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1.
Clin Exp Hypertens ; 44(3): 263-267, 2022 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-35098816

RESUMEN

BACKGROUND AND AIM: There are conflicting results about the early administration of beta-blockers (bb) on in-hospital mortality and arrhythmias. Here, we wanted to investigate the effects of chronic bb use on in-hospital Atrial Fibrillation (AF) development in ST-Elevation Myocardial Infarction (STEMI) patients. MATERIALS AND METHODS: A total of 814 consecutive patients with STEMI were included in the study. They were divided into two groups according to whether they are using bb on admission or not. They were followed for AF development in-hospital and predictors of AF were determined by multivariable logistic regression analysis. RESULTS: Of the 814 patients, 103 (12.67%) patients were already using bb, while 711 (87.3%) were not. There were no significant differences in the frequency of AF development [3 (%2.9) vs 30 (%4.2), p = .788] between the groups. Multivariable logistic regression analysis showed that left atrial (LA) diameter is the only independent predictor of in-hospital AF development. CONCLUSIONS: Our study showed that chronic bb use does not have an effect on in-hospital AF development in STEMI patients. Nevertheless, LA diameter was found to be an independent predictor of AF.


Asunto(s)
Fibrilación Atrial , Infarto del Miocardio con Elevación del ST , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Atrios Cardíacos , Mortalidad Hospitalaria , Hospitales , Humanos , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/complicaciones , Infarto del Miocardio con Elevación del ST/tratamiento farmacológico
2.
Kardiologiia ; 62(9): 54-59, 2022 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-36206138

RESUMEN

Aim    This study evaluated the prognostic ability of the APACHE II score and compared it with inflammatory indices in patients with acute coronary syndrome (ACS).Material and Methods    A total of 525 patients with ACS were retrospectively enrolled in the study. APACHE II scores were calculated and C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammatory index (SII) were recorded. The APACHE II score was compared with inflammatory indices for predicting in-hospital mortality.Results    Univariate logistic regression (LR) analysis showed that CRP, SII, NLR, ejection fraction, chronic kidney disease, gender, and APACHE II score were significant predictors of mortality. In multiple LR analysis, the APACHE II score was found to be a solitary, significant predictor of in-hospital mortality (OR: 1.201, 95 % CI: 1.122-1.285; p<0.001). In the Receiver Operating Characteristics curve, using a cut-off point of 16.5, the APACHE II score predicted in-hospital mortality with 70.4 % sensitivity and 92.9 % specificity.Conclusion    The APACHE II score may be used as a predictor of in-hospital mortality better than inflammatory markers in ACS patients.


Asunto(s)
Síndrome Coronario Agudo , Proteína C-Reactiva , APACHE , Síndrome Coronario Agudo/diagnóstico , Mortalidad Hospitalaria , Humanos , Pronóstico , Curva ROC , Estudios Retrospectivos
3.
Int J Clin Pract ; 75(11): e14798, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34482615

RESUMEN

BACKGROUND/AIM: Permanent daylight saving time has been implemented in Turkey since 2016. The present study determines the characteristics of road traffic collisions in the short-term, trauma severity, and whether permanent daylight saving time has an impact on these parameters. MATERIALS AND METHODS: Drivers admitted because of road traffic collisions to a tertiary care university hospital emergency service two weeks before and after the transition to wintertime in 2014 and 2015 and summertime in 2015 and 2016 as well as those admitted two weeks before and after the same period with permanent daylight saving time in 2016 and 2017 wintertime and 2017 and 2018 summertime were included in the study. Trauma severity was measured using the Injury Severity Score. RESULTS: The study analysed the data of 710 patients. There was no statistically significant difference was found between admissions in the summertime and permanent daylight saving time periods in terms of gender, time of admission, week of admission, Injury Severity Score and outcome (P > .05 for all values). CONCLUSIONS: In this study, we examined the short-term effects of daylight saving time on road traffic collisions, and demonstrated that it had no impact on the number or time of admission, trauma severity and patient outcomes. More comprehensive studies covering longer periods can be performed across the country.


Asunto(s)
Accidentes de Tránsito , Heridas y Lesiones , Servicio de Urgencia en Hospital , Hospitalización , Humanos , Tiempo , Turquía/epidemiología , Heridas y Lesiones/epidemiología , Heridas y Lesiones/terapia
4.
Turk J Med Sci ; 51(2): 743-748, 2021 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-33356023

RESUMEN

Background/aim: The aim of present study was to investigate the dynamic thiol/disulfide homeostasis as oxidative stress marker in diabetic ketoacidosis (DKA). Materials and methods: A total of 77 participants consisting of 32 patients with DKA and 45 healthy volunteers were included in the study. Thiol/disulfide homeostasis (TDH) [total thiol-native thiol/disulfide changes] were measured in both groups (patient group and control group) using a brand new method developed by Erel and Neselioglu. Half of the difference between total thiol and native thiol concentrations gives the amount of disulfide bond. Results: Total thiol, native thiol, and disulfide levels in blood were found to be low. The levels of total thiol (P < 0.001) and native thiol (P < 0.001 ) were significantly lower in patients with DKA than in the control group. At the same time, the level of disulfide was nonsignificantly lower in the patient group than the control group (P = 0.388). The level of IMA was higher in the patient group than in the control group (P < 0.001). Conclusion: The total thiol, native thiol, and disulfide levels in DKA decrease in favor of oxidative stress.


Asunto(s)
Cetoacidosis Diabética/metabolismo , Disulfuros/metabolismo , Homeostasis/fisiología , Compuestos de Sulfhidrilo/metabolismo , Adulto , Anciano , Biomarcadores/metabolismo , Estudios de Casos y Controles , Cetoacidosis Diabética/diagnóstico , Disulfuros/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estrés Oxidativo , Compuestos de Sulfhidrilo/sangre
5.
Turk J Med Sci ; 51(6): 2810-2821, 2021 12 13.
Artículo en Inglés | MEDLINE | ID: mdl-33726485

RESUMEN

Background/aim: Coronavirus 2019 disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a pandemic infectious disease that causes morbidity and mortality. As a result of high mortality rate among the severe COVID-19 patients, the early detection of the disease stage and early effective interventions are very important in reducing mortality. Hence, it is important to differentiate severe and nonsevere cases from each other. To date, there are no proven diagnostic or prognostic parameters that can be used in this manner. Due to the expensive and not easily accessible tests that are performed for COVID-19, researchers are investigating some parameters that can be easily used. In some recent studies, hematological parameters have been evaluated to see if they can be used as predictive parameters. Materials and methods: In the current study, almost all hematological parameters were used, including the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, mean platelet volume to lymphocyte ratio, mean platelet volume to platelet ratio, plateletcrit, and D-dimer/fibrinogen ratio, neutrophil/lymphocyte/platelet scoring system, and systemic immune-inflammation index. A total of 750 patients, who were admitted to Ankara City Hospital due to COVID-19, were evaluated in this study. The patients were classified into 2 groups according to their diagnosis (confirmed or probable) and into 2 groups according to the stage of the disease (nonsevere or severe). Results: The values of the combinations of inflammatory markers and other hematological parameters in all of the patients with severe COVID-19 were calculated, and the predicted values of these parameters were compared. According to results of the study, nearly all of the hematological parameters could be used as potential diagnostic biomarkers for subsequent analysis, because the area under the curve (AUC) was higher than 0.50, especially for the DFR and NLR, which had the highest AUC among the parameters. Conclusion: Our findings indicate that, the parameters those enhanced from complete blood count, which is a simple laboratory test, can help to identify and classify COVID-19 patients into non-severe to severe groups.


Asunto(s)
Biomarcadores/sangre , COVID-19/diagnóstico , Servicio de Urgencia en Hospital/estadística & datos numéricos , Pruebas Hematológicas/métodos , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/sangre , COVID-19/epidemiología , Prueba de COVID-19 , Femenino , Hemoglobinas/metabolismo , Humanos , Linfocitos , Masculino , Persona de Mediana Edad , Neutrófilos , Valor Predictivo de las Pruebas , Pronóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , SARS-CoV-2/aislamiento & purificación , Turquía/epidemiología
6.
Surg Radiol Anat ; 42(1): 23-29, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31501910

RESUMEN

PURPOSE: The purpose of this study was to assess the three-dimensional morphometric features of the sella turcica using cone beam computed tomography (CBCT) in subjects with unilateral and bilateral maxillary impacted canines and normal controls. METHODS: In this retrospective study, CBCT images captured with ultra-low dose protocol of 73 subjects (21 males, 52 females; mean age 20.01 ± 6.53 years) with unilateral or bilateral maxillary impacted canines (29 unilateral and 29 bilateral) and 15 controls were evaluated. Nineteen different measurements of the pituitary fossa were made on CBCT images. To evaluate the normality, the Kolmogorov-Smirnov test was used. The nonparametric statistical Kruskal-Wallis and Mann-Whitney U tests were applied to analyze the significant differences among and between the groups. Statistical significance was set at 5%. RESULTS: No measurement differed significantly among the groups (all p > 0.05) other than the right sella length, which differed between the unilateral and bilateral test groups and the unilateral test group and controls (both p < 0.05). The bilateral test group and control group did not differ significantly, but both exhibited greater right sella length than did the unilateral test group (p > 0.05). CONCLUSIONS: Other than the right sella length, there were no among-group differences in the mean pituitary fossa measurements of subjects with impacted unilateral and bilateral canines and normally erupted canines. The right sella length was lower in subjects with impacted unilateral canines than in those with bilateral impacted canines and normal controls.


Asunto(s)
Cefalometría/métodos , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Silla Turca/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Adolescente , Adulto , Femenino , Humanos , Imagenología Tridimensional , Masculino , Maxilar/diagnóstico por imagen , Estudios Retrospectivos , Adulto Joven
7.
Med Princ Pract ; 25(4): 316-22, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27164841

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the efficacy of nebivolol, carvedilol or metoprolol succinate on the outcome of patients presenting with acute myocardial infarction (AMI) complicated by left ventricular dysfunction. SUBJECTS AND METHODS: Patients (n = 172, aged 28-87 years) with AMI and left ventricular ejection fraction ≤0.45 were randomized to the nebivolol (n = 55), carvedilol (n = 60) and metoprolol succinate (n = 57) groups. Baseline demographic and clinical characteristics and composite event rates of nonfatal MI, cardiovascular mortality, hospitalization due to unstable angina pectoris or heart failure, stroke or revascularization during the 12-month follow-up were compared among the groups using the x03C7;2 test, t test or log-rank test as appropriate. RESULTS: Baseline demographic and clinical characteristics were similar in the three groups. The composite end point during follow-up was lower in the patients treated with nebivolol than those treated with metoprolol (14.5 vs. 31.5%; p = 0.03). However, event rates were similar between the patients treated with carvedilol and those treated with the metoprolol (20.3 vs. 31.5%, p > 0.05) and between the patients treated with nebivolol and carvedilol (14.5 vs. 20.3%, p > 0.05). CONCLUSION: The patients treated with nebivolol experienced 12-month cardiovascular events at a lower rate than those treated with metoprolol succinate. However, event rates were similar between the carvedilol and the metoprolol succinate groups and between the nebivolol and the carvedilol groups.


Asunto(s)
Agonistas de Receptores Adrenérgicos beta 1/uso terapéutico , Infarto del Miocardio/epidemiología , Disfunción Ventricular Izquierda/tratamiento farmacológico , Disfunción Ventricular Izquierda/epidemiología , Agonistas de Receptores Adrenérgicos beta 1/administración & dosificación , Agonistas de Receptores Adrenérgicos beta 1/efectos adversos , Anciano , Carbazoles/uso terapéutico , Carvedilol , Femenino , Humanos , Masculino , Metoprolol/uso terapéutico , Persona de Mediana Edad , Infarto del Miocardio/mortalidad , Nebivolol/uso terapéutico , Propanolaminas/uso terapéutico , Método Simple Ciego , Disfunción Ventricular Izquierda/mortalidad
8.
9.
Scand J Clin Lab Invest ; 75(4): 327-32, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25797068

RESUMEN

BACKGROUND: High-density lipoprotein cholesterol (HDL-C) inhibits inflammation associated with the development of atherosclerotic plaques. Monocyte chemoattractant protein-1 (MCP-1) contributes to the pathogenesis of atherosclerosis. The aim of this study was to evaluate the relationship between plasma MCP-1 levels and low HDL-C levels in patients without cardiovascular disease (CVD). METHODS: This study included 55 patients with low HDL-C (≤ 35 mg/dL) and 33 age- and sex-matched control subjects with normal HDL-C (˃ 35 mg/dL). In addition to MCP-1 levels, laboratory parameters associated with inflammation such as neutrophil-lymphocyte ratio (NLR), uric acid and high sensitivity C-reactive protein (hs-CRP) were also evaluated. RESULTS: HDL-C levels was significantly lower in study group compared to that of the control group (p < 0.001). MCP-1 were prominently higher in the low HDL-C group compared with those of the control group (p < 0.01). NLR, uric acid and hs-CRP levels were also higher in patients with low HDL-C than controls. CONCLUSION: These findings suggest that elevated plasma MCP-1 levels and inflammation status might be associated with the increased cardiovascular risk in patients with low HDL-C.


Asunto(s)
Quimiocina CCL2/sangre , HDL-Colesterol/sangre , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Recuento de Leucocitos , Modelos Lineales , Masculino , Persona de Mediana Edad , Ácido Úrico/sangre
10.
Turk Kardiyol Dern Ars ; 43(3): 284-7, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25906002

RESUMEN

Hyponatremia is frequently seen in heart failure patients and has a high mortality rate. If not treated adequately, acute and chronic hyponatremia may worsen the prognosis of heart failure. Despite its high incidence in heart failure patients, other underlying conditions that possibly lead to the incidence of hyponatremia may be underestimated, thus making its treatment more difficult. In this case study, we describe a rare case of levetiracem-induced and tolvaptan-resistant hyponatremia.


Asunto(s)
Antagonistas de los Receptores de Hormonas Antidiuréticas/uso terapéutico , Benzazepinas/uso terapéutico , Hiponatremia/inducido químicamente , Hiponatremia/tratamiento farmacológico , Piracetam/análogos & derivados , Anciano , Anticonvulsivantes/efectos adversos , Anticonvulsivantes/uso terapéutico , Epilepsia/tratamiento farmacológico , Insuficiencia Cardíaca , Humanos , Hiponatremia/fisiopatología , Síndrome de Secreción Inadecuada de ADH , Levetiracetam , Masculino , Piracetam/efectos adversos , Piracetam/uso terapéutico , Tolvaptán
11.
Angiology ; 75(5): 454-461, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-36799537

RESUMEN

High-grade intracoronary thrombus (ICT) burden leads to greater myocardial injury following anterior myocardial infarction (MI). The modified Glasgow prohgnostic score (mGPS) is a novel immune-inflammatory index, calculated by using C-reactive protein (CRP) and albumin levels, was shown to have prognostic value in heart diseases. The present study investigated the role of mGPS in predicting high grade ICT in patients with acute anterior MI admitted between February 2017 and March 2020. Blood samples were obtained at admission and mGPS was calculated. The ICT burden was evaluated visually from angiographic images. Patients were divided into 2 groups according to the ICT burden as high and low. A total of 1132 patients were enrolled: a mean age 61 ± 12.4 years and 370 males (32.7%). Serum albumin was lower, whereas mGPS and CRP were higher in high grade ICT group. CRP (odds ratio (OR): 1.404 95% CI: 1.312-1.502; P < .001), albumin (OR: .486; 95% CI: .301-.782 P < .001), and mGPS (0 vs ≥ 1) (OR: 7.391; 95% CI: 3.910-13.972; P < .001) were independent predictors of high-grade ICT burden in the left anterior descending coronary artery. The mGPS is a novel predictor of high-grade ICT burden and may be useful for risk stratification in patients with acute anterior MI.


Asunto(s)
Infarto del Miocardio , Trombosis , Masculino , Humanos , Persona de Mediana Edad , Anciano , Pronóstico , Proteína C-Reactiva/metabolismo , Albúmina Sérica/metabolismo , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico , Estudios Retrospectivos
12.
Rev Assoc Med Bras (1992) ; 70(3): e20231029, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38655998

RESUMEN

OBJECTIVE: In our study, we aimed to compare the effect of standard rapid sequence intubation protocol and the application of rocuronium priming technique on the procedure time and hemodynamic profile. METHODS: Patients who applied to the emergency department and needed rapid sequence intubation were included in our study, which we conducted with a randomized controlled design. Randomization in the study was made according to the order of arrival of the cases. Rapid sequence intubation was performed in the standard group. In the priming group, 10% of the rocuronium dose was administered approximately 3 min before the induction agent. Intubation time, amount of drug used, vital signs, and end-tidal CO2 level before and after intubation used to confirm intubation were recorded. RESULTS: A total of 52 patients were included in the study, of which 26 patients were included in the standard group and 26 patients in the priming group. While intubation time was 121.2±21.9 s in the standard group, it was calculated as 68.4±11.6 s in the priming group (p<0.001). While the mean arterial pressure was 58.3±26.6 mmHg in the standard group after intubation, it was 80.6±21.1 mmHg in the priming group (p=0.002). CONCLUSION: It was observed that priming with rocuronium shortened the intubation time and preserved the hemodynamic profile better. CLINICAL TRIAL REGISTRATION NUMBER: NCT05343702.


Asunto(s)
Androstanoles , Servicio de Urgencia en Hospital , Intubación Intratraqueal , Fármacos Neuromusculares no Despolarizantes , Intubación e Inducción de Secuencia Rápida , Rocuronio , Humanos , Rocuronio/administración & dosificación , Fármacos Neuromusculares no Despolarizantes/administración & dosificación , Femenino , Masculino , Intubación e Inducción de Secuencia Rápida/métodos , Adulto , Persona de Mediana Edad , Androstanoles/administración & dosificación , Factores de Tiempo , Intubación Intratraqueal/métodos , Hemodinámica/efectos de los fármacos
13.
Anatol J Cardiol ; 28(6): 273-282, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38829258

RESUMEN

BACKGROUND: The aim of this study was to assess the adherence to the current European Society of Cardiology dyslipidemia guidelines, the ratio of reaching target values according to risk groups, and the reasons for not reaching LDL-cholesterol (LDL-C) goals in patients on already statin therapy in a cardiology outpatient population. METHODS: The AIZANOI study is a multi-center, cross-sectional observational study including conducted in 9 cardiology centers between August 1, 2021, and November 1, 2021. RESULTS: A total of 1225 patients (mean age 62 ± 11 years, 366 female) who were already on statin therapy for at least 3 months were included. More than half (58.2%) of the patients were using high-intensity statin regimens. Only 26.2% of patients had target LDL-C level according to their risk score. Despite 58.4% of very high-risk patients and 44.4% of high-risk patients have been using a high-intensity statin regimen, only 24.5% of very-high-risk patients and only 34.9% of high-risk patients have reached guideline-recommended LDL-C levels. Most prevalent reason for not using target dose statin was physician preference (physician inertia) (40.3%). CONCLUSION: The AIZANOI study showed that we achieved a target LDL-C level in only 26.2% of patients using statin therapy. Although 58.4% of patients with a very high SCORE risk and 44.4% of patients with a high SCORE risk were using a target dose statin regimen, we were only able to achieve guideline-recommended LDL-C levels in 24.5% and 34.9% of them, respectively, in cardiology outpatients clinics. Physician inertia is one of the major factors in non-adherence to guidelines. These findings highlight that combination therapy is needed in most of the patients.


Asunto(s)
Dislipidemias , Adhesión a Directriz , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Femenino , Estudios Transversales , Persona de Mediana Edad , Masculino , Adhesión a Directriz/estadística & datos numéricos , Dislipidemias/tratamiento farmacológico , Dislipidemias/sangre , Dislipidemias/complicaciones , Turquía , Anciano , Factores Sexuales , Factores de Riesgo , Guías de Práctica Clínica como Asunto , LDL-Colesterol/sangre
14.
Turk Kardiyol Dern Ars ; 52(3): 175-181, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38573092

RESUMEN

OBJECTIVE: The MORtality in CORonary Care Units in Türkiye (MORCOR-TURK) trial is a national registry evaluating predictors and rates of in-hospital mortality in coronary care unit (CCU) patients in Türkiye. This report describes the baseline demographic characteristics of patients recruited for the MORCOR-TURK trial. METHODS: The study is a multicenter, cross-sectional, prospective national registry that included 50 centers capable of 24-hour CCU service, selected from all seven geographic regions of Türkiye. All consecutive patients admitted to CCUs with cardiovascular emergencies between September 1-30, 2022, were prospectively enrolled. Baseline demographic characteristics, admission diagnoses, laboratory data, and cardiovascular risk factors were recorded. RESULTS: A total of 3,157 patients with a mean age of 65 years (range: 56-73) and 2,087 (66.1%) males were included in the analysis. Patients with arterial hypertension [1,864 patients (59%)], diabetes mellitus (DM) [1,184 (37.5%)], hyperlipidemia [1,120 (35.5%)], and smoking [1,093 (34.6%)] were noted. Non-ST elevation myocardial infarction (NSTEMI) was the leading cause of admission [1,187 patients (37.6%)], followed by ST elevation myocardial infarction (STEMI) in 742 patients (23.5%). Other frequent diagnoses included decompensated heart failure (HF) [339 patients (10.7%)] and arrhythmia [272 patients (8.6%)], respectively. Atrial fibrillation (AF) was the most common pathological rhythm [442 patients (14%)], and chest pain was the most common primary complaint [2,173 patients (68.8%)]. CONCLUSION: The most common admission diagnosis was acute coronary syndrome (ACS), particularly NSTEMI. Hypertension and DM were found to be the two leading risk factors, and AF was the most commonly seen pathological rhythm in all hospitalized patients. These findings may be useful in understanding the characteristics of patients admitted to CCUs and thus in taking precautions to decrease CCU admissions.


Asunto(s)
Fibrilación Atrial , Hipertensión , Infarto del Miocardio sin Elevación del ST , Anciano , Femenino , Humanos , Masculino , Unidades de Cuidados Coronarios , Estudios Transversales , Mortalidad Hospitalaria , Estudios Prospectivos , Turquía , Persona de Mediana Edad
15.
Turk Kardiyol Dern Ars ; 41(2): 131-5, 2013 Mar.
Artículo en Turco | MEDLINE | ID: mdl-23666300

RESUMEN

OBJECTIVES: We aimed to investigate the demographic and clinical characteristics, echocardiographic and microbiologic features, and outcomes of patients with permanent pacemaker (PM) and implantable cardioverter-defibrillator (ICD) endocarditis in this study. STUDY DESIGN: The study population consisted of 15 patients with permanent PM and ICD endocarditis. Data on demographics, medications, clinical procedures, microbiology, echocardiography, surgery, and outcome were collected. RESULTS: The mean age of the patients was 57 ± 16. Seven patients (47%) were female. Of the 15 permanent PM and ICD endocarditis patients, 5 died during hospital follow-up (33%). Four patients (27%) experienced a pulmonary embolism. Culture-negative endocarditis was seen in 5 cases (33%). Staphylococci were the most common causative organisms (60%). Three patients had undergone surgical treatment (20%). CONCLUSION: Cardiac device-related endocarditis remain a rare but potentially fatal complication of device implantation.


Asunto(s)
Desfibriladores Implantables/efectos adversos , Endocarditis/etiología , Marcapaso Artificial/efectos adversos , Infecciones por Pseudomonas/etiología , Infecciones Estafilocócicas/etiología , Adulto , Anciano , Anciano de 80 o más Años , Endocarditis/complicaciones , Endocarditis/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pseudomonas aeruginosa , Embolia Pulmonar/etiología , Infecciones Estafilocócicas/complicaciones , Infecciones Estafilocócicas/mortalidad , Staphylococcus aureus , Staphylococcus epidermidis , Adulto Joven
16.
Medicine (Baltimore) ; 102(41): e35636, 2023 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-37832061

RESUMEN

Acute coronary syndrome (ACS) is an urgent clinical condition of cardiovascular diseases. The present study evaluated the predictive efficacy of the hemoglobin to serum creatinine ratio (Hgb/Cr) on long-term mortality in patients with ACS. The ratio, representing the proportion of the 2 values, is cheap, practical, and very easy to calculate at the bedside. Our study included 475 patients who were admitted to the coronary intensive care unit with a diagnosis of ACS and who underwent coronary angiography. The Hgb/Cr ratio was calculated by dividing the admission hemoglobin by the admission serum creatinine. All patient data were collected from the electronic hospital information system, patient files, and the hospital's archive. A comparison of the patients laboratory findings revealed that the Hgb/Cr ratios differed significantly between the survivor and non-survivor group [16.6 (7.7-49) vs 13.8 (4.91-32.8), respectively; P < .001]. A univariate Cox regression analysis showed that the Hgb/Cr ratio was statistically significant in predicting long-term mortality (0.836; 95% confidence interval [CI]: 0.781-0.895; P < .001). After adjusting the model by adding clinically and statistically significant variables, the Hgb/Cr ratio was still an independent predictor of long-term mortality (0.886; 95% CI: 0.815-0.963; P = .004). The Hgb/Cr ratio's discriminant ability was tested with an receiver operating characteristic curve analysis. The Hgb/Cr ratio's area under the curve value was 0.679 (95% CI: 0.609-0.750; P < .001). A survival analysis using the Kaplan-Meier curve of the 2 Hgb/Cr ratio groups (according to cutoff value) revealed that the low-Hgb/Cr group had a significantly higher mortality rate than high-Hgb/Cr group. The Hgb/Cr ratio was found to be an independent predictor of long-term mortality in ACS patients.


Asunto(s)
Síndrome Coronario Agudo , Humanos , Estudios Retrospectivos , Creatinina , Biomarcadores , Hemoglobinas , Pronóstico
17.
Int J Cardiol ; 371: 427-431, 2023 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-36181949

RESUMEN

OBJECTIVE: We investigated the predictive values of the expanded Simplified Acute Physiology Score (SAPS) II and Acute Physiologic Score and Chronic Health Evaluation (APACHE) II score in predicting in-hospital mortality in coronary care unit (CCU) patients. METHODS: In this study, expanded SAPS II and APACHE II scores were calculated in the CCU of a single-center tertiary hospital. Patients admitted to CCU with any cardivascular indication were included in the study. Both scores were calculated according to previously determined criteria. Calibration and discrimination abilities of the scores in predicting in-hospital mortality were tested with Hosmer-Lemeshow goodness-of-fit C chi-square and receiver operating characteristics (ROC) curve analyses. RESULTS: A total of 871 patients were included in the analysis. The goodness-of-fit C chi-square test showed that both scores have a good performance in predicting survivors and nonsurvivors in CCU. Expanded SAPS II score has a sensitivity of 80% and a specificity of 91.8% with the cut-off value of 5.55, while APACHE II has a sensitivity of 75.9% and a specificity of 87.4% with the cut-off value of 16.5 in predicting mortality. CONCLUSION: Expanded SAPS II and APACHE II scores have good ability to predict in-hospital mortality in CCU patients. Therefore, they can be used as a tool to predict short-term mortality in cardiovascular emergencies.


Asunto(s)
Unidades de Cuidados Coronarios , Puntuación Fisiológica Simplificada Aguda , Humanos , APACHE , Unidades de Cuidados Intensivos , Mortalidad Hospitalaria , Curva ROC , Pronóstico
18.
North Clin Istanb ; 10(1): 17-23, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36910435

RESUMEN

OBJECTIVE: Acute coronary syndrome (ACS) is one of the leading causes of mortality, globally. Atherosclerosis is an underlying factor in ACS process and coagulative cascade is activated secondary to atherosclerotic plaque rupture. Fibrinopeptide A (FPA) takes an active role in thrombus formation and is an indicator of coagulative process. We aimed to evaluate serum FPA level in patients with ACS. METHODS: Patients diagnosed with ACS and chronic coronary syndrome (CCS), with non-obstructive coronary artery disease as a control group, were included in the study. Blood samples and demographic data of all patients were obtained at admission. Obtained data were compared between ACS and control groups. RESULTS: The study consisted of 107 patients with ACS and 69 patients with CCS. ACS group was older (p<0.001) with male preponderance (p<0.001), more likely to had hypertension (p<0.001), and had a higher smoking rate (p<0.001). Serum FPA level was highest in the ST elevated myocardial infarction group (p<0.001). FPA>3.38 ng/mL predicted ACS with 89.7% sensitivity and 78% specificity (AUC: 0.825, 95% CI 0.745-0.905; p<0.001). CONCLUSION: Serum FPA may be used for the differential diagnosis of ACS. In addition, patients with increased FPA may be considered to be given more aggressive antithrombotic medication.

19.
Anatol J Cardiol ; 27(5): 258-265, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37119186

RESUMEN

BACKGROUND: Coronary care units are sophisticated clinics established to reduce deaths due to acute cardiovascular events. Current data on coronary care unit mortality rates and predictors of mortality in Turkey are very limited. The MORtality predictors in CORonary care units in TURKey (MORCOR-TURK) trial was designed to provide information on the mortality rates and predictors in patients followed in coronary care units in Turkey. METHODS: The MORCOR-TURK trial will be a national, observational, multicenter, and noninterventional study conducted in Turkey. The study population will include coronary care unit patients from 50 centers selected from all regions in Turkey. All consecutive patients admitted to coronary care units with cardiovascular diagnoses between 1 and 30 September 2022 will be prospectively enrolled. All data will be collected at one point in time, and the current clinical practice will be evaluated (ClinicalTrials.gov number NCT05296694). In the first step of the study, admission diagnoses, demographic characteristics, basic clinical and laboratory data, and in-hospital management will be assessed. At the end of the first step, the predictors and rates of in-hospital mortality will be documented. The second step will be in cohort design, and discharged patients will be followed up till 1 year. Predictors of short- and long-term mortality will be assessed. Moreover, a new coronary care unit mortality score will be generated with data acquired from this cohort. RESULTS: The short-term outcomes of the study are planned to be shared by early 2023. CONCLUSION: The MORCOR-TURK trial will be the largest and most comprehensive study in Turkey evaluating the rates and predictors of in-hospital mortality of patients admitted to coronary care units.


Asunto(s)
Mortalidad Hospitalaria , Pacientes , Humanos , Hospitalización , Alta del Paciente , Turquía/epidemiología , Unidades de Cuidados Coronarios/estadística & datos numéricos , Estudios Multicéntricos como Asunto , Estudios Observacionales como Asunto , Cardiopatías/mortalidad , Cardiopatías/terapia
20.
J Coll Physicians Surg Pak ; 32(12): 1519-1523, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36474367

RESUMEN

OBJECTIVE: To investigate the usability of leuko-glycemic index (LGI) at chronic coronary syndromes (CCS) class 1 for determining the extent and severity of coronary artery disease (CAD). STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Cardiology, University of Pamukkale University Hospital, Turkey, between September 2021 and January 2022. METHODOLOGY: One hundred and thirty-four patients, whose myocardial perfusion scintigraphy (MPS) was requested due to CCS class 1, and on whom a coronary angiogram (CAG) was performed due to evidence of ischemia, were analysed. Blood samples were taken from the patients during their hospitalisation before CAG. LGI was calculated as mg/dl.mm3 by multiplying both values and dividing by a thousand. The patients were analysed in two groups according to the critical stenosis and non-critical stenosis detected in the coronary arteries. RESULTS: The LGI was recorded as 480 mg/dl.mm3 (407-603) vs. 572 mg/dl.mm3 (433-877), p=0.006, and the Gensini score (6 (3-10) vs 40 (23-60), p<0.001) was significantly higher in the critical CAD group. A significant relationship has detected the increase in LGI and the extensity and severity of CAD (Unadjusted; OR (95% CI); 1.003 (1.001 - 1.004) p=0.002, adjusted; OR (95% CI); 1.002 (1.001 - 1.004) p=0.004). CONCLUSION: A high LGI was a predictor of CAD severity among CCS class 1 patients and was found to correlate with the Gensini score. The use of this simple and inexpensive index, together with other non-invasive tests before CAG, may provide some knowledge about the severity of CAD. KEY WORDS: Coronary artery disease, Leukocyte glucose index, Myocardial perfusion scintigraphy.


Asunto(s)
Enfermedad de la Arteria Coronaria , Humanos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Glucosa , Constricción Patológica , Leucocitos , Turquía
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