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  • Küçük Resim
    Öğe
    Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)
    (2021) Ozyildiz, Ali Gokhan; Cetin, Mustafa; Ozer, Savas; Duman, Hakan; Kiris, Tuncay
    Aim: Increased serum blood urea nitrogen (BUN) level is an indicator of neurohormonal and renal dysfunction, and is associated with the major adverse cardiovascular events (MACE). Chronic total occlusion (CTO) is a typical coronary artery disease diagnosed by coronary angiography. We established and tested the hypothesis that there might be a relationship between serum BUN level and long-term prognosis in patients with CTO. Materials and Methods: The study consisted of 124 patients diagnosed with CTO. The patients were followed up for a mean of 9.2 (7.4-9.5) years, and all-cause mortality was determined. Results: Patients were divided into two groups according to mortality outcome. During the follow-up, 38 of 124 patients died. Univariate Cox analysis showed that age (p=0.002), BUN (p=0.001), and serum creatinine levels (p=0.039) were associated with mortality. BUN level (OR: 1.074; 95% CI: 1.018-1.134; p=0.009) and age (OR: 1.043; 95% CI: 1.001-1.087, p=0.043) were independently associated with mortality in multivariate Cox analysis. In the ROC analysis, the AUC values for BUN and estimated glomerular filtration rate were 0.689 (p=0.002) and 0.650 (p=0.001), respectively. When the cutoff value for BUN level was considered >16 mg/dL, the sensitivity was 68%, and the specificity was 53% (OR:1.38) to predict mortality. When the cutoff value was considered >20 mg/dL, the sensitivity diminished to 40%, while the specificity increased to 90% (OR:3.9). Conclusion: In patients with CTO, BUN level is associated with increased all-cause mortality during long-term following. This relationship is independent of renal dysfunction.
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    Relation of apolipoprotein E gene polymorphism with the severity of coronary artery disease in patients with stable ischemic heart disease
    (2021) Yilmaz, Ahmet Seyda; Duman, Hakan; Citli, Senol; Gurbak, Ismail; Kahraman, Fatih
    Aim: Atherosclerosis begins from an early age and manifests in later years as Coronary artery disease (CAD). This inflammatory process is aggravated by age, smoking, hypercholesterolemia, hypertension, diabetes mellitus, and genetic factors. We aimed to investigate which isoform of APOE is related to extensive coronary lesions in patients with stable coronary heart disease.Materials and Methods: This study was carried on single center. One hundred and ten patients diagnosed with stable coronary artery disease by coronary angiogram were enrolled consecutively. Syntax score was calculated by a tool of website calculator (www.syntax.com). According to the Syntax score, patients were split into three groups. APOE genotyping was performed through blood samples. Patients split into three groups according to the APOE genotypes: E4 (3/4 and 4/4 genotypes), E3(3/3 genotype), E2 (2/2 and 2/3 genotypes). APOE groups were compared according to baseline characteristics and syntax scores.Results: Coronary angiography and APOE genotypes of 98 patients were analyzed. 81 of patients (%82.6) had E3E3 allele; 6 of patients (%6.1) had E2E3 allele; 10 patients (%10.2) had E3E4 allele and 1 patient (%1) had E2E4 allele. Due to the contrast effect of E2 and E4 on CAD, we excluded patients with E2E4 allele from the study. Firstly, we assessed distribution of APOE genotype E2 (E2E3), E3 (E3E3 and E3E4), E4 (E3E4) within 3 groups of syntax scores. Total of 6 patients of E2 allele was at low syntax score group. 83 patients of E3 allele were at the low-risk group of syntax score. 10 patients of E3 allele were at the mid group and 4 patients were at the high-risk group of syntax score. 7 patients of E4 allele subjects were at the low-risk and 1 patient was at the high-risk group of syntax score. Compared to syntax score groups and APOE genotypes, E2 alleles were in lower syntax score group versus E3 (P=0.046) and E4 (P=0.003) alleles. However E4 alleles were in higher syntax score group versus E3 alleles (P= 0.034). The Syntax score was seemed to be lower in the E2 allele group versus E4 and E2 groups (P=0.013).Conclusion: we reported the first study that E2 allele was related with less and E4 allele was more extensity and severity of CAD in patients with stable ischemic coronary disease.