Browsing by Author "Tekkesin, Ahmet Ilker"

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Digital Health Interventions in Patient Management Following Acute Coronary Syndrome: a Meta-Analysis of the Literature
(Kare Publ, 2023) Saylik, Faysal; Cinar, Tufan; Hayiroglu, Mert Ilker; Tekkesin, Ahmet Ilker
Objective: Acute coronary syndrome patients should be closely followed-up to maintain optimal adherence to medical treatments and to reduce adverse events. Digital health interventions might provide improved outcomes for patient care by providing closer follow-up, compared to standard care. Thus, in this meta-analysis, we aimed to evaluate the effect of digital health interventions on follow-up in acute coronary syndrome patients. Methods: We searched medical databases to obtain all relevant studies comparing digital health interventions with standard care in acute coronary syndrome patients. After reviewing all eligible studies, a meta-analysis was conducted with the remaining 11 randomized controlled studies and 2 non-randomized controlled studies. A modified Jadad scale and Newcastle-Ottawa scale were used to assess the quality of the publications for randomized controlled studies and non-randomized controlled studies, respectively. Results: This meta-analysis consisted of 7657 patients. The all-cause mortality rate was 49% lower in the digital health intervention cases, compared to those who received standard care [relative risk (RR) = 0.51 (0.37; 0.70), P <.01]. There was a significant decrease in systolic blood pressure in the digital health interventions group, compared to the standard care group [mean difference = -5.28 (-9.47; -1.08), P =.01]. The rate of nonadherence to anti-aggregant drugs was 69% lower in the digital health interventions than in the standard care group [RR = 0.31 (0.20; 0.46), P <.01]. Also, nonadherence rates for statin and beta-blockers were lower in the digital health interventions group. The risk of rehospitalization was observed to be 55% less in the digital health interventions patients, compared to the standard care group [RR = 0.45 (0.30; 0.67), P <.01]. Conclusion: Digital health interventions can be effective in follow-up for secondary prevention in acute coronary syndrome patients.
Incidence, Risk Factors, and Outcomes of Perioperative Acute Kidney Injury in Noncardiac and Nonvascular Surgery
(Excerpta Medica inc-elsevier Science inc, 2014) Biteker, Murat; Dayan, Akin; Tekkesin, Ahmet Ilker; Can, Mehmet M.; Tayci, Ibrahim; Ilhan, Erkan; Sahin, Gulizar
BACKGROUND: The aim of this study was to determine the incidence rate, identify the risk factors, and describe the clinical outcome of perioperative acute kidney injury (AKI) in patients undergoing noncardiac, nonvascular surgery (NCS). METHODS: A total of 1,200 adult consecutive patients undergoing NCS were prospectively evaluated. Patients with pre-existing renal dysfunction were excluded. The primary outcome of this study was perioperative AKI defined by the RIFLE (risk, injury, failure, loss of function, and end-stage kidney disease) criteria. RESULTS: Eighty-one patients (6.7%) met the AKI criteria. Multivariate analysis identified age, diabetes, revised cardiac risk index, and American Society of Anesthesiologists physical status as independent predictors of AKI. Patients with AKI had more cardiovascular (33.3% vs 11.3%, P < .001) complications and a higher in-hospital mortality rate (6.1% vs 0.9%, P = .003) compared with patients without AKI. CONCLUSIONS: Several preoperative predictors are found to be associated with AKI after NCS. Perioperative AKI is an independent risk factor for outcome after NCS. (C) 2014 Elsevier Inc. All rights reserved.
Outcome of Noncardiac and Nonvascular Surgery in Patients With Mechanical Heart Valves
(Excerpta Medica inc-elsevier Science inc, 2012) Biteker, Murat; Tekkesin, Ahmet Ilker; Can, Mehmet Mustafa; Dayan, Akin; Ilhan, Erkan; Turkmen, Funda Muserref
There is a tendency to avoid noncardiac surgery in patients with mechanical heart valves (MHVs) owing to the increased risk of perioperative thromboembolism, infective endocarditis, and bleeding. We aimed to determine the risk of cardiac and noncardiac complications in patients with MHVs who underwent noncardiothoracic, nonvascular surgery. A total of 140 patients with MHVs (77 aortic, 46 mitral, and 17 double valve) and 1,200 patients with native valves (control group) were prospectively followed up for a minimum of 3 months after noncardiothoracic and nonvascular surgery. Patients with bioprostheses were excluded. Those patients aged >18 years who underwent an elective, non-outpatient, open surgical procedure were enrolled. Subcutaneous enoxaparin 1 mg/kg, twice daily, was used as bridging anticoagulation. The demographics, co-morbidities, and preoperative (medications, echocardiographic findings, laboratory results) and postoperative data were evaluated for their association with the occurrence of perioperative adverse events. The incidence of perioperative adverse cardiovascular (10.8% vs 10.7%, p = 0.985) and non-cardiovascular (11.9% vs 11.4%, p = 0.989) events was similar in those patients with and without MHVs. Bleeding (18.6% vs 14.2%, p = 0.989), thromboembolism (3.6% vs 2%, p = 0.989), and mortality at 3 months (1.4% vs 1.3%, p = 0.825) were also similar for the 2 groups. In conclusion, with close follow-up and strict adherence to the guidelines, patients with MHVs and patients with native heart valves undergoing noncardiac and nonvascular surgery have a similar risk of mortality and morbidity. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110:562-567)
The Role of Smart Devices and Mobile Application on the Change in Peak Vo2 in Patients With High Cardiovascular Risk: a Sub-Study of the Light Randomised Clinical Trial
(Taylor & Francis Ltd, 2023) Hayiroglu, Mert Ilker; Cinar, Tufan; Hayiroglu, Selin Cilli; Saylik, Faysal; Uzun, Mehmet; Tekkesin, Ahmet Ilker
BackgroundThis investigation aims to assess the influence of a mobile application and smart devices on cardiopulmonary exercise testing (CPET) over a one-year period in individuals who have high risk for cardiovascular disease. Methods: This is a post-hoc subgroup analysis of Lifestyle Intervention Using Mobile Technology in Patients with High Cardiovascular Risk: A Pragmatic Randomised Clinical Trial (LIGHT). In the intervention plus standard care standard standard care arms, 138 and 103 patients were recruited, respectively. The 1-year VO2 measurements were adjusted to the baseline VO2 measurements as the study's endpoint. VO2 measurements were taken for each subject during the randomisation and final CPET examinations. Results The intervention plus standard care improved VO2 measurements by 1.1 (adjusted treatment effect 1.1, 95% confidence interval (CI): 0.8, 1.4, p < 0.001) compared to standard care following 1-year follow-up. Conclusion At a 1-year follow-up, the smart device and mobile application technologies increased VO2 measurements in individuals with high cardiovascular risk compared to conventional treatment alone.