Does negative affectivity have an association with achieving target values in hypertensive patients: primary care perspective.

OBJECTIVES: The current study aimed to seek the relationship between demographic characteristics, treatment compliance status, and type D personality characteristics to achieve target BP values. METHODS: This cross-sectional research was conducted on HT patients at three family medicine health-care services in Ankara, Turkey, between 1 February 2021, and 31 January 2022. The sociodemographic questionnaire survey, Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCHBPTS), and Type D Scale-14 (DS-14) were applied to 317 patients. HBCHBPTS consists of 14 items with three domains. DS-14 consists of 14 items assessing negative affectivity (NA) and social inhibition (SI). RESULTS: Patients with NA were less likely to achieve the SBP target values (62.20% vs 47.50, p = 0.011). NA scores were correlated with HBCHBPTS total scores and HBCHBPTS medication-taking domain scores. Living in a city center (ß = -0.157, p = 0.017), not smoking (ß = -0.114, p = 0.042), knowing the names of HT drugs (ß = - 0.152, p = 0.005), having a Mediterranean-style diet (ß = -0.182, p = 0.002), starting treatment immediately after diagnosis (ß = -0.121, p = 0.029), older age (ß = -0.164, p = 0.028), having less NA scores (ß = 0.171, p = 0.029) were effective on better treatment adherence. Variables affecting the failure to achieve the SBP target values were not being in the extended family (p = 0.022, OR: 0.337), anti-HT drug side effects (p = 0.029, OR: 2.566), higher HBCHBPTS total scores (p = 0.001, OR: 1.178), higher DBP values (p < 0.001, OR: 1.141). CONCLUSION: HBCHBPTS total and HBCHBPTS medication-taking domain indicators worsened as the NA and SI characteristics increased. Predictors, including those not living in an extended family, being affected by the side effects of anti-HT drugs, high HBCHBPTS total score, and high DBP values, were effective in failure to achieve the SBP target values.

Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience.

Objective: This study aimed to investigate the frequency of sexual dysfunction and the effect of short-term testosterone replacement therapy on sexual functions in congenital hypogonadism patients. Furthermore, we sought to reveal the consistency of the self-report scales used for the diagnosis of sexual dysfunction and the relationship between biochemical parameters. Materials and methods: The study was conducted on 47 young male patients aged above 18 years who were diagnosed with hypogonadotropic hypogonadism. Short (IIEF-5) and long (IIEF-15) forms of the International Index of Erectile Function and Arizona Sexual Experiences Scale (ASEX) were applied before treatment under the supervision of a physician. The patients' blood pressure, height, and weight were measured, and their luteinizing hormone (LH), FSH, and total testosterone levels were recorded. Patients who started their treatments were called for a follow-up checkup after 6 months. Their blood pressure, height, and weight were measured by reapplying the ASEX, IIEF-5, and IIEF-15. In addition, their LH, FSH, and total testosterone levels in the biochemical tests were rerecorded. Results: In this study, the sexual dysfunction status of patients diagnosed with hypogonadotropic hypogonadism before and after treatment was evaluated using the ASEX, IIEF-15, and IIEF-5 scales. A decrease in sexual dysfunction was observed in all three scales after treatment compared with that before treatment. The IIEF-5 and IIEF-15 scales were found to be uncorrelated in terms of the pretreatment values but were correlated in terms of the post-treatment values. Although a correlation was observed between ASEX and IIEF- 5 before treatment, no correlation was detected between ASEX and IIEF-15. After the treatment, ASEX was found to be correlated with both IIEF-5 and IIEF-15. The results of the scales indicated the correlation in all categories, except the pretreatment results of the IIEF-15 scale. Conclusion: The results of the current study demonstrated a significant improvement in the sexual function of hypogonadism patients undergoing short-term testosterone therapy. The ASEX, IIEF-5, and IIEF-15 scales used in the diagnosis and follow-up of sexual dysfunction were useful for evaluating sexual functions in hypogonadotropic hypogonadism patients.

Statin adherence in patients with high cardiovascular risk: a cross-sectional study.

OBJECTIVES: Statin adherence is an essential problem although lifetime medication is recommended especially in patients with high cardiovascular risk. The importance of perceived risk as a predictor of adherence among cardiology patients has not been fully explored. This study aimed to test the importance of perceived risk as a predictor of statin adherence amongst hypercholesterolemic patients to identify predictors associated with poor adherence. METHODS: This cross-sectional study was conducted at cardiology outpatient clinics of the University hospital in Ankara, Turkey. A total of 327 consecutive patients with high CV risk were recruited. Self-reported Morisky Green Levine Medication Adherence Scale was used to assess statin adherence. RESULTS: Of the patients studied, 34.5% had concerns about side effects. Also, the mean age was 63.85 ± 11.29 years, 66.1% were men, 32.4% applied non-drug alternative therapies, 53.2% had a Mediterranean-style diet and 20.8% checked their lipid values irregularly. Participants reported 50.2% high, 30% moderate, and 19.9% low statin medication adherence. Low-density lipoprotein cholesterol (LDL-C), Total Cholesterol (TC), Triglyceride (TG) and high-density lipoprotein (HDL) control rates were 44.6%, 74.3%, 61.5% and 41.6%. On multiple logistic regression, concern about side effects was associated with a statistically significant quadruple elevation of odds of non-adherence. Also, being male, former smokers, not having complementary interventions, having regular visits, being educated for more than 5 years, having low depressive symptom scores, living in a rural, being never or former smokers, employee were significant predictors of high medication adherence scores. CONCLUSION: Approximately half of the patients reported high medication adherence. Proper strategies to improve adherence would include patient education efforts focused on patients with concerns about side effects and those who are female, less educated, current smokers, interested in complementary interventions, have irregular follow-up visits, and have depressive symptoms. Brief medication adherence scales may facilitate the assessment of patients' adherence.

Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience

ABSTRACT Objective: This study aimed to investigate the frequency of sexual dysfunction and the effect of short-term testosterone replacement therapy on sexual functions in congenital hypogonadism patients. Furthermore, we sought to reveal the consistency of the self-report scales used for the diagnosis of sexual dysfunction and the relationship between biochemical parameters. Materials and methods: The study was conducted on 47 young male patients aged above 18 years who were diagnosed with hypogonadotropic hypogonadism. Short (IIEF-5) and long (IIEF-15) forms of the International Index of Erectile Function and Arizona Sexual Experiences Scale (ASEX) were applied before treatment under the supervision of a physician. The patients' blood pressure, height, and weight were measured, and their luteinizing hormone (LH), FSH, and total testosterone levels were recorded. Patients who started their treatments were called for a follow-up checkup after 6 months. Their blood pressure, height, and weight were measured by reapplying the ASEX, IIEF-5, and IIEF-15. In addition, their LH, FSH, and total testosterone levels in the biochemical tests were rerecorded. Results: In this study, the sexual dysfunction status of patients diagnosed with hypogonadotropic hypogonadism before and after treatment was evaluated using the ASEX, IIEF-15, and IIEF-5 scales. A decrease in sexual dysfunction was observed in all three scales after treatment compared with that before treatment. The IIEF-5 and IIEF-15 scales were found to be uncorrelated in terms of the pretreatment values but were correlated in terms of the post-treatment values. Although a correlation was observed between ASEX and IIEF-5 before treatment, no correlation was detected between ASEX and IIEF-15. After the treatment, ASEX was found to be correlated with both IIEF-5 and IIEF-15. The results of the scales indicated the correlation in all categories, except the pretreatment results of the IIEF-15 scale. Conclusion: The results of the current study demonstrated a significant improvement in the sexual function of hypogonadism patients undergoing short-term testosterone therapy. The ASEX, IIEF-5, and IIEF-15 scales used in the diagnosis and follow-up of sexual dysfunction were useful for evaluating sexual functions in hypogonadotropic hypogonadism patients.

Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study.

BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on hypertension management recommend new stage 1 hypertension thresholds (130-139/80-89 mmHg) for starting antihypertensive treatment. OBJECTIVE: To analyze the impact of the 2017 ACC/AHA guidelines on patients' diagnoses within daily practice, in comparison with management using the 2018 European hypertension guidelines, regarding the new thresholds. DESIGN AND SETTING: Cross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital. METHODS: The diagnosis of hypertension was defined separately using each guideline. The participants were patients who were attending the hypertension clinic, who were evaluated using the thresholds of two guidelines, based on cardiovascular risk factors, including age, gender, smoking status, diabetes mellitus, dyslipidemia, obesity, osteoporosis, chronic renal failure and family history of hypertension. RESULTS: After adapting the guidelines to the blood pressure values of our sample, 74.5% (n = 277) of the patients were diagnosed as hypertensive according to the blood pressure classification of the European Society of Cardiology (ESC) guidelines published in 2018, while 91.1% (n = 339) of the patients were hypertensive according to the new 2017 ACC/AHA guidelines. Multivariate regression analysis revealed that the significant demographic and cardiovascular risk factors associated with hypertension, based on the 2018 European Society of Hypertension (ESH)/ESC guidelines, were age (odds ratio, OR: 1.027; 95% confidence interval, CI: 1.001-1.054; P = 0.042), obesity (OR: 4.534; 95% CI: 1.830-11.237; P = 0.001) and family history of hypertension (OR: 2.199; 95% CI: 1.252-3.862; P = 0.006). CONCLUSIONS: The factors associated with the definition of hypertension may vary through changing the threshold values.

Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study

ABSTRACT BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on hypertension management recommend new stage 1 hypertension thresholds (130-139/80-89 mmHg) for starting antihypertensive treatment. OBJECTIVE: To analyze the impact of the 2017 ACC/AHA guidelines on patients' diagnoses within daily practice, in comparison with management using the 2018 European hypertension guidelines, regarding the new thresholds. DESIGN AND SETTING: Cross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital. METHODS: The diagnosis of hypertension was defined separately using each guideline. The participants were patients who were attending the hypertension clinic, who were evaluated using the thresholds of two guidelines, based on cardiovascular risk factors, including age, gender, smoking status, diabetes mellitus, dyslipidemia, obesity, osteoporosis, chronic renal failure and family history of hypertension. RESULTS: After adapting the guidelines to the blood pressure values of our sample, 74.5% (n = 277) of the patients were diagnosed as hypertensive according to the blood pressure classification of the European Society of Cardiology (ESC) guidelines published in 2018, while 91.1% (n = 339) of the patients were hypertensive according to the new 2017 ACC/AHA guidelines. Multivariate regression analysis revealed that the significant demographic and cardiovascular risk factors associated with hypertension, based on the 2018 European Society of Hypertension (ESH)/ESC guidelines, were age (odds ratio, OR: 1.027; 95% confidence interval, CI: 1.001-1.054; P = 0.042), obesity (OR: 4.534; 95% CI: 1.830-11.237; P = 0.001) and family history of hypertension (OR: 2.199; 95% CI: 1.252-3.862; P = 0.006). CONCLUSIONS: The factors associated with the definition of hypertension may vary through changing the threshold values.

Does the trait anxiety affect the dental fear?

The aims of the present study were to evaluate possible associations between trait anxiety, dental fear and the predictors of these interactions including demographic characteristics and dental history of patients applied to the dental care center in Ankara, Turkey. A sample of 607 participants (mean age: 21.02 ± 2.32) responded to a Turkish version of the Modified Dental Fear Survey (MDFS), the State-Trait Anxiety Inventory (STAI-T) and a questionnaire regarding previous negative dental experience. Multiple logistic regression analysis was used to identify the association between dental fear and the independent variables including trait anxiety, age groups, education level, dental visit frequency, experience and the source of dental knowledge. There was a trend for increasing in trait anxiety scores with greater levels of dental fear in a medium level of the dental fear group (OR = 1.055, 95%CI [1.025-1.086]; p < 0.001) and in a high level of the dental fear group (OR = 1.090 [1.057-1.124]; p < 0.001). Comparing to the low level of dental fear group; participants of medium dental fear level intended more likely to go to the dentist when they have a complaint instead of regularly going (odds ratio; OR = 3.177, 95%CI [1.304-7.741]; p = 0.011). Participants of high dental fear level tended to be less likely to have experienced no problem (OR = 0.476, 95%CI [0.284-0.795]; p = 0.005) than the low level of the dental fear group. We strongly indicate that higher dental fear scores have a predisposition of having high trait anxiety scores. Unpleasant dental experiences increased the risk for high dental fear levels. Patients with dental fear tended only to visit a dentist when necessary, avoiding regular visits.

General and Disease-specific Scales in Children with Asthma and their Parents.

OBJECTIVE: To investigate and compare the efficiency of general and disease-specific life quality scales in children with asthma. METHODS: Children with asthma, and their parents completed the Childhood Asthma Control Test (C-ACT), Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Pediatric Quality of Life Inventory (PedsQL), and also underwent spirometry. RESULTS: 82 children (55 males) with a median (IQR) age of 10.1 (8.9-10.5) years were included. C-ACT, PAQLQ and PedsQL child scores were significantly higher in children with controlled asthma. CONCLUSION: Quality of life in children, assessed using disease- specific quality of life measures, is better for children with good asthma control.

Does the trait anxiety affect the dental fear?

Abstract The aims of the present study were to evaluate possible associations between trait anxiety, dental fear and the predictors of these interactions including demographic characteristics and dental history of patients applied to the dental care center in Ankara, Turkey. A sample of 607 participants (mean age: 21.02 ± 2.32) responded to a Turkish version of the Modified Dental Fear Survey (MDFS), the State–Trait Anxiety Inventory (STAI-T) and a questionnaire regarding previous negative dental experience. Multiple logistic regression analysis was used to identify the association between dental fear and the independent variables including trait anxiety, age groups, education level, dental visit frequency, experience and the source of dental knowledge. There was a trend for increasing in trait anxiety scores with greater levels of dental fear in a medium level of the dental fear group (OR = 1.055, 95%CI [1.025–1.086]; p < 0.001) and in a high level of the dental fear group (OR = 1.090 [1.057–1.124]; p < 0.001). Comparing to the low level of dental fear group; participants of medium dental fear level intended more likely to go to the dentist when they have a complaint instead of regularly going (odds ratio; OR = 3.177, 95%CI [1.304–7.741]; p = 0.011). Participants of high dental fear level tended to be less likely to have experienced no problem (OR = 0.476, 95%CI [0.284–0.795]; p = 0.005) than the low level of the dental fear group. We strongly indicate that higher dental fear scores have a predisposition of having high trait anxiety scores. Unpleasant dental experiences increased the risk for high dental fear levels. Patients with dental fear tended only to visit a dentist when necessary, avoiding regular visits.

Impact of predictors upon the reduction of lipid parameters in family medicine practice.

CONTEXT AND OBJECTIVE: To evaluate predictors of changes in lipid parameters consisting of LDL-C (low-density lipoprotein cholesterol), TC (total cholesterol) and non-HDL-C (non-high density lipoprotein cholesterol) among primary care patients. DESIGN AND SETTING: Retrospective study conducted on family medicine patients. METHODS: Demographic features and other clinically relevant information were abstracted from medical records. The primary outcome was the difference in LDL-C level from initial testing to the index test. Secondary outcomes were the changes in TC and non-HDL-C levels between two measurements. RESULTS: Three hundred and eleven participants were included in the final secondary analysis. Multiple linear regression revealed that male patients (ß = 4.97, P = 0.040), diabetes (ß = 9.75, P = 0.003) and higher LDL-C levels at baseline (ß = 0.35, P < 0.001) were positively associated with LDL variance, whereas longer time period (ß = -0.15, P = 0.045) and familial hypercholesterolemia history (ß = -7.56, P = 0.033) were negatively associated. Male patients (ß = 8.45, P = 0.002), DM (ß = 9.26, P = 0.011), higher TC levels at baseline (ß = 0.35, P < 0.001) and taking statins (ß = 7.31, P = 0.023) were positively associated with TC variance, whilst longer time period (ß = -0.183, P = 0.031) and familial hypercholesterolemia (ß = -10.70, P = 0.008) were negatively associated. CONCLUSION: In the present study, patients who were male, on statin treatment, diagnosed with diabetes and had higher baseline lipid values were more likely associated with better lipid outcomes at future testing.

Impact of predictors upon the reduction of lipid parameters in family medicine practice / Impacto de preditores da redução dos parâmetros de lipídios na prática da medicina de família

ABSTRACT CONTEXT AND OBJECTIVE: To evaluate predictors of changes in lipid parameters consisting of LDL-C (low-density lipoprotein cholesterol), TC (total cholesterol) and non-HDL-C (non-high density lipoprotein cholesterol) among primary care patients. DESIGN AND SETTING: Retrospective study conducted on family medicine patients. METHODS: Demographic features and other clinically relevant information were abstracted from medical records. The primary outcome was the difference in LDL-C level from initial testing to the index test. Secondary outcomes were the changes in TC and non-HDL-C levels between two measurements. RESULTS: Three hundred and eleven participants were included in the final secondary analysis. Multiple linear regression revealed that male patients (β = 4.97, P = 0.040), diabetes (β = 9.75, P = 0.003) and higher LDL-C levels at baseline (β = 0.35, P < 0.001) were positively associated with LDL variance, whereas longer time period (β = -0.15, P = 0.045) and familial hypercholesterolemia history (β = -7.56, P = 0.033) were negatively associated. Male patients (β = 8.45, P = 0.002), DM (β = 9.26, P = 0.011), higher TC levels at baseline (β = 0.35, P < 0.001) and taking statins (β = 7.31, P = 0.023) were positively associated with TC variance, whilst longer time period (β = -0.183, P = 0.031) and familial hypercholesterolemia (β = -10.70, P = 0.008) were negatively associated. CONCLUSION: In the present study, patients who were male, on statin treatment, diagnosed with diabetes and had higher baseline lipid values were more likely associated with better lipid outcomes at future testing.

RESUMO CONTEXTO E OBJETIVO: Avaliar preditores de alterações nos parâmetros lipídicos que consistem em LDL-C (colesterol de lipoproteína de baixa densidade), TC (colesterol total) e não HDL-C (não colesterol de lipoproteína de alta densidade) entre os pacientes de cuidados primários. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo realizado em pacientes de medicina familiar. MÉTODOS: Aspectos demográficos e outras informações clinicamente relevantes foram extraídos dos prontuários médicos. O desfecho primário foi a diferença de nível de LDL-C entre os exames iniciais e o exame índice. Os desfechos secundários foram as mudanças dos níveis de TC e não HDL-C entre as duas medidas. RESULTADOS: Trezentos e onze participantes foram incluídos na análise secundária final. Regressão linear múltipla revelou que os pacientes do sexo masculino (β = 4,97, P = 0,040), diabetes (DM) (β = 9,75, P = 0,003) e níveis de LDL mais elevados no início do estudo (β = 0,35, P < 0,001) foram associados positivamente com variância LDL, enquanto longo período de tempo (β = -0,15, P = 0,045) e história hipercolesterolemia familiar (β = -7,56, P = 0,033) foram associados negativamente. Pacientes do sexo masculino (β = 8,45, P = 0,002), com DM (β = 9,26, P = 0,011), níveis elevados de CT na linha de base (β = 0,35, P < 0,001) e tomar estatinas (β = 7,31, P = 0,023) associaram-se positivamente com a variância TC, enquanto longo período de tempo (β = -0,183, P = 0,031), hipercolesterolemia familiar (β = -10,70, P = 0,008) foram associados negativamente. CONCLUSÕES: No presente estudo, os pacientes que eram do sexo masculino, em tratamento com estatinas, com diagnóstico de DM e que tinham valores lipídicos basais mais elevados foram mais provavelmente associados a melhores resultados de lipídios em testes futuros.

Serum Pentraxin-3 Level in Patients Who Underwent Coronary Angiography and Relationship with Coronary Atherosclerosis.

OBJECTIVES: To evaluate the role of pentraxin-3 (PTX-3) in determining the presence and severity of coronary atherosclerosis in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: Ninety-five patients (77 males and 18 females) who underwent elective coronary angiography were enrolled in this study. Patients with heart failure, renal failure, diabetes and thyroid disease were excluded. The study population was divided into 3 groups: individuals with normal coronary arteries, patients with critical CAD (n = 35) and patients with noncritical CAD (n = 36). The association of PTX-3 levels with the presence and severity of CAD and the number of involved vessels were analyzed. RESULTS: The mean age was 53.40 ± 10.25 years. The PTX-3 levels were significantly higher in patients with CAD than without CAD (146.48 ± 48.52 vs. 109.83 ± 49.06 pg/ml, p < 0.001). A statistically significant difference was found among the 3 groups regarding the severity of CAD (165.66 ± 49.10, 127.83 ± 40.51 and 109.83 ± 49.06 pg/ml, p < 0.001, respectively). The serum PTX-3 levels in normal arteries were 110.4 ± 48.11 pg/ml, in single-vessel disease 132.35 ± 32.96 pg/ml, in 2-vessel disease 142.57 ± 55.88 pg/ml, in 3-vessel disease 156.07 ± 50.53 pg/ml, and in 3-vessel disease 160.50 ± 30.41 pg/ml. After adjusting for baseline confounders, older age (OR = 1.107, 95% CI = 1.027-1.193, p = 0.008) and higher PTX-3 levels (OR = 1.017, 95% CI = 1.003-1.032, p = 0.021) were detected as significant predictors for the presence of CAD. CONCLUSIONS: Higher PTX-3 levels were associated with the presence of CAD and its increased severity in clinically stable patients. Higher PTX-3 levels may be regarded as a novel diagnostic predictor and may offer therapeutic options in the clinic.

The Prevalence and Sociodemographic Risk Factors of Enuresis Nocturna among Elementary School-age Children.

INTRODUCTION AND AIM: Many etiological reasons are blamed for enuresis nocturna (EN). The aim of this study was to research prevalence and severity of EN among elementary school-age children and sociodemographic risk factors related to it. MATERIALS AND METHODS: The study was performed in three elementary schools in Ankara, Turkey between January and May 2011. It was planned to have 2500 students of 6-14 ages in the study. The questionnaire, which consisted of questions, aiming to evaluate the EN condition of participants and their characteristics, were distributed to the parents. It was observed that 2314 participants' questionnaires (92.56%) were in accordance with evaluation criteria. STATISTICAL ANALYSIS: The relation between EN and the sociodemographic factors was evaluated through Chi-square test and logistic regression analysis. RESULTS: The mean age of 2314 participants was 9.21 ± 2.08. 48.5% (n = 1123) of the students were male and 51.5% (n = 1191) were female. While the general EN prevalence was 9.9% (n = 230); 10.7% (n = 120) for males, as 9.2% (n = 110) for females. Statistical significant difference was determined between the two groups, with EN and without EN, regarding age groups (P < 0.001), education level of parents (P < 0.001, P < 0.001), and the number of sibling (P = 0.002), income level (P < 0.001), and positive family history (P < 0.001). However, logistic regression analysis revealed that there was a significant difference only between EN and age groups (odds ratio [OR] =4.42, P < 0.001), education level of mother (OR = 2.13, P = 0.017) and family history (OR = 0.12, P < 0.001). CONCLUSIONS: As a consequence, such factors as age groups, education level of parents, positive family history could be accepted as a risk of concerning EN. It is important to perform a detailed evaluation on population, carrying risk of having EN.

Comparison of estimated GFR equations based on serum cystatin C alone and in combination with serum creatinine in patients with coronary artery disease.

OBJECTIVE: Several new equations (GFRCKD-EPI-cr, GFRCKD-EPI-CysC, GFRCKD-EPI Cr+CysC) are used for the calculation of estimated GFR (eGFR) to evaluate renal function. These equations explicitly demonstrate the association of coronary artery disease (CAD) and severe renal impairment cases. However, these equations are considered insufficient to explain the relation with normal or mildly impaired eGFR and CAD. Our hypothesis was to indicate the inversely proportional relationship of eGFR values, calculated by the different equations, with the presence of CAD in patients with normal or mildly impaired renal function. METHODS: Eighty-eight patients who underwent elective coronary angiographic intervention were enrolled into the study. The study population was divided into two groups based on angiographic documents: patients with normal coronary arteries (CAD-) and patients with CAD (CAD +). These patients were stable and decided to implement angiography for the purpose of suspicion about CAD and control. Since it is thought that eGFR equations based on creatinine are inadequate to determine chronic kidney disease (CKD) and overestimate CKD diagnosis, cystatin C-based equations are considered an alternative. Due to the potential effects of inflammatory events of the markers used in equations, patients with diabetes mellitus, severe CKD, and inflammatory bowel disease were excluded from the study. RESULTS: The average age of all participants was 51.93±9.31 (32-65 years); 80.7% (n=71) was male. A statistical difference was found between the CAD (-) group and the CAD (+) group in terms of the variables of age (45.46±8.48 vs. 54.95±8.11, p<0.001), gender (67.9% vs. 86.7%, male, p=0.037), cystatin C values (1.37±0.34 vs. 0.85±0.39, p<0.001), and GFR equations defined by the Chronic Kidney Disease Epidemiology: GFRCKD-EPI-cr (85.86±14.20 vs. 79.45±10.25, p=0.018), GFRCKD-EPI-CysC (58.61±21.87 vs. 100.82±32.00, p<0.001), and GFRCKD-EPI Cr+CysC (68.29±13.49 vs. 90.75±18.34, p<0.001). After adjustment of the variables in multiple regression analyses, only age (OR, 1.199; 95% CI, 1.077 to 1.335, p=0.001), gender (OR, 8.252; 95% CI, 0.223 to 55.659, p=0.030), and the GFRCKD-EPI-CysC equation (OR, 1.059; 95% CI, 1.028 to 1.090, p<0.001) were detected as predictors for presence of CAD. CONCLUSION: GFR equations based on cystatin C or combined with creatinine may have superiority to GFR equations based on creatinine alone in CAD patients. However, the impact of different variables on the GFRCKD-EPI-CysC equation should not be ignored in specific groups, such as CAD.

Simulated application of US cardiology guidelines for statin use to hospital patients in Turkey.

OBJECTIVES: Simulate the application of the new cardiology prevention guideline on statin use in an angiography clinic sample taken from a hospital in Turkey. METHODS: Taking statins was used as a quality indicator. All cases (323) included in the sample met criteria for taking statins upon arrival in the angiography clinic. The study population was divided into 3 groups: critical coronary artery disease (CAD) (>50%), noncritical (<50%), or individuals with normal coronary arteries. Patient risk factors were tested for association with taking statins using multiple logistic regression analysis. RESULTS: Only 20.2% of patients were taking statins when they were accepted for coronary angiography. Patients with critical CAD and noncritical CAD had higher odds of receiving statins than persons with no CAD [odds ratio (OR)=12.9, P<.001 and OR=3.5, P=.025, respectively]. Patients receiving angiographic interventions for stent control were more likely to be on statins than patients with angina (OR=5.298, P=0.004). Compared to those not taking the treadmill test, both those with positive and those with negative results had reduced odds of receiving statins (OR=0.260, P=.002, and OR=0.130, P=.002, respectively). Both former and current smokers had lower odds of receiving statins than persons who had never smoked (OR=0.148, P<.001, and OR=0.161, P=.001). Patients taking aspirin were at risk of not being on statins (OR=0.238, P = .001). CONCLUSIONS: Most of the patients in this study were not taking statins comparing according to US guidelines. Patients who exhibited risk factors for a cardiovascular event but who had not been diagnosed with CAD were at risk for not being on statins.