hakan uçar - Academia.edu (original) (raw)

Papers by hakan uçar

Research paper thumbnail of Assessment of the Relationship between Mortality and Troponin I Levels in Hospitalized Patients with the Novel Coronavirus (COVID-19)

Medicina, 2020

Background and Objectives: This study aimed to evaluate the relationship between mortality and ca... more Background and Objectives: This study aimed to evaluate the relationship between mortality and cardiac laboratory findings in patients who were hospitalized after a positive PCR for COVID-19 infection. Materials and Methods: This study included patients who were admitted to or referred to the hospital between 20 March and 20 June 2020, diagnosed with COVID-19 via a positive RT-PCR from nasal and pharyngeal swab samples. The troponin I level was measured from each patient. Medical records of patients were retrospectively reviewed and analyzed. Results: A hundred and five patients who were diagnosed with COVID-19 and hospitalized, or who died in the hospital due to COVID-19, were included in this study. There was a statistically significant difference between the troponin I high and low level groups in terms of age (years), BMI, shortness of breath (SB), oxygen saturation (%), hypertension, length of stay in the ICU; and for mortality, C-reactive protein, the neutrophil-to-lymphocyte ...

Research paper thumbnail of Evaluation of the Relationship Between Serum Bilirubin with hscTnT Levels and SYNTAX Score in Non-ST Elevation Acute Coronary Syndrome

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2019

Amaç: ST segment yükselmesiz miyokardiyal infarktüs (NSTEMI) tanı ve ayırıcı tanısında son dönemd... more Amaç: ST segment yükselmesiz miyokardiyal infarktüs (NSTEMI) tanı ve ayırıcı tanısında son dönemde acil servislerde negatif prediktif değerinin oldukça yüksek olması nedeniyle birçok merkezde kullanılmaya başlanan yüksek duyarlıklı kardiyak troponin T (hs-cTnT) ile serum bilirubin değerleri arasındaki ilişkiyi inceledik. Yöntemler: Acil servise göğüs ağrısı şikayeti ile başvurmuş ve hs-cTnT (+) olup NSTEMI tanısıyla yatışı ve sonrasında koroner anjiyografisi yapılmış 371 hasta ile hs-cTnT (-) 374 kontrol grubu hasta çalışmaya alındı. Her iki grupta serum bilirubin (total ve direkt) düzeylerine bakıldı ve sonuçları karşılaştırıldı. Ayrıca hs-cTnT + hasta grubunda median SYNTAX (SX) skoru belirlenip alt grup analizi yapıldı. Buna göre düşük SX skoru (<12) ve yüksek SX skoru (>12) grupları arasında bilirubin değerleri arasındaki farklılık da araştırıldı. Bulgular: Bilirubin düzeyleri karşılaştırıldığında total bilirubin sınırda olmak kaydıyla hem total hem de direkt bilirubin değerlerinde hs-cTnT (+) ve (-) gruplar arasında anlamlı farklılık izlenmedi (sırasıyla; total bilirubin; p=0,05 ve direkt bilirubin; p=0,42). Korelasyon analizi yapıldığında hs-cTnT ile yalnızca total bilirubin arasında orta düzeyde pozitif bir korelasyonun olduğu görüldü (r=0,43, p=0,042). Total ve direkt bilirubin değerlerinin SX skoru ile olan ilişkisine bakıldığında ise SX skorunun arttıkça hem total hem de direkt bilirubin değerlerinin azaldığı görüldü ama aralarında yine anlamlı negatif bir korelasyon izlenmedi. Sonuç: Çalışmanın sonuçları bize NSTEMI'da kardiyak troponinler (I ve T) ile anlamlı ilişkisi olduğu daha önce birçok çalışmada gösterilen hatta troponin yüksekliği için bağımsız öngördürücü olabileceği bildirilen serum bilirubinin çok erken dönemde kardiyomyosit hasarına olan duyarlılığının düşük olduğunu göstermektedir. Çalışmamızda bilirubin değerleri ile hs-cTnT ile bir ilişki bulunmamıştır. Ancak koroner arter hastalığı yaygınlığı açısından bakıldığında ve regresyon analizi yapıldığında SX skoru düşük olanlarda (çalışmada median SX skoru=12) bilirubin düzeylerinin yüksek olması miyokart infarktüsü'nden ve hs-cTnT düzeyinden bağımsız olarak aralarında anlamlı korelasyon olmasa da negatif bir ilişki olduğunu önceki çalışmalarda olduğu gibi doğrular niteliktedir. Anahtar Kelimeler: Bilirubin, yüksek duyarlıklı kardiyak troponin T, ST segment yükselmesiz miyokardiyal infarktüsü (NSTEMI) Objective: We investigated the relationship between high-sensitivity cardiac troponin T (hs-cTnT), which has been recently introduced in many emergency departments because of its very high negative predictive value in the diagnosis and differential diagnosis of non-ST elevated myocardial infarction (NSTEMI), and serum bilirubin levels. Methods: A total of 371 patients who admitted to the emergency department with the complaint of chest pain and hs-cTnT (+), were hospitalized with the diagnosis of NSTEMI and who underwent coronary angiography, and 374 patients with hs-cTnT (-) as the control group were included in the study. Serum bilirubin levels (total and direct) were studied and compared between the two groups. In addition, the median SYNTAX (SX) score was determined in hs-cTnT (+) patient group and a sub-analysis was performed. Accordingly, bilirubin levels were investigated between the group with low SX scores (<12) and the group with high SX scores. Results: When bilirubin levels were compared; no significant difference was found between hs-cTnT (+) and hs-cTnT (-) groups in terms of both total and direct bilirubin values, with total bilirubin being at the limit (total bilirubin, p=0.05; direct bilirubin, p=0.42; respectively). In the correlation analysis, a moderate positive correlation was found only between hs-cTnT and total bilirubin (r=0.43, p=0.042). When the correlation of total and

Research paper thumbnail of The relationship between erectile dysfunction and the Atherogenic Index of Plasma

International Journal of Impotence Research, 2019

The objective of this study was to compare the Atherogenic Index of Plasma (AIP) values as indica... more The objective of this study was to compare the Atherogenic Index of Plasma (AIP) values as indicators of subclinical atherosclerosis among 124 patients with erectile dysfunction, which was thought to be vasculogenic and 126 control subjects who had no erectile dysfunction, and to compare cardiac performance values between both the groups using exercise stress tests (EST). Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire form. AIP values were studied and compared between patients with ED (IIEF < 22) and those without ED (IIEF > 22) using the log 10 TG/HDL-C formula. In addition, the correlation between the severity of ED and AIP was investigated according to IIEF-5 scoring. Metabolic equivalent (MET) values, maximal heart rates (max HR), and heart rate recovery (HRR) were evaluated with effort tests. AIP values were significantly higher in the ED group than in the control group (0.45 ± 0.27, and 0.37 ± 0.27; p = 0.015). According to IIEF-5 scoring, AIP values increased as ED scores decreased. In the EST, MET score and max HR values were significantly lower in the ED group (METs: 11.1 ± 2.2, and 11.6 ± 2.2; p = 0.045; Max HR: 162.8 ± 6.1, and 165 ± 8.7; p = 0.019). Although not statistically significant, HRR values were lower in the ED group. Higher AIP values were found in the ED group, and a positive correlation was established between AIP and the severity of ED. In addition, lower performance during the EST and lower HRR values, again in the ED group, confirms cardiac interaction with ED. These results indicate the importance of referral of patients with ED from urology clinics to cardiology units for risk determination and cardiac assessment, even if they areasymptomatic.

Research paper thumbnail of Value of Syntax Score II in Prediction of New-Onset Atrial Fibrillation in Patients With NSTE-ACS Undergoing Percutaneous Coronary Intervention

Angiology, 2019

New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute... more New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACSs). The objective of this study was to investigate the relationship between the development of NOAF and severity of coronary artery disease using the SYNTAX score (SS) and SYNTAX score II (SSII) in patients with non-ST-segment elevation ACS (NSTE-ACS) who were treated with percutaneous coronary intervention (PCI). A total of 662 patients with NSTE-ACS were consecutively enrolled. The incidence of NOAF was 11.4% among the patients with NSTE-ACS. Mean age was significantly higher in NOAF group ( P = .011). White blood cell count, peak troponin I, high sensitivity C-reactive protein, uric acid, left atrial volume index, and ratio between early mitral inflow velocity and mitral annular early diastolic velocity were significantly higher in NOAF group (respectively, P = .024, P = .017, P = .002, P = .009, P = .025, P < .001, and P < .001). The hemoglobin, ejection...

Research paper thumbnail of A case of stent thrombosis presenting as acute myocardial infarction related to right coronary artery originating from the left coronary system

Intractable & rare diseases research, 2018

Right coronary artery (RCA) originating from the left coronary system is a subtype of single coro... more Right coronary artery (RCA) originating from the left coronary system is a subtype of single coronary artery (SCA) anomaly, and the origin of RCA as a branch from the left anterior descending artery (LAD) is a very rare variant. A 55-year-old male who had a percutaneous coronary intervention (PCI) history was hospitalized due to acute coronary syndrome. Coronary angiography revealed an aberrant RCA originating from the mid-LAD as well as stent thrombosis. A successful PCI was performed and he was discharged from the hospital three days after the PCI. It is known that there is an increased incidence of atherosclerosis and stent thrombosis in coronary anomaly patients. Therefore, interventional cardiologists should consider the most suitable PCI strategy before stenting and avoid complex techniques.

Research paper thumbnail of Assessment of the Relationship between Mortality and Troponin I Levels in Hospitalized Patients with the Novel Coronavirus (COVID-19)

Medicina, 2020

Background and Objectives: This study aimed to evaluate the relationship between mortality and ca... more Background and Objectives: This study aimed to evaluate the relationship between mortality and cardiac laboratory findings in patients who were hospitalized after a positive PCR for COVID-19 infection. Materials and Methods: This study included patients who were admitted to or referred to the hospital between 20 March and 20 June 2020, diagnosed with COVID-19 via a positive RT-PCR from nasal and pharyngeal swab samples. The troponin I level was measured from each patient. Medical records of patients were retrospectively reviewed and analyzed. Results: A hundred and five patients who were diagnosed with COVID-19 and hospitalized, or who died in the hospital due to COVID-19, were included in this study. There was a statistically significant difference between the troponin I high and low level groups in terms of age (years), BMI, shortness of breath (SB), oxygen saturation (%), hypertension, length of stay in the ICU; and for mortality, C-reactive protein, the neutrophil-to-lymphocyte ...

Research paper thumbnail of Evaluation of the Relationship Between Serum Bilirubin with hscTnT Levels and SYNTAX Score in Non-ST Elevation Acute Coronary Syndrome

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2019

Amaç: ST segment yükselmesiz miyokardiyal infarktüs (NSTEMI) tanı ve ayırıcı tanısında son dönemd... more Amaç: ST segment yükselmesiz miyokardiyal infarktüs (NSTEMI) tanı ve ayırıcı tanısında son dönemde acil servislerde negatif prediktif değerinin oldukça yüksek olması nedeniyle birçok merkezde kullanılmaya başlanan yüksek duyarlıklı kardiyak troponin T (hs-cTnT) ile serum bilirubin değerleri arasındaki ilişkiyi inceledik. Yöntemler: Acil servise göğüs ağrısı şikayeti ile başvurmuş ve hs-cTnT (+) olup NSTEMI tanısıyla yatışı ve sonrasında koroner anjiyografisi yapılmış 371 hasta ile hs-cTnT (-) 374 kontrol grubu hasta çalışmaya alındı. Her iki grupta serum bilirubin (total ve direkt) düzeylerine bakıldı ve sonuçları karşılaştırıldı. Ayrıca hs-cTnT + hasta grubunda median SYNTAX (SX) skoru belirlenip alt grup analizi yapıldı. Buna göre düşük SX skoru (<12) ve yüksek SX skoru (>12) grupları arasında bilirubin değerleri arasındaki farklılık da araştırıldı. Bulgular: Bilirubin düzeyleri karşılaştırıldığında total bilirubin sınırda olmak kaydıyla hem total hem de direkt bilirubin değerlerinde hs-cTnT (+) ve (-) gruplar arasında anlamlı farklılık izlenmedi (sırasıyla; total bilirubin; p=0,05 ve direkt bilirubin; p=0,42). Korelasyon analizi yapıldığında hs-cTnT ile yalnızca total bilirubin arasında orta düzeyde pozitif bir korelasyonun olduğu görüldü (r=0,43, p=0,042). Total ve direkt bilirubin değerlerinin SX skoru ile olan ilişkisine bakıldığında ise SX skorunun arttıkça hem total hem de direkt bilirubin değerlerinin azaldığı görüldü ama aralarında yine anlamlı negatif bir korelasyon izlenmedi. Sonuç: Çalışmanın sonuçları bize NSTEMI'da kardiyak troponinler (I ve T) ile anlamlı ilişkisi olduğu daha önce birçok çalışmada gösterilen hatta troponin yüksekliği için bağımsız öngördürücü olabileceği bildirilen serum bilirubinin çok erken dönemde kardiyomyosit hasarına olan duyarlılığının düşük olduğunu göstermektedir. Çalışmamızda bilirubin değerleri ile hs-cTnT ile bir ilişki bulunmamıştır. Ancak koroner arter hastalığı yaygınlığı açısından bakıldığında ve regresyon analizi yapıldığında SX skoru düşük olanlarda (çalışmada median SX skoru=12) bilirubin düzeylerinin yüksek olması miyokart infarktüsü'nden ve hs-cTnT düzeyinden bağımsız olarak aralarında anlamlı korelasyon olmasa da negatif bir ilişki olduğunu önceki çalışmalarda olduğu gibi doğrular niteliktedir. Anahtar Kelimeler: Bilirubin, yüksek duyarlıklı kardiyak troponin T, ST segment yükselmesiz miyokardiyal infarktüsü (NSTEMI) Objective: We investigated the relationship between high-sensitivity cardiac troponin T (hs-cTnT), which has been recently introduced in many emergency departments because of its very high negative predictive value in the diagnosis and differential diagnosis of non-ST elevated myocardial infarction (NSTEMI), and serum bilirubin levels. Methods: A total of 371 patients who admitted to the emergency department with the complaint of chest pain and hs-cTnT (+), were hospitalized with the diagnosis of NSTEMI and who underwent coronary angiography, and 374 patients with hs-cTnT (-) as the control group were included in the study. Serum bilirubin levels (total and direct) were studied and compared between the two groups. In addition, the median SYNTAX (SX) score was determined in hs-cTnT (+) patient group and a sub-analysis was performed. Accordingly, bilirubin levels were investigated between the group with low SX scores (<12) and the group with high SX scores. Results: When bilirubin levels were compared; no significant difference was found between hs-cTnT (+) and hs-cTnT (-) groups in terms of both total and direct bilirubin values, with total bilirubin being at the limit (total bilirubin, p=0.05; direct bilirubin, p=0.42; respectively). In the correlation analysis, a moderate positive correlation was found only between hs-cTnT and total bilirubin (r=0.43, p=0.042). When the correlation of total and

Research paper thumbnail of The relationship between erectile dysfunction and the Atherogenic Index of Plasma

International Journal of Impotence Research, 2019

The objective of this study was to compare the Atherogenic Index of Plasma (AIP) values as indica... more The objective of this study was to compare the Atherogenic Index of Plasma (AIP) values as indicators of subclinical atherosclerosis among 124 patients with erectile dysfunction, which was thought to be vasculogenic and 126 control subjects who had no erectile dysfunction, and to compare cardiac performance values between both the groups using exercise stress tests (EST). Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire form. AIP values were studied and compared between patients with ED (IIEF < 22) and those without ED (IIEF > 22) using the log 10 TG/HDL-C formula. In addition, the correlation between the severity of ED and AIP was investigated according to IIEF-5 scoring. Metabolic equivalent (MET) values, maximal heart rates (max HR), and heart rate recovery (HRR) were evaluated with effort tests. AIP values were significantly higher in the ED group than in the control group (0.45 ± 0.27, and 0.37 ± 0.27; p = 0.015). According to IIEF-5 scoring, AIP values increased as ED scores decreased. In the EST, MET score and max HR values were significantly lower in the ED group (METs: 11.1 ± 2.2, and 11.6 ± 2.2; p = 0.045; Max HR: 162.8 ± 6.1, and 165 ± 8.7; p = 0.019). Although not statistically significant, HRR values were lower in the ED group. Higher AIP values were found in the ED group, and a positive correlation was established between AIP and the severity of ED. In addition, lower performance during the EST and lower HRR values, again in the ED group, confirms cardiac interaction with ED. These results indicate the importance of referral of patients with ED from urology clinics to cardiology units for risk determination and cardiac assessment, even if they areasymptomatic.

Research paper thumbnail of Value of Syntax Score II in Prediction of New-Onset Atrial Fibrillation in Patients With NSTE-ACS Undergoing Percutaneous Coronary Intervention

Angiology, 2019

New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute... more New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACSs). The objective of this study was to investigate the relationship between the development of NOAF and severity of coronary artery disease using the SYNTAX score (SS) and SYNTAX score II (SSII) in patients with non-ST-segment elevation ACS (NSTE-ACS) who were treated with percutaneous coronary intervention (PCI). A total of 662 patients with NSTE-ACS were consecutively enrolled. The incidence of NOAF was 11.4% among the patients with NSTE-ACS. Mean age was significantly higher in NOAF group ( P = .011). White blood cell count, peak troponin I, high sensitivity C-reactive protein, uric acid, left atrial volume index, and ratio between early mitral inflow velocity and mitral annular early diastolic velocity were significantly higher in NOAF group (respectively, P = .024, P = .017, P = .002, P = .009, P = .025, P < .001, and P < .001). The hemoglobin, ejection...

Research paper thumbnail of A case of stent thrombosis presenting as acute myocardial infarction related to right coronary artery originating from the left coronary system

Intractable & rare diseases research, 2018

Right coronary artery (RCA) originating from the left coronary system is a subtype of single coro... more Right coronary artery (RCA) originating from the left coronary system is a subtype of single coronary artery (SCA) anomaly, and the origin of RCA as a branch from the left anterior descending artery (LAD) is a very rare variant. A 55-year-old male who had a percutaneous coronary intervention (PCI) history was hospitalized due to acute coronary syndrome. Coronary angiography revealed an aberrant RCA originating from the mid-LAD as well as stent thrombosis. A successful PCI was performed and he was discharged from the hospital three days after the PCI. It is known that there is an increased incidence of atherosclerosis and stent thrombosis in coronary anomaly patients. Therefore, interventional cardiologists should consider the most suitable PCI strategy before stenting and avoid complex techniques.