Browsing by Author "Ozdemir, Mahmut"

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Acute Serious Thrombocytopenia Associated With Intracoronary Tirofiban Use for Primary Angioplasty
(Hindawi Ltd, 2014) Yurtdas, Mustafa; Yaylali, Yalin Tolga; Aladag, Nesim; Ozdemir, Mahmut; Atay, Memis Hilmi
Tirofiban, a specific glycoprotein IIb/IIIa inhibitor, may cause extensive thrombocytopenia with an incidence of 0.2% to 0.5%. We report the case of a 50-year-oldman who developed thrombocytopenia after tirofiban use (both intracoronary and peripheral) over hours and the successful management of this complication after primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
The Association of Glomerular Filtration Rate With Echocardiographic Parameters in Chronic Kidney Disease
(Elmer Press inc, 2021) Ozdemir, Mahmut; Asoglu, Ramazan; Dogan, Zeki; Aladag, Nesim; Akbulut, Tayyar; Yurtdas, Mustafa
Background: Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in chronic kidney disease (CKD) patients. Aortic propagation velocity (APV), epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) measurements could provide additional information on assessing renal decline in CKD patients. The study aimed to evaluate EFT, AVP and CIMT in CKD patients and then investigate the association among those parameters.Methods: A total of 170 CKD consecutive subjects were enrolled in the study. Patients were divided into five groups according to their estimated glomerular filtration rate (eGFR) values. Each patient underwent complete transthoracic echocardiography examination. APV, EFT and CIMT were measured for analyses. A multivariate linear regression model was used for analysis to determine the independent predictors of eGFR.Results: The lowest APV was observed in stage IV-V, and the highest APV was observed in stage I-II (P < 0.001). Stage IV-V patients had the highest EFT and stage I-II patients had the lowest EFT (P < 0.001). Moreover, the lowest CIMT was observed in stage III, and the highest CIMT was observed in stage V (P < 0.001). eGFR was significantly and positively correlated with APV and negatively correlated with EFT and CIMT. In multivariate analyses, APV (odds ratio (OR): 0.289, P < 0.001), EFT (OR:-0.135, P < 0.001) and CIMT (OR: -0.388, P < 0.001) were independent predictors of eGFR.Conclusion: We found that APV decreased, and EFT and CIMT increased as CKD progress. The present study suggests that APV, EFT and CIMT might be incorporated with the examination of CKD patients in daily practice.
Association of Heart Rate Recovery With Microalbuminuria in Non-Obstructive Coronary Artery Disease
(Elmer Press inc, 2017) Yurtdas, Mustafa; Ozdemir, Mahmut; Aladag, Nesim; Yaylali, Yalin Tolga
Background: Non-obstructive coronary artery disease (CAD) is associated with significantly increased risk for myocardial infarction. Heart rate recovery (HRR), a measure of autonomic function, is a strong predictor of all-cause mortality. Microalbuminuria, a marker of early arterial disease, is an independent risk factor for cardiovascular disease and mortality. We aimed to investigate HRR and determine its relationship with microalbuminuria in patients with non-obstructive CAD. Methods: We prospectively studied 565 patients who underwent elective coronary angiography. All participants underwent urinary analysis and then an exercise test. Microalbuminuria was defined as an urinary albumin-to-creatinine ratio (UACR) of 30 -299 mg/g. The HRR was abnormal if <= 12 beats/min during the first minute after exercise. First, all patients were divided into two groups, patients with microalbuminuria (n = 152) and patients without microalbuminuria (n = 413). Then, all patients were re-divided into two groups, those with lower HRR (<= 12 beats/min, n = 126) and those with higher HRR (> 12 beats/min, n = 439). Results: Patients with microalbuminuria had lower HRR and patients with lower HRR had higher UACR. While UACR was negatively correlated with HRR in patients with microalbuminuria (r = -0.424; P < 0.001) and in patients with lower HRR (r = -0.192; P = 0.042), there was no correlation of UACR with HRR in neither patients with normoalbuminuria nor patients with higher HRR, respectively. In the all study population, there was a significant inverse association between UACR and HRR (r = -0.445, P < 0.001), and UACR independently predicted the presence of lower HRR (P < 0.001). Conclusions: Our findings showed that there was a significant inverse association between UACR and HRR in patients especially with microalbuminuria, and that albuminuria might predict cardiac autonomic imbalance evaluated by HRR in patients with non-obstructive CAD.
Cardiovascular Drugs and Analysis of Potential Risk Factors Associated With Mortality in Severe Coronavirus Disease 2019 Patients
(Assoc Medica Brasileira, 2022) Atabey, Rukiye Derin; Aladag, Nesim; Sipal, Abdulcebbar; Akbulut, Tayyar; Dogan, Zeki; Ozdemir, Mahmut
OBJECTIVES: Cardiovascular diseases are also considered to increase the risk of death in COVID-19 patients. However, real-world data concerning the risk factors for death in patients with severe COVID-19 still remain vague. This study aimed to identify the potential risk factors associated with mortality in severe COVID-19 patients. METHODS: All consecutive patients admitted to the intensive care unit (ICU) of our institute for COVID-19 for severe COVID-19 pneumonia from April 1, 2020 to July 20, 2020 were included in the analysis. Patient characteristics, including complete medical history and comorbid diseases, blood test results during admission and on day 7, and clinical characteristics were compared between survivors and nonsurvivors. RESULTS: There was no significant difference between survivors and nonsurvivors regarding age, gender, and preexisting cardiovascular diseases. Moreover, the rate of the medications including angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blockers did not differ between survivors and nonsurvivors. The peak C-reactive protein (CRP), procalcitonin, fibrinogen, and D-dimer levels and the rate for chronic renal failure were significantly higher in nonsurvivors compared with survivors. Intubated patients had a higher risk of death than the others had. CONCLUSIONS: This study failed to demonstrate a significant difference in preexisting cardiovascular diseases and cardiovascular medications between survivors and nonsurvivors who were admitted to ICU for severe COVID-19. Our findings indicate that the presence of chronic renal failure, a high peak ferritin concentration, and the need for invasive mechanical ventilation appear predictive for mortality. We propose that these risk factors should be taken into account in defining the risk status of severe COVID-19 patients admitted to the ICU.
Comparison of Inflammatory Markers in Non-Dipper Hypertension Vs. Dipper Hypertension and in Normotensive Individuals: Uric Acid, C-Reactive Protein and Red Blood Cell Distribution Width Readings
(Termedia Publishing House Ltd, 2014) Tosu, Aydin Rodi; Demir, Serafettin; Selcuk, Murat; Kaya, Yuksel; Akyol, Aytac; Ozdemir, Mahmut; Tenekecioglu, Erhan
Aim: In this study, we investigated the relationship of increased inflammatory parameters (C-reactive protein - CRP), oxidative stress markers (serum uric acid -SUA) and red blood cell distribution width (RDW) with non-dipper hypertension (NDHT). Material and methods: Among the individuals who presented to the cardiology clinic, 40 patients (32.5% male, 67.5% female; mean age: 54.4+/-7.1) who had hypertension and were diagnosed with NDHT through ambulatory blood pressure monitoring, 40 age- and sex-matched dipper hypertension (DHT) patients (25% male, 75% female, mean age: 54.2+/-7.0), and 40 normotensive individuals (42.5% male, 57.5% female, mean age: 51.9+/-9.0) were enrolled in the study. Peripheral venous blood samples were collected from all the patients in order to evaluate the hematological and biochemical parameters. All the assessed parameters were compared among the groups. Results: The CRP, RDW and uric acid levels were observed to be significantly higher in the non-dipper hypertension group in comparison to the dipper hypertension patients and the normotensive population (p < 0.05). These parameters were also significantly higher in the dipper HT group compared to the normotensive population (p < 0.05). Conclusions: We found in our study that increased CRP, uric acid and RDW levels, which are indicators of increased inflammation and oxidative stress, are significantly higher in the non-dipper HT patients in comparison to the dipper HT patients and control group.
The Comparison of the Treatment Strategies Preferred in Patients With St Segment Elevated Myocardial Infarction (Thrombolytic Therapy for Life)
(Elsevier Science inc, 2013) Ozdemir, Mahmut; Yurtdas, Mustafa; Sahin, Musa; Aladag, Nesim; Karadas, Sevdegul; Babat, Naci; Gumrukcuoglu, Hasan Ali
Fibrinogen To Albumin Ratio as a Powerful Predictor of the Exaggerated Morning Blood Pressure Surge in Newly Diagnosed Treatment-Naive Hypertensive Patients
(Taylor & Francis inc, 2020) Ozdemir, Mahmut; Yurtdas, Mustafa; Asoglu, Ramazan; Yildirim, Tarik; Aladag, Nesim; Asoglu, Emin
Background The exaggerated morning blood pressure surge (MS) is a risk factor for cardiovascular diseases. Inflammation is associated with the pathogenesis of hypertension. We aimed to investigate the association between fibrinogen, albumin, fibrinogen to albumin ratio (FAR), and exaggerated MS, and which of those variables is a better predictor for identifying an exaggerated MS in newly diagnosed treatment-naive hypertensive patients. Material and Methods The study included 249 treatment-naive patients who were newly diagnosed with hypertension in both clinical and ambulatory blood pressure (BP) monitoring measurements. Morning BP was defined as the mean of BPs measured during the first 2 hours after wake-up. The lowest BP was defined as the mean of 3 BP measurements focused on the lowest nighttime computations. The MS was calculated as the morning systolic BP minus the lowest systolic BP. Fibrinogen and albumin levels were measured from venous blood. FAR was obtained by dividing the fibrinogen to the albumin. Results Patients with higher-value MS had a higher fibrinogen, FAR, and a lower albumin than those with low-value MS. MS was positively correlated with fibrinogen and FAR, and negatively correlated with albumin (for all,p< .001). Fibrinogen, albumin, and FAR were independent predictors of exaggerated MS. FAR was a more powerful predictor than fibrinogen (p< .001) and albumin (p= .02) in determining exaggerated MS. Conclusion Patients with exaggerated MS had a higher fibrinogen and FAR, and a lower albumin level than those without exaggerated MS. FAR may be a better predictor than fibrinogen and albumin for determining exaggerated MS.
Heart Rate Recovery After Exercise and Its Relation With Neutrophil-To Ratio in Patients With Cardiac Syndrome X
(Lippincott Williams & Wilkins, 2014) Yurtdas, Mustafa; Yaylali, Yalin T.; Aladag, Nesim; Ozdemir, Mahmut; Ceylan, Yemlihan; Gencaslan, Murat; Akbulut, Tayyar
Objectives The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are measures of systemic inflammation. Heart rate recovery (HRR) after exercise is influenced by autonomic function. The aim of this study was to ascertain whether HRR and the Duke Treadmill Score (DTS) values are related to NLR and PLR in patients with cardiac syndrome X (CSX). Methods A total of 350 participants were enrolled in the study. Complete blood counts and high-sensitivity C-reactive protein (hsCRP) were obtained. All participants underwent an exercise test. HRR and DTS were calculated after exercise. Abnormal HRR was defined as 12 beats/min or less. Results CSX and coronary artery disease (CAD) groups had higher NLR, PLR, and hsCRP, and lower HRR and DTS values than the control group (for all, P<0.05). In both CSX and CAD groups, HRR was positively correlated with DTS (r=0.468, P<0.001 and r=0.491, P<0.001, respectively) and negatively correlated with NLR (r=-0.519, P<0.001 and r=-0.612, P<0.001, respectively), PLR (r=-0.422, P<0.001 and r=-0.438, P<0.001, respectively), and hsCRP (r=-0.553, P<0.001 and r=-0.521, P<0.001, respectively). NLR and hsCRP were important two predictors of the presence of lower HRR in both CSX [NLR: odds ratio (OR), 0.395; 95% confidence interval (CI), 0.168-0.925; P=0.032 and hsCRP: OR, 0.748; 95% CI, 0.591-0.945; P=0.015], and CAD groups (NLR: OR, 0.115; 95% CI, 0.026-0.501; P=0.004 and hsCRP: OR, 0.637; 95% CI, 0.455-0.892; P=0.009). Conclusion CSX patients have higher NLR and PLR and slower HRR and lower DTS, similar to CAD patients, suggesting that CSX patients may be at a higher risk for developing cardiovascular events in the future. NLR may predict autonomic imbalance assessed by HRR in CSX. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
Increased Plasma High-Sensitivity C-Reactive Protein and Myeloperoxidase Levels May Predict Ischemia During Myocardial Perfusion Imaging in Slow Coronary Flow
(Elsevier Science inc, 2014) Yurtdas, Mustafa; Yaylali, Yalin Tolga; Kaya, Yuksel; Ozdemir, Mahmut
Background and Aims. It is unclear whether changes in plasma levels of inflammatory markers could explain the link between ischemia and slow coronary flow (SCF). The aim of the study was to evaluate the plasma levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, and myeloperoxidase (MPO) during myocardial perfusion imaging (MPI) in SCF patients. Methods. The study population consisted of 53 SCF patients and 30 controls. Coronary flow rates were documented by TEVII frame count (TFC). Plasma levels of hsCRP, IL-6, MPO, and MPI were obtained in all participants. Results. hsCRP, IL-6 and MPO levels of SCF patients were higher than controls (hsCRP: 4.7 +/- 2.5 vs. 1.7 +/- 1.1 mg/L, p <0.001; IL-6: 8.2 +/- 4.3 vs. 5.2 +/- 2.1 pg/mL, p <0.001;. and MPO: 75.9 +/- 59.6 vs. 24.3 +/- 16.7 ng/mL, p <0.001). Twenty-one SCF patients exhibited myocardial perfusion defect (MPD) on MPI. In SCF patients, the highest hsCRP, IL-6 and MPO levels were observed in patients with both MPD and three-vessel slow flow. Mean TFCs were positively correlated with plasma levels of hsCRP (r = 0.424, p = 0.002), IL-6 (r = 0.367, p = 0.007), MPO (r = 0.430, p = 0.001), and reversibility score (r = 0.671, p <0.001) in SCF patients. HsCRP and MPO were the independent variables, which predicted positive MPI results (hsCRP: OR, 2.176; 95% CI, 1.200-3.943; p = 0.010, MPO: OR, 1.026; 95% CI, 1.007-1.046; p = 0.008). Conclusions. Inflammation may play a crucial role in both the pathogenesis and development of ischemia in SCF. Association of increased levels of inflammatory markers and ischemia suggests that endothelial inflammation may be largely responsible for clinical presentation. New combined treatment regimens should target endothelial activation and inflammation in SCF. (C) 2014 IMSS. Published by Elsevier Inc.
Increased Plasma Hscrp and Mpo Levels May Predict Ischemia During Mpi in Slow Coronary Flow
(Elsevier Science inc, 2013) Yurtdas, Mustafa; Yaylali, Yalin Tolga; Ozdemir, Mahmut; Kaya, Yuksel; Arin, Can Baba
Increased Qt Dispersion and P Wave Dispersion in Major Depressive Disorder
(Cardiology Academic Press, 2013) Tosu, Aydin Rodi; Demir, Serafettin; Kaya, Yuksel; Selcuk, Murat; Asker, Muntecep; Ozdemir, Mahmut; Tenekecioglu, Erhan
BACKGROUND: QT and P wave dispersion parameters can indicate abnormalities in autonomic nervous system and cardiac functioning. OBJECTIVES: To determine QT and P wave dispersion in patients with major depressive disorder compared with healthy volunteers. METHODS: Fifty newly diagnosed patients with major depressive disorder and 50 age- and sex-matched healthy volunteers underwent 12-lead electrocardiography. QT interval, QT dispersion, heart rate-corrected QT dispersion and P wave dispersions were calculated manually by a blinded specialist. RESULTS: Groups were comparable in terms of age, sex, body mass index, smoking status, metabolic diseases and left ventricular ejection fraction. The major depressive disorder group had significantly higher QT dispersion (58.5 +/- 9.9 versus 41.7 +/- 3.8; P<0.001), heart rate-corrected QT dispersion (62.5 +/- 10.0 versus 45.2 +/- 4.3; P<0.001) and P wave dispersion (46.9 +/- 4.8 versus 41.5 +/- 5.1; P<0.001). CONCLUSION: Increased QT dispersion, heart-rate corrected QT dispersion and P wave dispersion in major depressive disorder patients may be indicative of autonomic imbalance and increased risk of cardiac morbidity and mortality.
Neutrophil-To Ratio May Predict Subclinical Atherosclerosis in Patients With Psoriasis
(Wiley, 2014) Yurtdas, Mustafa; Yaylali, Yalin T.; Kaya, Yuksel; Ozdemir, Mahmut; Ozkan, Ilker; Aladag, Nesim
Background: Systemic inflammation beyond the skin may provide an explanation of the increased cardiovascular risk observed in psoriasis. It was hypothesized that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are potential predictors of subclinical atherosclerosis measured by aortic velocity propagation (AVP) and carotid intima-media thickness (CIMT) in psoriasis. Methods: Fifty-one patients with psoriasis taking no antipsoriatic therapy and 37 age- and sex-matched healthy controls were prospectively enrolled. The Psoriasis Area and Severity Index (PASI) was calculated. Complete blood counts were obtained. Measurements of AVP and CIMT were performed. Results: The baseline clinical and demographic features, and white blood cell, platelet, neutrophil, lymphocyte, monocyte, and PLR were similar in both groups. NLR and high-sensitivity C-reactive protein (hs-CRP) were higher in the psoriasis group than the control group (P = 0.001, P < 0.001; respectively). The psoriasis group had lower AVP and higher CIMT values than those of controls (AVP: 48.9 +/- 18.1 vs. 64.3 +/- 14.5 cm/sec; P < 0.001, CIMT: 0.84 +/- 0.29 vs. 0.63 +/- 0.27 mm; P = 0.001, respectively). PASI was positively correlated with NLR and hs-CRP (r = 0.423, P = 0.002; r = 0.315, P = 0.024, respectively). There was an inverse association between AVP and CIMT (r = -0.749, P < 0.001). Binary logistic regression analysis demonstrated that NLR was the only variable able to predict lower AVP (= 41 cm/sec) and higher CIMT (>0.9 mm) values (P = 0.024 and 0.023; respectively). Conclusion: NLR is potentially an unrecognized predictor of subclinical atherosclerosis in patients with psoriasis. Future studies assessing the prognostic significance of NLR on cardiovascular event rates in psoriasis patients would be of great interest.
Neutrophil-To Ratio May Predict Subclinical Atherosclerosis in Patients With Psoriasis Reply
(Wiley-blackwell, 2014) Yurtdas, Mustafa; Yaylali, Yalin Tolga; Ozdemir, Mahmut; Aladag, Nesim; Ozkan, Ilker; Kaya, Yuksel
Oxidants and Antioxidants in Myocardial Infarction (Mi); Investigation of Ischemia Modified Albumin, Malondialdehyde, Superoxide Dismutase and Catalase in Individuals Diagnosed With St Elevated Myocardial Infarction (Stemi) and Non-Stemi (Nstemi)
(Soc Medical Biochemists Serbia, 2021) Aladag, Nesim; Asoglu, Ramazan; Ozdemir, Mahmut; Asoglu, Emin; Atabey, Rukiye Derin; Demir, Canan; Demir, Halit
Background: Coronary ischemia can lead to myocardial damage and necrosis. The pathogenesis of cardiovascular diseases often includes increased oxidative stress and decreased antioxidant defense. The study aimed to assess levels of ischemia modified albumin (IMA), malondialdehyde acid (MDA), superoxide dismutase (SOD), and catalase in individuals diagnosed with ST elevated myocardial infarction (STEMI) and non-STEMI. Methods: The present study prospectively included 50 STEMI patients, 55 NSTEMI patients, and 55 healthy subjects. Only patients who were recently diagnosed with STEMI or NSTEMI were included in this study. IMA, MDA, SOD, and catalase activities were measured spectrophotometrically. Significant coronary artery lesions were determined by angiography. Results: Patients with ACS had significantly greater IMA and MDA values than the healthy controls (p<0.001). Besides, patients with STEMI had IMA levels that were significantly greater than those of the patients with NSTEMI (p<0.001), while the reverse was true for MDA levels (p<0.001). The healthy controls had the highest levels of SOD and catalase levels, followed by patients with STEMI and patients with NSTEMI, respectively (p<0.001). There was a significant negative correlation among MDA and SOD with catalase levels (r = -0.771 p<0.001 MDA vs catalase; r = -0.821 p<0.001 SOD vs catalase). Conclusions: Data obtained in this study reveals that compared to healthy controls, STEMI and NSTEMI patients had increased levels of MDA and IMA and decreased levels of SOD and catalase.
The Relationship of the Degree of Coronary Stenosis and Percutaneous Coronary Revascularization With Heart Rate Recovery Index
(Elsevier Science inc, 2013) Yurtdas, Mustafa; Kaya, Yuksel; Aladag, Nesim; Ozdemir, Mahmut; Arin, Can Baba; Tuncer, Mustafa; Balci, Bahattin
Relationships Between Coronary Angiography, Mood, Anxiety and Insomnia
(Elsevier Ireland Ltd, 2015) Ozdemir, Pinar Guzel; Selvi, Yavuz; Boysan, Murat; Ozdemir, Mahmut; Akdag, Serkan; Ozturk, Fatih
The purpose of this study was to investigate and compare the anxiety, depression and insomnia levels in the pre- and post-coronary angiography in patients undergoing elective coronary angiography due to suspected coronary artery disease. This prospective cross-sectional study consisted of 120 patients consecutively underwent coronary angiogram (CAG) between January and August 2014 in Departments of Cardiology. The mean age was 57.49 (SD +/- 9.73), and 58.3% of the sample were women. The Hospital Anxiety and Depression Scale, Profile of Mood States Scale, Spielberger's State-Trait Anxiety Inventory, and Insomnia Severity Index were used. Patients were subsumed under 2 groups as normal and critical according to the presence or the absence of visually severe stenosis in at least one coronary artery. Subjects with significant stenosis had greater mean scores on depression-dejection and anger-hostility sub-scales of the POMS in the post-angiography than pre-angiography scores. We found that older age and having a physical illness significantly contributed to the risk of having significant stenosis in coronary vasculature. Subjects with severe coronary artery stenosis scored higher on depression-dejection and anger-hostility sub-scales at the post-angiography time period relative to pre-angiography scores. Trait and state anxiety levels were found to be moderate higher in both groups. (C) 2015 Elsevier Ireland Ltd. All rights reserved.