Browsing by Author "Tanboga, Ibrahim Halil"

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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.
Development and Validation of Nomogram Based on the Systemic-Immune Inflammation Response Index for Predicting Contrast-Induced Nephropathy in St-Elevation Myocardial Infarction Patients
(Sage Publications inc, 2024) Saylik, Faysal; Cinar, Tufan; Sarikaya, Remzi; Tanboga, Ibrahim Halil
Contrast-induced nephropathy (CIN) is a prominent complication of ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (pPCI). The systemic immune inflammation response index (SIIRI) is a novel inflammatory marker developed by multiplying the monocyte count by the systemic immune inflammation index (SII) and is associated with coronary artery disease severity. We investigated the predictive ability of SIIRI for detecting CIN in STEMI patients (n = 2289) following pPCI and developed a nomogram based on SIIRI for risk stratifying. CIN was diagnosed based on an elevation in baseline creatinine levels >.5 mg/dL or 25% within 72 h after pPCI; 219 CIN (+) and 2070 CIN (-) patients were included. CIN (+) patients had higher SIIRI than CIN (-) patients and SIIRI was an independent predictor of CIN. A nomogram based on SIIRI had good calibration and discrimination abilities for predicting CIN development. SIIRI was superior to SII in discriminating CIN (+) patients. Adding SIIRI to the baseline model, which consists of age, hypertension, hemoglobin, estimated glomerular filtration rate, albumin, ejection fraction, lesion length, and pain-to-balloon time, had a higher discriminative ability and benefit in detecting CIN (+) patients than baseline model as assessed by decision curve analysis.
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.
The Effect of Prior Covid-19 Infection on Coronary Microvascular Dysfunction
(Taylor & Francis Ltd, 2022) Bilge, Onder; Cap, Murat; Kepenek, Ferat; Erdogan, Emrah; Tatli, Ismail; Ozturk, Cansu; Tanboga, Ibrahim Halil
Background Thrombolysis in Myocardial Infarction Frame Count (TFC) is an index that provides a quantitative evaluation of coronary microvascular dysfunction. In this study, we aimed to examine the effect of COVID-19 infection on TFC in patients admitted with chest pain and dyspnoea after COVID-19 disease and had abnormal findings in myocardial perfusion scintigraphy. Methods For this single-center retrospective study, patients with and without a history of COVID-19 who were underwent coronary angiography for abnormal findings in myocardial perfusion scintigraphy between January 1, 2021 and June 30, 2021 were analysed. Patients were divided into two groups as patients with COVID-19 history and those without. After exclusion criteria, patients with adequate angiographic monitoring and data were included in the study. Results A total of 210 patients, 48 with a history of COVID-19, were included in the study. The mean age was +/- 55 10 years, and 122 (58%) patients were women. In patients with a history of COVID-19, TFC was significantly higher in the LAD (p < 0.001) and LCx (p < 0.001) arteries and RCA TFC (p = 0.223) was similar in both groups. In the linear mix model, male gender (beta = 2.38, 95% CI = 1.26-3.51, p < 0.001) and history of COVID-19 (beta = 1.51, 95% CI = 0.49-2.53, p = 0.004) were significantly associated with TFC. Conclusion TFC may be elevated due to coronary microvascular dysfunction in patients with a history of COVID-19.
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.
Implications of Coronary Calcification on the Assessment of Plaque Pathology: a Comparison of Computed Tomography and Multimodality Intravascular Imaging
(Springer, 2025) Yap, Nathan Angelo Lecaros; Ramasamy, Anantharaman; Tanboga, Ibrahim Halil; He, Xingwei; Cap, Murat; Bajaj, Retesh; Bourantas, Christos V.
Objectives This study aimed to investigate the impact of calcific (Ca) on the efficacy of coronary computed coronary angiography (CTA) in evaluating plaque burden (PB) and composition with near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) serving as the reference standard. Materials and methods Sixty-four patients (186 vessels) were recruited and underwent CTA and 3-vessel NIRS-IVUS imaging (NCT03556644). Expert analysts matched and annotated NIRS-IVUS and CTA frames, identifying lumen and vessel wall borders. Tissue distribution was estimated using NIRS chemograms and the arc of Ca on IVUS, while in CTA Hounsfield unit cut-offs were utilized to establish plaque composition. Plaque distribution plots were compared at segment-, lesion-, and cross-sectional-levels. Results Segment- and lesion-level analysis showed no effect of Ca on the correlation of NIRS-IVUS and CTA estimations. However, at the cross-sectional level, Ca influenced the agreement between NIRS-IVUS and CTA for the lipid and Ca components (p-heterogeneity < 0.001). Proportional odds model analysis revealed that Ca had an impact on the per cent atheroma volume quantification on CTA compared to NIRS-IVUS at the segment level (p-interaction < 0.001). At lesion level, Ca affected differences between the modalities for maximum PB, remodelling index, and Ca burden (p-interaction < 0.001, 0.029, and 0.002, respectively). Cross-sectional-level modelling demonstrated Ca's effect on differences between modalities for all studied variables (p-interaction <= 0.002). Conclusion Ca burden influences agreement between NIRS-IVUS and CTA at the cross-sectional level and causes discrepancies between the predictions for per cent atheroma volume at the segment level and maximum PB, remodelling index, and Ca burden at lesion-level analysis. Clinical relevance statement Coronary calcification affects the quantification of lumen and plaque dimensions and the characterization of plaque composition coronary CTA. This should be considered in the analysis and interpretation of CTAs performed in patients with extensive Ca burden. Key Points Coronary CT Angiography is limited in assessing coronary plaques by resolution and blooming artefacts. Agreement between dual-source CT angiography and NIRS-IVUS is affected by a Ca burden for the per cent atheroma volume. Advanced CT imaging systems that eliminate blooming artefacts enable more accurate quantification of coronary artery disease and characterisation of plaque morphology.
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.
Predictive Ability of Inflammatory Markers on In-Hospital Outcomes in Patients Admitted To Coronary Care Unit (morcor-Turk Inflame)
(Sage Publications inc, 2024) Kumet, Omer; Ozgeyik, Mehmet; Topuz, Sahin; Tascanov, Mustafa Begenc; Dindas, Ferhat; Sahin, Irfan; Tanboga, Ibrahim Halil
We investigated the prognostic implications of the systemic immune-inflammatory index (SII), atherogenic index of plasma (AIP), C-reactive protein/albumin ratio (CAR), neutrophil-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and triglyceride/glucose index (TGI) in the MORtality predictors in the CORonary Care Units in TURKey (MORCOR-TURK) population. This is the largest registry of coronary care unit (CCU) patients in Turkey (3157 patients admitted to CCU in 50 different centers). The study population was divided into two according to in-hospital survival status; 137 patients (4.3%) died in-hospital follow-up. A significant correlation was found between death and SII, CAR, NLR, and PNI but not for AIP and TGI in logistic regression. In Model 1 (combining parameters proven to be risk predictors), the -2 log-likelihood ratio was 888.439, Nagelkerke R2 was 0.235, and AUC (area under curve) was 0.814 (95% CI: 0.771-0.858). All other models were constructed by adding each inflammatory marker separately to Model 1. Only Model 3 (CAR + Model 1) had a significantly greater AUC than Model 1 (DeLong P = .01). Our study showed that CAR, but not other inflammatory index, is a significant predictor of in-hospital mortality in CCU patients when added to proven risk predictors.
The Predictive Value of the Inflammatory Prognostic Index for Detecting No-Reflow in St-Elevation Myocardial Infarction Patients
(Arquivos Brasileiros Cardiologia, 2024) Saylik, Faysal; Cinar, Tufan; Tanboga, Ibrahim Halil
Background: No-reflow (NR) is characterized by an acute reduction in coronary flow that is not accompanied by coronary spasm, thrombosis, or dissection. Inflammatory prognostic index (IPI) is a novel marker that was reported to have a prognostic role in cancer patients and is calculated by neutrophil/lymphocyte ratio (NLR) multiplied by C -reactive protein/albumin ratio. Objective: We aimed to investigate the relationship between IPI and NR in ST -segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Methods: A total of 1541 patients were enrolled in this study (178 with NR and 1363 with reflow). Lasso panelized shrinkage was used for variable selection. A nomogram was created based on IPI for detecting the risk of NR development. Internal validation with Bootstrap resampling was used for model reproducibility. A two-sided p-value <0.05 was accepted as a significance level for statistical analyses. Results: IPI was higher in patients with NR than in patients with reflow. IPI was non-linearly associated with NR. IPI had a higher discriminative ability than the systemic immune-inflammation index, NLR, and CRP/albumin ratio. Adding IPI to the baseline multivariable logistic regression model improved the discrimination and net-clinical benefit effect of the model for detecting NR patients, and IPI was the most prominent variable in the full model. A nomogram was created based on IPI to predict the risk of NR. Bootstrap internal validation of nomogram showed a good calibration and discrimination ability. Conclusion: This is the first study that shows the association of IPI with NR in STEMI patients who undergo pPCI.
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.
The Relationship Between Uric Acid/Albumin Ratio and Carotid Intima-Media Thickness in Patients With Hypertension
(Arquivos Brasileiros Cardiologia, 2023) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Tanboga, Ibrahim Halil
Background: Hypertension causes subendothelial inflammation and dysfunction in resulting atherosclerosis. Carotid intima-media thickness (CIMT) is a useful marker of endothelial dysfunction and atherosclerosis. The uric acid to albumin ratio (UAR) has emerged as a novel marker for predicting cardiovascular events.Objective: We aimed to investigate the association of UAR with CIMT in hypertensive patients.Methods: Two hundred sixteen consecutive hypertensive patients were enrolled in this prospective study. All patients underwent carotid ultrasonography to classify low (CIMT < 0.9 mm) and high (CIMT >= 0.9 mm) CIMT groups. The predictive ability of UAR for high CIMT was compared with systemic immune inflammation index (SII), neutrophil/ lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein/albumin ratio (CAR). A two-sided p-value <0.05 was accepted as statistically significant.Results: Patients with high CIMT were older and had higher UAR, SII, NLR, and CAR than low CIMT. Age, UAR, SII, NLR, and CAR, but not PLR, were associated with high CIMT. In multivariable analysis, age, CRP, SII, and UAR were independent predictors of high CIMT. The discrimination ability of UAR was higher than uric acid, albumin, SII, NLR, and CAR, and UAR had a higher model fit than those variables. UAR had higher additive improvement in detecting high CIMT than other variables, as assessed with net-reclassification improvement, IDI, and C-statistics. UAR was alsoConclusion: UAR might be used to predict high CIMT and might be useful for risk stratification in hypertensive patients.
Spect Myocardial Perfusion Imaging Identifies Myocardial Ischemia in Patients With a History of Covid-19 Without Coronary Artery Disease
(Springer, 2022) Cap, Murat; Bilge, Onder; Gundogan, Cihan; Tatli, Ismail; Ozturk, Cansu; Tastan, Ercan; Tanboga, Ibrahim Halil
We aimed to examine the effect of a history of COVID-19 on myocardial ischemia in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients who presented with shortness of breath and/or chest pain after recovery. For this single-center retrospective study, patients who presented at cardiology outpatient clinics and had SPECT-MPI were screened. A total of 1888 patients were included in the study, 340 of whom had a history of COVID-19. 64 patients with > 50% stenosis on coronary angiography were excluded from the study. The primary outcome of the study was abnormal MPI. In the study population, the median age was 56 (49-64 IQR) years, and 1127 (65%) of the patients were female. Abnormal MPI was detected in 77 patients (23%) in the COVID-19 group and in 244 patients (16%) in the non-COVID-19 group. After adjustment was performed for clinical predictors using Bayesian logistic regression, an important association was found between the presence of a confirmed prior COVID-19 infection and abnormal MPI (posterior median odds ratio, 1.70 [95% CrI, 1.20-2.40], risk difference, 9.6% [95% CrI, 1.8%, 19.7%]). In SPECT-MPI, ischemia rates were observed to be higher in COVID-19 group and it was found that a confirmed prior COVID-19 might predict of abnormal MPI.
Turkish Real Life Atrial Fibrillation in Clinical Practice: Traffic Study
(Kare Publ, 2024) Karabay, Can Yucel; Tasolar, Hakan; Kunak, Aysegul Ulgen; Cap, Murat; Astarcioglu, Mehmet Ali; Sen, Taner; Tanboga, Ibrahim Halil
Background: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia worldwide and is associated with an increased risk of thromboembolism, ischemic stroke, impaired quality of life, and mortality. The latest research that shows the prevalence and incidence of AF patients in Turkiye was the Turkish Adults' Heart Disease and Risk Factors study, which included 3,450 patients and collected data until 2006/07.The Turkish Real Life Atrial Fibrillation in Clinical Practice (TRAFFIC) study is planned to present current prevalence data, reveal the reflection of new treatment and risk approaches in our country, and develop new prediction models in terms of outcomes. Methods: The TRAFFIC study is a national, prospective, multicenter, observational registry. The study aims to collect data from at least 1900 patients diagnosed with atrial fibrillation, with the participation of 40 centers from Turkiye. The following data will be collected from patients: baseline demographic characteristics, medical history, vital signs, symptoms of AF, ECG and echocardiographic findings, CHADS2VASC2 and HAS -BLED (1 -year risk of major bleeding) risk scores, interventional treatments, antithrombotic and antiarrhythmic medications, or other medications used by the patients. For patients who use warfarin, international normalized ratio levels will be monitored. Follow-up data will be collected at 6, 12, 18, and 24 months. Primary endpoints are defined as systemic embolism or major safety endpoints (major bleeding, clinically relevant nonmajor bleeding, and minor bleeding as defined by the International Society on Thrombosis and Hemostasis). The main secondary endpoints include major adverse cardiovascular events (systemic embolism, myocardial infarction, and cardiovascular death), all -cause mortality, and hospitalizations due to all causes or specific reasons. Results: The results of the 12 -month follow-up of the study are planned to be shared by the end of 2023. Conclusion: The TRAFFIC study will reveal the prevalence and incidence, demographic characteristics, and risk profiles of AF patients in Turkiye. Additionally, it will provide insights into how current treatments are reflected in this population. Furthermore, risk prediction modeling and risk scoring can be conducted for patients with AF.
The Value of Systemic-Immune Inflammatory Response Index in Predicting Contrast-Induced Nephropathy in Patients With St-Elevation Myocardial Infarction
(Sage Publications inc, 2024) Saylik, Faysal; Cinar, Tufan; Sarikaya, Remzi; Tanboga, Ibrahim Halil