Browsing by Author "Yildirimturk, Ozlem"

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New Oral Anticoagulants-Turkey (noac-Turk): Multicenter Cross-Sectional Study
(Turkish Soc Cardiology, 2017) Altay, Servet; Yildirimturk, Ozlem; Cakmak, Huseyin Altug; Askin, Lutfu; Sinan, Umit Yasar; Besli, Feyzullah; Pehlivanoglu, Seckin
Objective: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. Methods: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study. A total of 2,862 patients from 21 different centers of Turkey under the treatment of NOACs for at least three months were included in this study. Demographic, clinical, and laboratory characteristics of study participants with their medications used were obtained through the NOAC-TURK survey database. Additional necessary medical records were obtained from electronic health records of participating centers. Results: Of the 2. 862 patients, 1.131 (39.5%) were male and the mean age was 70.3 +/- 10.2 years. Hypertension was found as the most frequent comorbidity (81%). The most common indication for NOACs was permanent atrial fibrillation (83.3%). NOACs were mainly preferred because of inadequate therapeutic range or overdose during warfarin usage. The most frequent complication was bleeding (n=217, 7.6%), and major bleeding was observed in 1.1% of the patients. Embolic events were observed in 37 patients (1.3%). Rivaroxaban and dabigatran were both more preferred than apixaban. Almost half of the patients (47.6%) were using lower doses of NOACs, which is definitely much more than expected. Conclusion: The NOAC-TURK study showed an important overview of the current NOACs treatment regimens in Turkey. Although embolic and bleeding complications were lower than or similar to previous studies, increased utilization of low-dose NOACs in this study should be considered carefully. According to the results of this study, NOACs treatment should be guided through CHA(2)DS(2)-VASc and HASBLED scores to ensure more benefit and less adverse effects in NVAF patients.
Results of a Screening Program for Diagnosis of Amyloid Cardiomyopathy Among Patients with Left Ventricular Hypertrophy: PAPCAT Cardiac Amyloidosis Turkiye Survey
(Kare Publ, 2025) Ozpelit, Ebru; Cavusoglu, Yuksel; Guler, Gamze Babur; Unlu, Serkan; Yildirimturk, Ozlem; Yilmaz, Dilek Cicek; Degertekin, Muzaffer
Background: Cardiac amyloidosis (CA) is an increasingly recognized disease. Several recent advanced imaging techniques and parameters have been introduced into the diagnosis of CA. However, the first step in using those techniques is clinical suspicion. Left ventricular hypertrophy (LVH) is the main entity in rising the suspicion of CA in routine echocardiography, although it is not a diagnosisfor CA. The aim of this study isto investigate the prevalence of CA and its subtypes and predictive value of clinical and echocardiographic red flags of CA among consecutive adult patients with LVH identified during routine echocardiographic examination in 25 tertiary institutions in T & uuml;rkiye. Methods: This was a prospective observational multicenter, national registration study. Patients with LVH (interventricular septum thickness >= 13 mm or >15 mm in those with hypertension) were screened for CA stepwise. The first step was a clinical questionnaire for the red flags of CA. Those having >= 2 red flags were further analyzed by detailed echocardiography, blood tests, Tc-pyrophosphate (PYP) bone scintigraphy, and histopathological examination if needed. Parameters associated with CA were evaluated via univariate and multivariate analyses. Wild-type transthyretin (wTTR) vs. mutant-type TTR (mTTR), CA discriminators were also evaluated in the same manner. Results: A total of 420 patients meeting these criteria were included in the study. With a standardized algorithmic approach, 27.1% (114) of patients received a CA diagnosis. Among these patients with CA, 50.8% (58) were diagnosed with immunoglobulin free chain (AL) CA, 38.6% (44) with wTTR CA, and 7% (8) with mTTR CA. Leftventricular apical sparing pattern and restrictive type LV filling on echocardiography, low QRS voltage on ECG, bilateral carpal tunnel syndrome, low blood pressure, right ventricular diameter, and an increased basal heart rate (HR) were independent predictorsfor CA diagnosis. When it comesto diagnosis of wTTR CA; advanced age (age >75), lowertroponin values, absence of pericardial effusion and absence of proteinuria were the independent predictors. Conclusion: Cardiac amyloidosis is highly prevalent in a patient population with LVH and >2 red flagswho underwent a standardized algorithmic approach, in which apical sparing, restrictive filling pattern, low QRS voltage, carpal tunnel syndrome, low blood pressure, and increased HR are the highly suggestive signs of CA. Among this pool of newly diagnosed CA patients in T & uuml;rkiye, AL-CA constituted 50.8%, wTTR CA 38.6%, and mTTR CA 7%, emphasizing that approximately 1 in 2 patients diagnosed with CA may have TTR CA.