Browsing by Author "Agirbasli, M."

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Does Off-Pump Coronary Artery Bypass Surgery Reduce Secretion of Plasminogen Activator Inhibitor-1
(Wiley, 2007) Ozkara, C.; Guler, N.; Batyraliev, T.; Okut, H.; Agirbasli, M.
Prior studies showed that postoperative increase in plasminogen activator inhibitor-1 (PAI-1) levels is associated with an increased risk of graft occlusion after coronary artery bypass surgery (CABG). This prospective study aimed to compare the changes of PAI-1 antigen levels after off-pump and on-pump CABG. Forty-four patients admitted for elective CABG were randomised to on-pump (n = 22) or off-pump (n = 22) surgery. Serum samples were collected for estimation of PAI-1 and tissue plasminogen activator (t-PA) antigen levels preoperatively and 2 h after the operation. The groups were similar in terms of age, weight, gender ratio and extent of coronary disease, left ventricular function and number of grafts per patient. Fibrinogen and t-PA levels increased postoperatively in both the groups when compared with baseline values. After operation, statistical analysis revealed that increase of PAI-1 values was higher in off-pump group (44.1 +/- 9.1 vs. 25.3 +/- 6.9) than on-pump group (37.2 +/- 5.5 vs. 27.3 +/- 7.8, p = 0.002). This study shows that increase in PAI-1 antigen values in patients who undergo off-pump (beating heart) CABG is significantly higher than in those who undergo conventional CABG with cardiopulmonary bypass.
Recovery of Left Ventricular Systolic Function After Left Anterior Descending Coronary Artery Stenting
(2005) Agirbasli, M.; Guler, N.
Our objective was to determine the factors affecting recovery of left ventricular (LV) contractility and myocardial perfusion after percutaneous coronary intervention (PCI). We selected 60 consecutive patients who underwent successful left anterior descending coronary artery (LAD) stenting. The mean stent diameter and length were 3.37 ± 0.47 mm and 17.4 ± 6 mm, respectively. Supporting a functional impact of successful PCI, myocardial perfusion and LV ejection fraction (LVEF) improved at 6 ± 3 months after the procedure (48.8 ± 11.6% vs 52.5 ± 11.5%, P = 0.05). Patient related factors such as diabetes mellitus, presentation with acute coronary syndrome, and age did not seem to affect LVEF change after the procedure. On univariate analysis, the change in LVEF after PCI was only related to the stent diameter. The increase in LVEF was higher in patients who received a stent >3 mm in diameter (P = 0.041). There was a weak but statistically positive correlation between the stent diameter and the LVEF change after the procedure (R = 0.267, P = 0.049). Other procedure related factors such as multivessel PCI or stent length did not affect the percent ejection fraction change after stenting.