclusion. These findings suggest that in stable haemodialysis patients abnormal bone mineral metabolism was associated with increased soluble adhesion molecules. These alterations in adhesion molecules may favour the development of cardiovascular changes and contribute to high cardiovascular morbidity and mortality in patients with abnormal mineral metabolism.

Journal of the American College of Cardiology, 2013

Background: Postdilatation after stent implantation in stable patients has been recommended to ac... more Background: Postdilatation after stent implantation in stable patients has been recommended to achieve better angiographic results, but its effect in primary percutaneous coronary intervention (PCI) is less clear. Objective: Our objective was to determine whether postdilatation has an effect on clinical outcomes in STEMI. Our objective was to determine whether postdilatation has an effect on clinical outcomes in STEMI. Methods: This study was a single-center retrospective, observational study including patients who presented with STEMI and were treated with primary PCI between January 2008 and March 2013. Patients with STEMI who were treated with primary PCI were included. Patients with non-ST-elevation myocardial infarction, bypass graft occlusion, or who were not treated with primary PCI were excluded. The patients were divided into two groups: 1) patients who did not undergo postdilatation after stent implantation (Group 1) and 2) patients who underwent postdilatation (Group 2). The patient demographics, risk factors, clinical presentation, procedural properties, and major adverse cardiac events (MACE), including target lesion revascularization, target vessel failure, and cardiac death at the hospital or during follow-up, were compared between the two groups. Conclusıon: In total, 227 patients underwent primary PCI for STEMI and were treated with at least one stent. A total of 218 patients were included (Group 1¼ 57, Group 2 ¼161). The follow-up time was 79.68 AE58.89 weeks in Group 1 and 141.30 AE 87.07 weeks in Group 2 (p<0.001). The patient demographics, risk factors, clinical presentation and procedural properties were all similar except for the increased use of predilatation (75.4% vs. 94.4%, p<0.001) and intracoronary nitroglycerine in Group 2 (50.9% vs. 71.4%, p<0.05). The mean final TIMI coronary flow was better in Group 1 (2.89 AE 0.31 vs. 2.61 AE 0.66, p<0.05). The MACE rate both in hospital and during follow-up did not differ between Groups 1 and 2. Conclusion: Although stent postdilatation is negatively correlated with the final TIMI flow grade, it does not appear to be correlated with worse long-term clinical outcomes.

American Journal of Hypertension, 2004