Browsing by Author "Selcuk, Murat"

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The Association Between Whole Blood Viscosity and High Thrombus Burden in Patients With Non-St Elevation Myocardial Infarction
(Polish Cardiac Soc, 2022) Cinar, Tufan; Saylik, Faysal; Akbulut, Tayyar; Asal, Suha; Selcuk, Murat; Cicek, Vedat; Orhan, Ahmet Lutfullah
Background: Prior studies showed that patients with elevated whole blood viscosity (WBV) had a higher risk of arterial thrombosis, acute stent thrombosis, and left ventricular apical thrombus presence after acute coronary syndrome. This investigation aimed to determine the association between WBV and high thrombus burden (HTB) in non-ST elevation myocardial infarction (NSTEMI) patients treated with percutaneous coronary intervention (PCI). Methods: This retrospective cohort investigation included data from consecutive 290 NSTEMI patients who received PCI at a tertiary institution. Patients with grade 1-3 thrombus burden were categorized as having low thrombus burden (LTB) (n = 178), whereas those with grade 4-5 thrombus burden were classified as having HTB (n = 112). WBV at high shear rate (HSR) and low shear rate (LSR) were estimated using hematocrit (HTC) and total protein levels. Results: Patients with HTB had higher WBV at both LSR and HSR. In HTB patients, the frequency of infarct-related artery (IRA) reference vessel diameter, distal embolization, and no-reflow was also higher. Multivariable logistic regression models indicated that WBV at LSR (odds ratio [OR], 1.028; 95% confidence interval [CI], 1.014-1.043; P < 0.001) and HSR (OR, 1.606; 95% CI, 1.334-1.953; P < 0.001) were independent predictors of HTB in NSTEMI patients. Notably, the area under the curve value of WBV at both shear rates was greater than that of its components, including total protein and HTC. Conclusion: This is the first study showing that WBV at both shear rates is a significant predictor of HTB in NSTEMI patients.
The Association of a Precise-Dapt Score With No-Reflow in Patients With St-Segment Elevation Myocardial Infarction
(Sage Publications inc, 2022) Selcuk, Murat; Cinar, Tufan; Saylik, Faysal; Demiroz, Onder; Yildirim, Ersin
This study aimed to evaluate the association of admission PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy (PRECISE-DAPT) score with the development of no-reflow (NR) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). In this observational, retrospective study, 335 consecutive STEMI patients who were treated with primary PCI were included. We classified the study population into 2 groups: patients with a PRECISE-DAPT score <25 and those with a PRECISE-DAPT score >= 25. Overall, 30 (8.9%) patients developed NR. The mean PRECISE-DAPT score (20.03 +/- 15.32 vs 11.33 +/- 12.18; P = .005) was significantly higher in cases who developed NR. Moreover, arrhythmic complications, in-hospital shock, and in-hospital mortality rates were significantly higher in patients with a PRECISE-DAPT score >= 25 compared to those with a PRECISE-DAPT score <25. According to a multivariable analysis, the PRECISE-DAPT score was found to be independently linked with NR (odds ratio: 2.87, with P = .015). To our knowledge, these data are the first in major medical science databases to determine the relationship between the PRECISE-DAPT score and the NR phenomenon in patients with STEMI undergoing primary PCI.
Association of P Wave Dispersion and Left Ventricular Diastolic Dysfunction in Non-Dipper and Dipper Hypertensive Patients
(Turkish Soc Cardiology, 2014) Tosu, Aydin Rodi; Demir, Serafettin; Kaya, Yuksel; Selcuk, Murat; Akdag, Serkan; Isik, Turay; Akkus, Oguz
Objective: Objective of this study was to investigate the correlation between P wave dispersion and left ventricular diastolic function, which are associated with the increased cardiovascular events in patients with dipper and non-dipper hypertensive (HT). Methods: Eighty sex and age matched patients with dipper and non-dipper HT, and 40 control subject were included in this observational cross-sectional study. P wave dispersion was measured through electrocardiography obtained during the admission. The left ventricular ejection fraction was measured using the modified Simpson's rule by echocardiography. In addition, diastolic parameters including E/A rate, deceleration time (DT) and isovolumetric relaxation time (IVRT) were recorded. Independent samples Bonferroni, Scheffe and Tamhane tests and correlation test (Spearman and Pearson) were used for statistical analysis. Results: P wave dispersion was found to be significantly increased in the non-dipper than in the dipper group (56.0 +/- 5.6 vs. 49.1 +/- 5.3, p<0.001). P-max duration was found significantly higher (115.1 +/- 5.6 vs. 111.1 +/- 5.8, p=0.003) and P-min duration significantly lower (59.0 +/- 5.6 vs. 62.3 +/- 5.3, p=0.009) in the non-dippers. Correlation analysis demonstrated presence of moderate but significant correlation between P-wave dispersion and left ventricular mass index (r=0.412, p=0.011), IVRT (r=0.290 p=0.009), DT (r=0.210, p=0.052) and interventricular septum thickness (r=0.230 p=0.04). Conclusion: P wave dispersion and P Max were found to be significantly increased and P min significantly decreased in the non-dipper HT patients compared to the dipper HT patients. P-wave dispersion is associated with left ventricular dysfunction in non-dipper and dipper HT.
The Association of Serum Uric Acid/Albumin Ratio With No-Reflow in Patients With St Elevation Myocardial Infarction
(Sage Publications inc, 2023) Cinar, Tufan; Saylik, Faysal; Hayiroglu, Mert Ilker; Asal, Suha; Selcuk, Murat; Cicek, Vedat; Tanboga, Ibrahim Halil
The goal of this investigation was to explore the relationship between serum uric acid/albumin ratio (UAR) and no-reflow (NR) in ST elevation myocardial infarction (STEMI) patients (n = 838) who underwent primary percutaneous coronary intervention (pPCI). Angiographic NR was defined as thrombolysis in myocardial infarction (TIMI) flows 0, 1, and 2 in the absence of coronary spasm or dissection. NR developed in 91 (10.9%) STEMI patients. Patients with NR had higher UAR and according to multivariable logistic regression models, a high UAR was an independent risk factor for NR. The area under the curve (AUC) value of the UAR was .760 (95%CI: .720-.801) in a receiver-operating characteristics curve (ROC) assessment. Notably, the UAR AUC value was greater than that of its components: albumin (AUC: .642) and serum uric acid (AUC: .637) (P < .05 for both comparisons). The optimum UAR value in detecting NR in STEMI patients was >1.21 with a sensitivity of 82% and a specificity of 67%. This was the first study to report that the UAR was independently associated with NR in STEMI patients who underwent pPCI.
The Association of Serum Uric Acid/Albumin Ratio With the Development of Coronary Collateral Circulation in Patients With Chronic Total Occluded Coronary Arteries
(Tabriz Univ Medical Sciences & Health Services, 2023) Saylik, Faysal; Cinar, Tufan; Sarikaya, Remzi; Akbulut, Tayyar; Selcuk, Murat; Ozbek, Emrah; Tanboga, Ibrahim Halil
Introduction: Coronary collateral circulation (CCC) develops in chronic total occluded (CTO) vessels and protects the myocardium against ischemia in addition to the improvement of cardiac functions. Poor CCC is related to adverse cardiac events as well as poor prognosis. Serum uric acid/albumin ratio (UAR) has emerged as a novel marker associated with poor cardiovascular outcomes. We aimed to investigate whether there was an association between UAR and poor CCC in CTO patients. Methods: This study was comprised of 212 patients with CTO (92 with poor CCC and 120 with good CCC). All patients were graded based on Rentrop scores to poor CCC (Rentrop scores 0 and 1) and good CCC (Rentrop scores 2 and 3). Results: Poor CCC patients had higher frequencies of diabetes mellitus, triglyceride levels, Syntax and Gensini scores, uric acid, and UAR and lower lymphocyte, high-density lipoprotein cholesterol, and ejection fraction when compared to good CCC patients. UAR was an independent predictor of poor CCC in CTO patients. Furthermore, UAR had a better discriminative ability for patients with poor CCC from good CCC compared to serum uric acid and albumin. Conclusion: Based on the results of the study, the UAR could be used to detect poor CCC in CTO patients.
Association of Tp-e/Qt Ratio With Syntax Score Ii in Patients With Coronary Artery Disease
(Taylor & Francis Ltd, 2022) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Akbulut, Tayyar
Background. The SYNTAX score II (SS) is an angiographic tool, which grades the complexity of coronary artery lesions and predicts short- and long-term events. Tp-e/QT ratio is a novel electrocardiographic marker for the risk of ventricular arrhythmias. We aimed to investigate whether there was a correlation between SS and Tp-e/QT ratio.Methods. A total of 227 consecutive patients who underwent elective coronary angiography were enrolled in this study. Patients who had a lumen diameter >1.5 mm and at least % 50 diameter stenosis on coronary angiogram were determined as coronary artery disease (CAD) group, and others were identified as a control group. The SS was calculated for the CAD group, and SS >= 23 was defined as a high SS group, and SS < 23 was identified as a low SS group. Electrocardiographic indices, such as Tp-e and Tp-e/QT, were measured for all patients. A multivariable logistic regression analysis was performed with variables age, interventricular septum thickness (IVS), hypertension, and Tp-e/QT. Results. Tp-e interval and Tp-e/QT ratio were higher in the CAD group compared with the control group. Tp-e, corrected Tp-e (cTP-e) and Tp-e/QT were higher in the high SS group than in the low SS group. The cTp-e and Tp-e/QT were correlated with SS score. Age, IVS and Tp-e/QT ratio were independent predictors of high SS in the logistic regression analysis. Conclusions. Tp-e/QT ratio was an independent predictor of high SS and might be used for risk stratification in CAD patients.
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.
Comparison of Monocyte With High Density Lipoprotein Cholesterol Ratio in Dipper and Nondipper Hypertensive Patients
(Future Medicine Ltd, 2019) Selcuk, Murat; Yildirim, Ersin; Saylik, Faysal
Aim: We aimed to compare the monocyte to HDL-cholesterol ratio (MHR) of nondipper hypertension (NDHT) and dipper hypertension patients. Patients & methods: A total of 162 patients were included in the study. Patients were grouped as dipper and nondipper according to 24-h ambulatory blood pressure recordings. Results: The MHR was significantly higher in nondipper hypertension group compared with control (p < 0.001) and dipper hypertension groups (p = 0.03). MHR, hs-CRP and red-cell distribution width (RDW) were independent predictors of nondipper hypertension. Area under the curve was 0.62 (p = 0.034) for MHR and 0.61 (p = 0.012) for hs-CRP in the ROC analysis. Conclusion: MHR has elevated levels in NDHT patients. Increased levels of MHR may evaluate as increased risk of cardiovascular events in NDHT patients.
Comparison of Outcomes Between Single Long Stent and Overlapping Stents: a Meta-Analysis of the Literature
(Urban & Vogel, 2023) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Cicek, Vedat; Hayiroglu, Mert Ilker; Orhan, Ahmet Lutfullah
ObjectivesThere is no consensus on whether to treat diffuse coronary artery lesions with a single long stent (SLS) or by overlapping two or more stents (OLS). The goal of this review was to compare the outcomes of these two approaches through a meta-analysis of the literature.MethodsWe searched for relevant studies in MEDLINE, Scopus, EMBASE, Google Scholar, and the Cochrane Library. Our meta-analysis included 12 studies (n = 6414) that reported outcomes during the follow-up period.ResultsIndividuals who received OLS had a greater risk of cardiac mortality and target lesion revascularization (TLR) than those who received SLS (RR: 1.51, CI: 1.03-2.21, p = 0.03, I-2 = 0% and RR: 1.64, CI: 1.02-2.65, p = 0.04, I-2 = 38%, respectively). The fluoroscopy period in the OLS group was longer than in the SLS group (SMD: 0.35, CI: 0.25-0.46, p < 0.01, I-2 = 0%). more contrast volume was sued for the OLS group; however, there was substantial variability in the pooled analysis (I-2 = 95%). In terms of all outcomes, there were no differences between stent generation types.ConclusionIn the first meta-analysis of mainly observational data comparing OLS vs. SLS for long coronary lesions, OLS had higher rates of cardiac mortality and TLR as well as longer fluoroscopy times compared to SLS.
Coronary Artery Fistula Presenting as Unstable Angina Pectoris in Patients With Antiphospholipid Syndrome
(Hindawi Ltd, 2013) Demir, Serafettin; Yucel, Ceyhun; Tufenk, Mucahit; Tosu, Aydin Rodi; Selcuk, Murat; Bozkurt, Abdi
The cardiovascular system is one of the primary targets in patients with antiphospholipid syndrome. The valves are the most frequently affected. Atherosclerosis and coronary thrombosis are also seen. The risk of acute coronary syndrome is 10 times higher in patients with APS. We present an APS patient case who was hospitalized with acute coronary syndrome and who was later found to have coronary artery fistula.
Double Orifice Mitral Valve and Bicuspid Aortic Valve: Pieces of the Same Single Puzzle
(Hindawi Ltd, 2015) Saylik, Faysal; Mutluer, Ferit Onur; Tosu, Aydin; Selcuk, Murat
Double orifice mitral valve is a very rare congenital abnormality. Well known associations of this pathology with other congenital lesions point to a complex and central pathophysiological mechanism leading to a sequence of pathologies. These associations have long been realized and arbitrarily defined as Shone complex. We would like to present a 21-year-old patient with double orifice mitral valve associated with bicuspid aortic valve, with a brief review of the literature on possible central mechanisms leading to different subsets of congenital abnormalities involving these two.
Effect of Heroin on Right Ventricular Cardiac Performance
(Clinics Cardive Publ Pty Ltd, 2020) Selcuk, Murat; Yildirim, Ersin; Saylik, Faysal; Deniz, Ozgur; Mutluer, Ferit Onur
Objective: The aim of this study was to investigate the effects of heroin addiction. which is an important social and health problem, on right cardiac function. Methods: A total of 85 individuals were included in the study The study group comprised 45 patients smoking heroin and the control group was 40 healthy individuals with no drug addiction. Patients injecting heroin were excluded. Echocardiographic evaluation of patients using heroin was performed and compared with those in the control group. Results: The right ventricle and pulmonary artery diameters in the heroin group were found to be higher compared to the control group. The myocardial performance index (WI) was higher and more abnormal in the heroin group (0.48 +/- 0.22 vs 0.39 +/- 0.11, p < 0.05) whereas isovolumic acceleration d VA) of the right ventricle was significantly lower in the heroin group (2.92 +/- 0.69 vs 3.4 +/- 0.68 m/s(2), p < 0.01). No significant difference was observed between the groups with regard to the right ventricular ejection fraction (RVEF) (59.6 +/- 2.5 vs 60.6 +/- p = 0.08), tricuspid annular plain systolic excursion (TAPSE) (24.1 +/- 4.2 vs 24.5 +/- 2.4 mm,p = 0.7), tissue Doppler imaging S wave (TDI-S) (13.7 +/- 2.1 vs 13.8 +/- 2.1 cm/s, p = 0.86) and right ventricular fractional area change (RVFAC) (42.7 +/- 8.3 vs 43.9 +/- 3.5%, p = 0.4). Multivariate and univariate regression analyses revealed independent correlation between the pulmonary artery diameter and RVIVA, and heroin addiction. Conclusion: Heroin addiction negatively affected right ventricular function and more attention should be paid to the cardiac function of these patients.
The Effect of Number of Pregnancies on Aortic Stiffness Index, Aortic Velocity Propagation, and Epicardial Fat Thickness
(Federal Reserve Bank St Louis, 2024) Saylik, Faysal; Cinar, Tufan; Akbulut, Tayyar; Hayiroglu, Mert Ilker; Selcuk, Murat; Uzuner, Zeynep Sevde Serdaroglu; Tanboga, Ibrahim Halil
Objective: Pregnancy causes physiological, hormonal, and hemodynamic changes that affect the aortic wall dimensions and elastic properties. Multiple pregnancies increase the risk of aortic enlargement and reduce aortic elasticity. The aortic stiffness index (ASI) and aortic velocity propagation (AVP) are markers of elasticity. Additionally, epicardial fat thickness (EFT) is associated with cardiovascular risk factors. The impact of multiparity on ASI, AVP, and EFT has not been previously reported in the literature. Therefore, we aimed to investigate the association of these parameters with the number of live pregnancies in this study. Methods: A total of 410 patients were enrolled in this prospective study. Patients were divided into three groups based on the number of live births: Group 1 (n = 0, 128 patients), Group 2 (4 >= n > 0, 157 patients), and Group 3 (n >= 5, 125 patients). A linear regression analysis was conducted to investigate trend associations of ASI, AVP, and EFT between the study groups. Multiple linear regression analysis was used to evaluate the independent predictors of continuous parameters. Results: There were increasing trends in multiparity with variables such as aortic systolic (ASD) and diastolic diameters, pulmonary artery diameters, ASI, and EFT, and a decreasing trend in AVP. The number of pregnancies was strongly and positively correlated with ASI, moderately and positively correlated with EFT and ASD, and moderately and negatively correlated with AVP. Conclusion: Multiparity was independently associated with ASI, EFT, ASD, and AVP, reflecting decreased elasticity and elevated cardiovascular risk in multiparous women.
Evaluating the Systemic Immune-Inflammation Index for In-Hospital and Long-Term Mortality in Elderly Non-St Myocardial Infarction Patients
(Springer, 2022) Orhan, Ahmet Lutfullah; Saylik, Faysal; Cicek, Vedat; Akbulut, Tayyar; Selcuk, Murat; Cinar, Tufan
Introduction This investigation aimed to evaluate the predictive value of the systemic immune-inflammation index (SII) for in-hospital and long-term mortality in elderly patients with non-ST-elevation myocardial infarction (NSTEMI). Methods This retrospective investigation included 314 consecutive elderly NSTEMI patients in a tertiary center. SII is computed as (neutrophils x platelets)/lymphocytes. Based on the increased SII values, we classified the research sample into three tertile groups as T1, T2, and T3. The in-hospital and long-term mortality were defined as the primary outcomes. Results Patients in the T3 group had lower chances of survival in the in-hospital and long-term periods compared with those in the T2 and T1 groups. According to the multivariable Cox regression models, SII independently related with in-hospital (hazard ratio (HR): 1.001, 95% CI: 1.000-1.1003, p = 0.038) and long-term mortality (HR: 1.004, 95% CI: 1.002-1.006, p < 0.001). To predict long-term mortality, the optimal SII value was > 2174 with 80% sensitivity and 85.4% specificity. SII had a slightly lower but statistically non-inferior discriminative ability for long-term mortality compared with the Charlson comorbidity index (CCI) in the receiver operating characteristic curve comparison (AUC: 86.2 vs. AUC: 890, p > 0.05). Additionally, combining SII with traditional risk factors and the CCI revealed a significant improvement in C-statistics. Conclusion This investigation may be the first to demonstrate that SII is independently linked with in-hospital and long-term mortality in elderly NSTEMI patients.
Evaluation of Naples Score for Long-Term Mortality in Patients With St-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
(Sage Publications inc, 2024) Saylik, Faysal; cinar, Tufan; Selcuk, Murat; Akbulut, Tayyar; Hayiroglu, Mert Ilker; Tanboga, Ibrahim Halil
The Naples score (NS), which is a composite of cardiovascular adverse event predictors including neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, albumin, and total cholesterol, has emerged as a prognostic risk score in cancer patients. We aimed to investigate the predictive value of NS for long-term mortality in ST-segment elevation myocardial infarction patients (STEMI). A total of 1889 STEMI patients were enrolled in this study. The median duration of the study was 43 months (IQR: 32-78). Patients were divided into 2 groups according to NS as group 1 and group 2. We created 3 models as a baseline model, model 1 (baseline + NS in continuous), and model 2 (baseline + NS as categorical). Group 2 patients had higher long-term mortality rates than group 1 patients. The NS was independently associated with long-term mortality and adding NS to a baseline model improved the model performance for prediction and discrimination of long-term mortality. Decision curve analysis demonstrated that model 1 had a better net benefit probability for detecting mortality compared with the baseline model. NS had the highest contributive significant effect in the prediction model. An easily accessible and calculable NS might be used for risk stratification of long-term mortality in STEMI patients undergoing primary percutaneous coronary intervention.
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.
Machine Learning Algorithms Using the Inflammatory Prognostic Index for Contrast-Induced Nephropathy in Nstemi Patients
(Taylor & Francis Ltd, 2024) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Tanboga, Ibrahim Halil
Aim: Inflammatory prognostic index (IPI), has been shown to be related with poor outcomes in cancer patients. We aimed to investigate the predictive role of IPI for contrast-induced nephropathy (CIN) development in non-ST segment elevation myocardial infarction patients using a nomogram and performing machine learning (ML) algorithms.Materials & methods: A total of 178 patients with CIN (+) and 1511 with CIN (-) were included.Results: CIN (+) patients had higher IPI levels, and IPI was independently associated with CIN. A risk prediction nomogram including IPI had a higher predictive ability and good calibration. Naive Bayes and k-nearest neighbors were the best ML algorithms for the prediction of CIN patients.Conclusion: IPI might be used as an easily obtainable marker for CIN prediction using ML algorithms.
One-Year Outcomes of Invasively Managed Acute Coronary Syndrome Patients With Covid-19
(Mosby-elsevier, 2022) Cinar, Tufan; Saylik, Faysal; Akbulut, Tayyar; Asal, Suha; Selcuk, Murat; Cicek, Vedat; Orhan, Ahmet Lutfullah
Background: There is a limited data about the one-year outcomes of patients diagnosed with acute coronary syndrome (ACS) and coronavirus disease 2019 (COVID-19). Objectives: To assess one-year mortality of invasively managed patients with ACS and COVID-19 compared to ACS patients without COVID-19. Methods: In our investigation, we defined the study time period as April 30 through September 1, 2020. The control groups consisted of ACS patients without COVID-19 at the same time period and ACS patients prior to the pandemic, within the same months as those of the study. COVID-19 infection was confirmed in all participants utilizing real-time polymerase chain reaction testing. Results: This investigation examined 721 ACS participants in total. Among the participants, 119 patients were diagnosed with ACS and COVID-19, while 149 were diagnosed with ACS and without COVID-19. The other 453 ACS participants were diagnosed before the outbreak of the pandemic, within the same months as those of the study. One-year mortality rates were higher in the ACS participants with COVID-19 than in the ACS participants without COVID-19 and the pre-COVID-19 ACS participants (21.3% vs. 6.5% vs. 6.9%, respectively). An ACS along with COVID-19 was the only independent predictor of one-year mortality (HR=2.902, 95%Cl=1 .211-6.824, P = 0.018). According to the Kaplan-Meier survival curves, patients with ACS and COVID-19 had a lower chance of survival in the short-term and one-year periods. Conclusion: This is believed to be the first study to report that ACS patients with COVID-19 had higher one-year risk of mortality compared to ACS patients without COVID-19. (C) 2022 Elsevier Inc. All rights reserved.
The Predictive Value of the Meld-Xi Score for Short- and Long-Term Mortality in Elderly Patients With Non-St Elevation Myocardial Infarction
(Springer, 2022) Cinar, Tufan; Saylik, Faysal; Selcuk, Murat; Akbulut, Tayyar; Orhan, Ahmet Lutfullah
Background In this study, we investigated the utility of the Model for End-stage Liver Disease excluding INR (MELD-XI) score in predicting short- and long-term mortality in elderly patients with non-ST elevation myocardial infarction (NSTEMI) who underwent coronary angiography (CAG). Methods In total, we analyzed 228 elderly NSTEMI patients above the age of 75. We used the modified 5-item frailty index and the Charlson Comorbidity Index (CCI) to assess the comorbidities. The MELD-XI score was calculated using the logarithmic relationship between the serum creatinine and total bilirubin. Results The median long-term follow-up was 530 [interquartile range (IQR) = 303-817] days and the short- and long-term mortality rates were 11.8% (n = 27) and 16.4% (n = 33), respectively. Patients who did not survive had a substantially higher MELD-XI score than those who did [10.1 (IQR = 7.8-15.1) vs. 4.5 (IQR = 1.9-6.9), p < 0.001, respectively]. Multivariable Cox regression analyses indicated that the MELD-XI score predicted both short- and long-term mortality independently. When the MELD-XI score, serum creatinine, and total bilirubin area under the curve (AUC) values were compared to predict long-term mortality, the MELD-XI score had the highest value (AUC: 0.833), followed by the serum creatinine (AUC: 0.741), and the total bilirubin (AUC: 0.723). The accuracy of the MELD-XI score was further tested with the GRACE risk score, which demonstrated noninferiority. Conclusion This was the first investigation which indicated that elderly NSTEMI patients with a high MELD-XI score had poor prognosis in the short- and long-term period.
The Predictive Value of Triglyceride-Glucose Index for In-Hospital and One-Year Mortality in Elderly Non-Diabetic Patients With St-Segment Elevation Myocardial Infarction
(Science Press, 2022) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Tanboga, Ibrahim Halil
BACKGROUND Triglyceride-glucose (TyG) index, a reliable marker of insulin resistance, was associated with cardiovascular morbidity and mortality. This study aimed to evaluate the predictive value of TyG index for mortality in elderly non-diabetic patients with ST-segment elevation myocardial infarction (STEMI). METHODS In total, 430 non-diabetic patients aged over 65 years with STEMI were consecutively included. The TyG index was calculated by using the following formula: TyG index = ln (fasting triglyceride x fasting glucose/2). The 5-item modified frailty index score was utilized to determine comorbidities. Patients were divided into three groups based on TyG index tertiles. RESULTS Patients included into high TyG index tertile were male and had higher body mass index, glucose, triglyceride, low-density lipoprotein cholesterol, 5-item modified frailty index and GRACE risk score; and had low systolic blood pressure, estimated glomerular filtration rate and left ventricular ejection fraction. A one-unit increase in TyG index was associated with 3.03 extra cases per 1000 person-day for in-hospital mortality and 0.29 extra cases per 1000 person-day for long-term mortality. There was a non-linear relationship between TyG index and the risk of mortality with an increased risk above 8.5 for TyG index. KaplanMeier survival curves revealed that patients in high TyG index tertile had higher in-hospital and long-term mortality rates than those in low TyG index tertile. CONCLUSIONS This was the first study to demonstrate that the TyG index could predict in-hospital and long-term mortality in elderly non-diabetic STEMI patients.