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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; Yenercag, Mustafa
    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.
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    The predictive value of the shock index and modified shock index for the short-term mortality in patients with acute pulmonary embolism
    (2020) Cinar, Tufan; Oz, Ahmet; Efe, Suleyman Cagan; Altintas, Mehmet S; Ayca, Burak; Karabag, Turgut
    Aim: The purpose of the study was to examine the relationship of shock index (SI) and modified shock index (MSI) with pulmonary embolism severity index (PESI) score in predicting short-term death in acute pulmonary embolism (APE) patients. Material and Methods: This retrospective analysis included 104 consecutive patients whose APE was confirmed using computerized tomographic pulmonary angiography. For each patient, the PESI score, the SI, and the MSI were calculated. The main endpoint of the study was short-term mortality.Results: Patients based on hemodynamic status or the PESI score upon admission were allocated into high risk and non-high risk groups. We noted that SI and MSI were significantly elevated in a high risk group (1.17 ± 0.17 vs. 0.77 ± 0.17 and 1.54 ± 0.29 vs. 1.05 ± 0.21, respectively, p 0.001). In a correlation analysis, we showed that SI and MSI were significantly correlated with the PESI score for short-term mortality (r = 0.491 and r = 0.504, respectively, p 0.001). An area under curve value of SI and MSI for short-term death were 0.66 (0.52-0.79 95% CI, p = 0.022) and 0.67 (0.53-0.80 95% CI, p = 0.026) respectively.Conclusion: The present study findings demonstrated that the SI and MSI may be applicable in predicting short-death in patients with APE.
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    Usability of aortic knob width as novel clinical predictor for coronary artery disease severity before elective coronary angiography
    (2020) Efe, Suleyman Cagan; Oz, Ahmet; Yalcin, Gunisil; Karabag, Turgut
    Aim: In this study, we aimed to investigate the relationship between AKW and the severity of CAD in patients with stable CAD. Stable coronary artery disease (CAD) patients coronary artery disease severity is determined invasive coronary angiography scoring systems as SYNTAX and Gensini scores. Therefore, there is a need for noninvasive and easy to apply methods for determining the severity of the disease in stable CAD. Aortic knob width (AKW) is a measurable radiographic structure from chest X-ray.Material and Methods: The study included 168 patients with stable CAD ranging from 18 to 70 years old after exclusions criteria applied 114 patients examined. Patients grouped according to coronary artery vessel diameter narrowing above and below 70%. Patients Baseline characteristics, physical examination, medical treatments and laboratory findings recorded. The severity of CAD was evaluated by SYNTAX and Gensini scores. AKW measurement was also evaluated. Results: The two groups were statistically similar with respect to demographic properties and laboratory findings. Prior medications were similar between the groups. Furthermore percentage of diabetes mellitus and CRP levels were significantly different between groups (48.4%, 22% p:0.004 , 6.3±12, 2.4±4 p:0.049 respectively). AKW was significantly higher in group 1 compared to group 2 (41.1±6.2, 37.3±5.2; p=0.007). AKWs were correlated with Gensini and SYNTAX scores (r=0.25;p=0.007 and r=0.26;p=0.006 respectively). In a ROC analysis, the area under the curve value of AKW for CAD was 0.648 (95% CI: 0.544-0.752, p 22 were; DM (Odds ratio [OR]: 6,088, 95% CI: 1.617-22.927; P= 0.008) , AKW (OR: 1.122, 95% CI: 1.024-1.229;P= 0.013).Conclusion: To demonstrate the severity and complexity of coronary artery disease in stable coronary artery disease, noninvasive and simply calculated AKW can be used instead of invasively calculated the calculated SYNTAX and Gensini scores.