Van Yüzüncü Yıl Üniversitesi

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Fixed-Dose Antiplatelet Dual Combination in Patients With Coronary Artery Disease in Turkish Population: Dapt-Tr
(Arquivos Brasileiros Cardiologia, 2024) Oz, Ahmet; Toprak, Kenan; Aydin, Ertan; Sarac, Ibrahim; Dogdus, Mustafa; Opan, Selcuk; Zoghi, Mehdi
Background: Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued. Objectives: The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study. Methods: A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%. Results: Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.
Is Ejection Fraction the Best Parameter for the Assessment of Ventricular Function? Responce
(Arquivos Brasileiros Cardiologia, 2010) Gunes, Yilmaz
Obstructive Sleep Apnea Related To Rapid Eye Movement or Non-Rapid Eye Movement Sleep: Comparison of Demographic, Anthropometric and Polysomnographic Features
(Soc Brasileira Pneumologia Tisiologia, 2016) Sunnetcioglu, Aysel; Sertogullarindan, Bunyamin; Ozbay, Bulent; Gunbatar, Hulya; Ekin, Selami
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.
Relationship Between Thiol-Disulfide Balance and Idiopathic Sudden Sensorineural Hearing Loss
(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2022) Cetin, Yaser Said; Bozan, Nazim; Avci, Koray; Aslan, Mehmet; Erel, Ozcan
Introduction: Impaired cochlear perfusion is a major etiological factor in idiopathic sudden sensorineural hearing loss. Oxidative stress has been shown to be a risk factor for oxidative damage. Objectives: We investigated the role of oxidative stress in idiopathic sudden sensorineural hearing loss by comparing serum levels of oxidant and antioxidant molecules including thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin and myeloperoxidase in patients who did and did not recover after treatment. Methods: The amount of dynamic disulfide was calculated by determining half of the difference between the total thiols and native thiols. After the determination of native, total thiol, and disulfide amounts, the disulfide/total thiol percent ratio, native thiol/total thiol ratio and disulfide/native thiol percent ratio were calculated and then compared between the two groups. Additionally, clinical relationship between audiological recovery and native thiol, disulfide, disulfide/native thiol percent ratio, and disulfide/total thiol percent ratio levels was investigated. Blood samples were also analyzed for the assessment of thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels. Results: A significant difference was found between the two groups with regard to total oxidant status disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio, and native thiol/total thiol ratio levels (p = 0.001, p = 0.001, p = 0.001, p = 0.003, p = 0.001, p = 0.002, respectively). However, no significant difference was found between the two groups with regard to thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, ceruloplasmin, and myeloperoxidase levels (p > 0.05 for all). Conclusion: The results supported the common hypothesis that vascular pathologies are the primary cause of idiopathic sudden sensorineural hearing loss and that other etiological factors ultimately result in vascular pathologies. The oxidant-antioxidant and thiol-disulfide balances were impaired in the idiopathic sudden sensorineural hearing loss group.
Successful Use of Sugammadex for Caesarean Section in a Patient With Myasthenia Gravis
(Elsevier Science inc, 2017) Soyoral, Lokman; Goktas, Ugur; Cegin, Muhammed Bilal; Baydi, Volkan
Myasthenia gravis is an autoimmune disorder that is characterized by muscle weakness that fluctuates, worsening with exertion, and improving with rest. Diagnosis of myasthenia gravis is made following clinical and physical examination and is confirmed by serum immunoassays to measure autoantibody levels. Myasthenia gravis especially when associated with pregnancy is a high-risk disease, and its course is unpredictable. We described the second report about use of sugammadex after rocuronium for a caesarean delivery with myasthenia gravis, but, unlike our case that formerly was diagnosed with myasthenia gravis, the patient was extubated on postoperative successfully and we did not encounter any respiratory problems. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.
Vascular Endothelial Function in Patients With Coronary Slow Flow and the Effects of Nebivolol
(Arquivos Brasileiros Cardiologia, 2011) Gunes, Yilmaz; Gumrukcuoglu, Hasan Ali; Akdag, Serkan; Simsek, Hakki; Sahin, Musa; Tuncer, Mustafa
Background: Brachial endothelial function has been associated with coronary slow flow (CSF). Increasing blood flow to brachial artery provokes endothelium to release nitric oxide (NO) with subsequent vasodilatation. Besides its beta 1-blocker activity, nebivolol causes vasodilatation by increasing endothelial NO release. Objective: To assess the effects of nebivolol on vascular endothelial function in patients with CSF Methods: Forty-six patients with CSF and 23 individuals with normal epicardial coronary arteries were examined with transthoracic echocardiography and brachial artery ultrasonography. The patients were reevaluated two months after treatment with aspirin or aspirin plus nebivolol. Results: Patients with CSF had higher body mass index (26.5 +/- 3.3 vs. 23.8 +/- 2.8, p < 0.001), mitral inflow isovolumetric relaxation time (IVRT) (114.9 +/- 18.0 vs. 95.0 +/- 22.0 msec, p < 0.001) and lower left ventricular ejection fraction (LVEF) (63.5 +/- 3.1% vs. 65.4 +/- 2.2, p = 0.009), HDL-cholesterol (39.4 +/- 8.5 vs. 45.8 +/- 7.7 mg/dL, p = 0.003) and brachial flow-mediated dilatation (FMD) (6.1 +/- 3.9% vs. 17.6 +/- 4.5%, p < 0.001). Mere were significant correlations between FMD and the presence of CSF(r = 0.800, p < 0.001) and HDL-cholesterol (r = 0.349, p = 0.003). Among Patients with CSF, although pretreatment mean FMD values were similar (6.1 +/- 4.3% vs. 6.0 +/-,6%, p = 0.917) compared to aspirin alone group, posttreatment FMD was significantly higher in patients treated with aspirin plus nebivolol (6.0 +/- 3.5% vs. 8.0 +/- 2.9%, p = 0.047). Treatment with nebivolol was associated with a significant increase in FMD (6.0 +/- 3.6 to 8.0 +/- 2.9 %, p = 0.030) whereas treatment with aspirin alone was not. Conclusion: Endothelial function may be impaired in both coronary and brachial arteries in patients with CSF and nebivolol may be effective in the improvement of endothelial function in patients with CSF. (Arq Bras Cardiol 2011;97(4):275-280)

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