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Öğe The CHA2DS2-VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke(Wiley, 2022) Yasar, Erdogan; Akalin, Yahya; Aktas, Ibrahim; Cakmak, Tolga; Karakus, Yasin; Bayramoglu, AdilObjectives Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2-VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2-VASC score in patients with acute ischemic stroke who underwent endovascular intervention. Materials and methods A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2-VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2-VASc score was evaluated. Results CHA2DS2-VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 +/- 1.44, 5.02 +/- 1.77 p < .001). Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score >= 3 as a predictor of unsuccessful intervention with 76,6% sensitivity and 83,3% specificity, positive predictive value 50%, negative predictive value 84,6% (area under the curve [AUC]: 0.827,95% CI: 0.739-0.895, p < .001). In the multivariate analysis; atrial fibrillation ([beta] = 4.201; [CI]: 1.251-14.103, p = .020), CHA2DS2-VASc score ([beta] = 0.053; [CI]: 0.004-0.750, p = .030) were found independent predictors for unsuccessful intervention treatment. Conclusions In our study, we showed that the CHA2DS2-VASc score is associated with the success of endovascular intervention in patients with acute ischemic stroke who underwent percutaneous endovascular treatment.Öğe The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction(Sage Publications Inc, 2022) Yasar, Erdogan; Bayramoglu, Adil; Karakus, Yasin; Cakmak, TolgaEarly detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age >= 75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 +/- 2.32 vs 2.15 +/- 1.79, P <.001). The Global Registry of Acute Coronary Events (GRACE) score (P = .002) and the CHA2DS2-VASc score (P < .001) were also found to be significant independent predictors for total occlusion in multiple regression analysis. A CHA2DS2-VASc score >= 3 had 68.1% sensitivity and 64.0% specificity (area under the curve (AUC): 0.657, 95% CI: 0.585-0.725, P < .001) for predicting TO. The CHA2DS2-VASc score was an effective tool that predicted TO in patients with NSTEMI.Öğe The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With NSTEMI: Reply(Sage Publications Inc, 2022) Yasar, Erdogan; Bayramoglu, Adil; Karakus, Yasin; Cakmak, Tolga[Abstract Not Available]Öğe Evaluation of Coronary Flow Level with Mots-C in Patients with STEMI Undergoing Primary PCI(Arquivos Brasileiros Cardiologia, 2023) Cakmak, Tolga; Yasar, Erdogan; Cakmak, Esin; Tekin, Suat; Karakus, Yasin; Turkoglu, Caner; Yuksel, FurkanBackground: The protective effects of mitochondrial open reading frame of the 12S rRNA-c (MOTS-C) on cardiovascular diseases have been shown in numerous studies. However, there is little documentation of the relationship between MOTS-C and coronary blood flow in ST-segment elevation myocardial infarction (STEMI). Objective: We aimed to investigate the role of MOTS-C, which is known to have cytoprotective properties in the pathogenesis of the no-reflow phenomenon, by comparing the coronary flow rate and MOTS-C levels in patients with STEMI submitted to primary PCI. Methods: 52 patients with STEMI and 42 patients without stenosis >50% in the coronary arteries were included in the study. The STEMI group was divided into two groups according to post-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade:(i) No-reflow: grade 0, 1, and 2 and (ii) grade 3(angiographic success). A p value of <0.05 was considered significant. Results: MOTS-C levels were significantly lower in the STEMI group compared to the control group (91.9 +/- 8.9 pg/mL vs. 171.8 +/- 12.5 pg/mL, p<0.001). In addition, the Receiver Operating Characteristics (ROC) curve analysis indicated that serum MOTS-C levels had a diagnostic value in predicting no-reflow (Area Under the ROC curve [AUC]:0.95, 95% CI:0.856-0.993, p<0.001). A MOTS-C >= 84.15 pg/mL measured at admission was shown to have 95.3% sensitivity and 88.9% specificity in predicting no-reflow. Conclusion: MOTS-C is a strong and independent predictor of no-reflow and in-hospital MACE in patients with STEMI. It was also noted that low MOTS-C levels may be an important prognostic marker of and may have a role in the pathogenesis of STEMI.
