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    The effect of smoking cessation with or without bupropion on p wave duration and amplitude
    (2019) Ilke Yildirim, Duygu; Hayiroglu, Mert Ilker; Eryilmaz, Mehmet Ali
    Aim: In the current study, the impact of smoking cessation with and without bupropion usage on p wave duration and p wave amplitude in lead I has been analyzed. Bupropion, which is an atypical antidepressant with effects on both dopaminergic and noradrenergic systems, is approved in the medical treatment of smoking cessation. Several cardiac side effects have been presented when bupropion is prescribed in smoking cessation. Material and Methods: Our study has a prospective design which has planned to evaluate p wave amplitude in lead I and p wave duration changes of bupropion by comparing smoking patients (n=78) before and after bupropion usage. The patients prescribed bupropion were also compared to ex-smoker group (n=50) who quit smoking without bupropion usage in regard to p wave indices in lead I. Differences in the median values between groups were analyzed using Mann-Whitney U test. Categorical variables were analyzed by chi-square test or Fisher’s exact test. For repeated measurements, paired sample t-test and Wilcoxon signed rank tests were used to evaluate the significance of the difference in parameters with normal and skewed distribution. Results: The study included both seventy-eight (79.5% male) patients under bupropion treatment and fifty (88.2% male) patients stopped smoking without pharmacotherapy. P wave duration was notably higher when compared before and after smoking cessation with bupropion (99.0 ± 15.7 ms vs 96.2 ± 11.9ms; p<0.001). The frequency of the patients with P wave duration >120 ms was significantly higher in smoking patients. (p=0.014) The frequency of the patients with P wave duration <100 ms was significantly lower in smoking patients.(p=0.001). P wave amplitude in lead I was statistically lower in smoking patients. (p=0.001) The change in P wave duration and P wave amplitude in lead I were positively correlated with the smoking packet/year. (Rho: 0.512, p<0.001 and rho=0.408, p<0.001) Conclusion: Smoking cessation with or without bupropion was demonstrated to shorten P wave duration and increase P wave amplitude in lead I. Smoking cessation with or without bupropion have an effect to reverse atrial electrical remodeling
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    Intra-aortic balloon pump-related thrombocytopenia: Its effects on in-hospital mortality in cardiogenic shock patients
    (2019) Hayiroglu, Mert Ilker; Cinar, Tufan; Tekkesin, Ahmet Ilker
    Aim: The present study aimed to evaluate the potential role of intra-aortic balloon pump (IABP)-related thrombocytopenia in patients with cardiogenic shock (CS) due to ST elevation myocardial infarction (STEMI) dien in hospital.Material and Methods: We retrospectively included 142 consecutive CS patients who were treated with IABP support from September 2013 to March 2017 in a tertiary heart center. IABP-related thrombocytopenia was defined as a platelet count of 150.000 mm3 or a 50% or greater reduction in the platelet count from the baseline following the IABP’s insertion. In-hospital, all-cause mortality was the primary endpoint.Results: The incidence rate of thrombocytopenia was 19% (n=27 patients). In-hospital mortality was significantly higher in patients who experienced thrombocytopenia compared to those who did not [22 patients (81.5%) vs. 56 patients (48.7%), respectively; p=0.004]. In a multivariate analysis, a decline in platelet count (OR: 1.037, 95%; CI: 1.011–1.064; p=0.005) was found to be independently associated with in-hospital mortality. In a receiver operating characteristic curve analysis, the optimal cut-off value of the decline in platelet count for the prediction of in-hospital mortality was ≥ 18.2%, with a sensitivity of 60% and a specificity of 77% [area under curve (AUC): 0.70, 95%; CI:0.61–0.78; p0.001].Conclusion: In the present study, we observed that the development of thrombocytopenia during IABP support was independently associated with in-hospital mortality in CS patients.Keywords: Intra-aortic balloon pump; thrombocytopenia; cardiogenic shock; in-hospital mortality.
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    Intra-aortic balloon pump-related thrombocytopenia: Its effects on in-hospital mortality in cardiogenic shock patients
    (2019) Hayiroglu, Mert Ilker
    Aim: The present study aimed to evaluate the potential role of intra-aortic balloon pump (IABP)-related thrombocytopenia in patients with cardiogenic shock (CS) due to ST elevation myocardial infarction (STEMI) dien in hospital.Material and Methods: We retrospectively included 142 consecutive CS patients who were treated with IABP support from September 2013 to March 2017 in a tertiary heart center. IABP-related thrombocytopenia was defined as a platelet count of 150.000 mm3 or a 50% or greater reduction in the platelet count from the baseline following the IABP’s insertion. In-hospital, all-cause mortality was the primary endpoint.Results: The incidence rate of thrombocytopenia was 19% (n=27 patients). In-hospital mortality was significantly higher in patients who experienced thrombocytopenia compared to those who did not [22 patients (81.5%) vs. 56 patients (48.7%), respectively; p=0.004]. In a multivariate analysis, a decline in platelet count (OR: 1.037, 95%; CI: 1.011–1.064; p=0.005) was found to be independently associated with in-hospital mortality. In a receiver operating characteristic curve analysis, the optimal cut-off value of the decline in platelet count for the prediction of in-hospital mortality was ≥ 18.2%, with a sensitivity of 60% and a specificity of 77% [area under curve (AUC): 0.70, 95%; CI:0.61–0.78; p0.001].Conclusion: In the present study, we observed that the development of thrombocytopenia during IABP support was independently associated with in-hospital mortality in CS patients.Keywords: Intra-aortic balloon pump; thrombocytopenia; cardiogenic shock; in-hospital mortality.