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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 atrial conduction time by P wave dispersion and tissue Doppler echocardiography in prehypertensive patients(Aves, 2010) Ermis, Necip; Acikgoz, Nusret; Yasar, Erdogan; Tasolar, Hakan; Yagmur, Julide; Cansel, Mehmet; Atas, HalilObjectives: Prehypertension is a predictor for the future development of hypertension and represents an increased risk for cardiovascular morbidity and mortality. Prolonged intra/interatrial conduction times demonstrated by P wave dispersion (PD) and tissue Doppler echocardiography (TDE) are related to the development of atrial fibrillation. The aim of this study was to evaluate atrial conduction time by PD and TDE in patients with prehypertension. Study design: In 46 prehypertensive patients (22 males, 24 females; mean age 56.5 +/- 12.3 years) and 39 normotensive healthy controls (19 males, 20 females; mean age 55.8 +/- 11.7 years), we measured P wave duration and dispersion on 12-lead electrocardiography, and atrial electromechanical coupling intervals (PA) by TDE. Results: Maximum P wave duration (Pmax) and PD were prolonged in prehypertensives compared to controls (Pmax 110.1 +/- 13.8 vs. 91.4 +/- 7.7 msec, p<0.001; PD 55.7 +/- 11.1 vs. 36.8 +/- 5.7 msec, p<0.001). Atrial PAs measured at the lateral and septal mitral annuluses were significantly delayed in the prehypertensive group (lateral PA 76.5 +/- 10.1 vs. 65.4 +/- 10.4 msec, p<0.001; septal PA 59.0 +/- 6.4 vs. 53.5 +/- 7.5 msec, p=0.002). Both interatrial (lateral PA-tricuspid PA) and intraatrial (septal PA-tricuspid PA) conduction times were delayed in the prehypertensive group (25.8 +/- 9.3 vs. 17.0 +/- 9.5 msec, p<0.001; 9.2 +/- 3.7 vs. 6.7 +/- 3.0 msec, p=0.008, respectively). Correlation analysis showed that both Pmax and PD were correlated with interatrial (r=0.38, p<0.001 and r=0.40, p<0.001, respectively) and intra-atrial (r=0.31, p=0.01 and r=0.38, p<0.001, respectively) electromechanical delays. Conclusion: Our finding of significant prolongation of atrial electromechanical coupling and PD may indicate an increased risk for the development of atrial fibrillation in prehypertensive subjects.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.Öğe Evaluation of Electrocardiographic T-peak to T-end Interval in Subjects with Increased Epicardial Fat Tissue Thickness(Arquivos Brasileiros Cardiologia, 2015) Kaplan, Ozgur; Kurtoglu, Ertugrul; Nar, Gokay; Yasar, Erdogan; Gozubuyuk, Gokhan; Dogan, Cem; Boz, Ahmet UgurBackground: The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Objective: to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio. Methods: The present study included 50 patients whose EFT thickness >= 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. Results: QTd (41.1 +/- 2.5 vs 38.6 +/- 3.2, p < 0.001) and corrected QTd (46.7 +/- 4.7 vs 43.7 +/- 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 +/- 6.3, 70.3 +/- 6.8, p < 0.001), cTp-e interval (83.1 +/- 4.3 vs. 76 +/- 4.9, p < 0.001), Tp-e/QT (0.20 +/- 0.02 vs. 0.2 +/- 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 +/- 0.01 vs. 0.18 +/- 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001). Conclusion: The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia.Öğe Left ventricular myocardial performance index in prehypertensive patients with normal coronary arteries(Lippincott Williams & Wilkins, 2017) Yasar, Erdogan; Tasolar, Hakan; Acikgoz, NusretObjectives Prehypertension, which may be the precursor of hypertension, is an important public health problem in the community. Myocardial performance index (MPI) is a noninvasive Doppler measurement of global ventricular function. Thus, our aim was to evaluate left ventricule (LV) functions with the MPI in prehypertensive patients with normal coronary artery angiography. Patients and materials Forty prehypertensive patients (21 women and 19 men), with blood pressures between 120/80 and 139/89 mmHg, and 40 normotensive controls (18 women and 22 men), with blood pressures under 120/80 mmHg, were included in the study. Patient population comprised those who underwent coronary angiography because of typical angina and had normal coronary arteries. The MPI was calculated and compared between the two groups. Results No statistically significant differences were found between the two groups in terms of age, sex, or other demographic characteristics (P > 0.05). Moreover, LV ejection fraction, late diastolic flow, deceleration time, isovolumetric contraction time, and ejection time values were not significantly different between the two groups (P > 0.05). However, early diastolic mitral inflow velocity, E/A ratio, isovolumetric relaxation, and MPI were all significantly higher in the patient group than in the control group. Conclusion The MPI was increased in prehypertensive patients. This result demonstrates that LV diastolic and systolic functions may be negatively affected in patients with prehypertension. The advantages of our method are as follows: it is simple, it does not demand special equipment, and it is not time consuming. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.Öğe Microvascular Dysfunction in Patients with Cardiac Syndrome X: Reply(Sage Publications Inc, 2023) Yasar, Erdogan; Bayramoglu, Adil[Abstract Not Available]Öğe Recurrent spontaneous dissection affecting different coronary arteries of a young female(Turkısh soc cardıology, cobancesme sanayı cad no 11, nısh ıstanbul a blok kat 8 no 47-48, yenıbosna, bahcelıevler, ıstanbul 34196, turkey, 2016) Ermis, Necip; Yasar, Erdogan; Cansel, Mehmet[Abstract Not Acailable]Öğe Systemic Immune-Inflammation Index as a Predictor of Microvascular Dysfunction in Patients With Cardiac Syndrome X(Sage Publications Inc, 2022) Yasar, Erdogan; Bayramoglu, AdilThe systemic immune inflammation index (SII; platelet count x neutrophil-lymphocyte ratio), a new marker, predicts adverse clinical outcomes in many conditions, including acute and chronic coronary syndromes, pulmonary embolism, cancers, and contrast nephropathy. The aim of this study was to determine the relationship between SII and microvascular dysfunction in patients with Cardiac Syndrome X (CSX); 105 patients with CSX and 105 patients with normal coronary arteries were included. Microvascular dysfunction was determined angiographically using myocardial blush grade (MBG) and total myocardial blush score (TMBS). We observed that the SII levels were higher in the CSX (+) group (687 [355-2211] vs 418 [198-1614], P<.001). The SII levels were also found to be significant independent predictors for CSX in multiple regression analysis (P=.001). SII levels >440 had 83.8% sensitivity and 55.2% specificity (area under the curve [AUC]: .923, 95% CI: .895-.999, P<.001) for predicting CSX. There is a significant correlation between SII levels and CSX.
