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1.
Eur J Clin Invest ; 52(10): e13834, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35851657

RESUMO

AIMS: To compare major cardiovascular and cerebrovascular events (MACCE) rates between patients in the pre-COVID-19 era and COVID-19 era, and to assess the impact of the presence of COVID-19 (+) on long-term MACCE in ST-segment elevation myocardial infarction (STEMI) in Turkey. METHODS: Using the TURSER study (TURKISH ST-segment elevation myocardial infarction registry) data, the current study included 1748 STEMI patients from 15 centres in Turkey. Patients were stratified into COVID-19 era (March 11st-May 15st, 2020; n = 723) or pre-COVID-19 era (March 11st-May 15st, 2019; n = 1025) cohorts. Long-term MACCE rates were compared between groups. In addition, the effect of COVID-19 positivity on long-term outcomes was evaluated. The primary outcome was the occurrence of MACCE at long-term follow-up, and the secondary outcome was hospitalization with heart failure. RESULTS: The MACCE and hospitalization with heart failure rates between pre-COVID-19 era and COVID-19 era were 23% versus 22% (p = .841), and 12% versus 8% (p = .002), respectively. In the COVID-19 era, the rates of MACCE and hospitalization with heart failure COVID-19-positive versus COVID-19-negative patients were 40% versus 20%, (p < .001), and 43% versus 11% (p < .001), respectively. CONCLUSION: There was no difference between the pre-COVID-19 era and the COVID-19 era in terms of MACCE  in STEMI patients in Turkey. In the COVID-19 era, STEMI patients positive for COVID-19 had a higher rate of MACCE and heart failure hospitalization at the long-term follow-up.


Assuntos
COVID-19 , Insuficiência Cardíaca , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , COVID-19/epidemiologia , Insuficiência Cardíaca/etiologia , Humanos , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Resultado do Tratamento
2.
J Thromb Thrombolysis ; 53(2): 321-334, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34050883

RESUMO

OBJECTIVE: We aimed to investigate both the impact of COVID-19 pandemic on ST-segment elevation myocardial infarction (STEMI) admission, and demographic, angiographic, procedural characteristics, and in-hospital clinical outcomes of patients with COVID-19 positive STEMI in Turkey. METHODS: This was a multi-center and cross-sectional observational study. The study population included 1788 STEMI patients from 15 centers in Turkey. The patients were divided into two groups: COVID-19 era (March 11st-May 15st, 2020; n = 733) or pre- COVID-19 era group (March 11st-May 15st, 2019; n = 1055). Also, the patients in COVID-19 era were grouped as COVID-19 positive (n = 65) or negative (n = 668). RESULTS: There was a 30.5% drop in STEMI admission during COVID-19 era in comparison to pre-COVID-19 era. The patients admitted to the medical centers during COVID-19 era had a longer symptom-to-first medical contact time [120 (75-240) vs. 100 (60-180) minutes, p < 0.001]. COVID-19 positive STEMI patients had higher thrombus grade and lower left ventricular ejection fraction compared to COVID-19 negative patients. COVID-19 positive patients had higher mortality (28% vs. 6%, p < 0.001) and cardiogenic shock (20% vs. 7%, p < 0.001) rates compared with those without COVID-19. Matching based on propensity scores showed higher mortality and high thrombus grade in STEMI patients who were infected by SARS-COV-2 (each p < 0.05). CONCLUSIONS: We detected significantly lower STEMI hospitalization rates and significant delay in duration of symptom onset to first medical contact in the context of Turkey during the COVID-19 outbreak. Moreover, high thrombus grade and mortality were more common in COVID-19 positive STEMI patients.


Assuntos
COVID-19 , Infarto do Miocárdio com Supradesnível do Segmento ST , COVID-19/epidemiologia , Estudos Transversais , Hospitalização/estatística & dados numéricos , Humanos , Pandemias , Sistema de Registros , SARS-CoV-2 , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Volume Sistólico , Tempo para o Tratamento , Turquia/epidemiologia , Função Ventricular Esquerda
3.
Clin Exp Hypertens ; 43(4): 311-319, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-33423545

RESUMO

Background: Ascending aortic aneurysms are one of the primary causes of mortality. However, not much is known about the etiologies of aortic aneurysm. Recently, in hypertensive (HT) patients, blood pressure variability (BPV) has been recommended as a remarkable risk factor for adverse cardiovascular outcomes. This study aimed to explore the association between short-term BPV and ascending aortic dilatation (AAD).Methods: In this study, a total of 53 HT patients with AAD (aortic size index [ASI] ≥21 mm/m2) and 126 HT patients with a normal ascending aortic diameter (ASI <21 mm/m2) were included. Baseline, echocardiographic, and 24-h ambulatory blood pressure (BP) monitoring results were compared between groups. Standard deviation (SD) and coefficient of variation (CV) of BP were used to determine short-term BPV.Results: Except for daytime SBP values, daytime, nighttime, and 24-h mean systolic (SBP) and diastolic (DBP) BP levels were similar between groups. Compared with the HT patients with normal AA, daytime SBP, daytime SD of SBP, 24-h SD of SBP, daytime CV of SBP, and 24-h CV of SBP were significantly higher in HT patients with AAD. Compared with the HT patients with normal AA, the frequency of nondipper pattern was higher and dipper pattern was lower in HT patients with AAD. In multivariate logistic regression analysis, the daytime CV of SBP, daytime SD of SBP, 24-h SD of SBP, daytime SBP, and left ventricular mass index were independently associated with AAD. In receiver operating characteristic curve analysis, the daytime CV of SBP levels of >12.95 had a sensitivity of 61% and a specificity of 59% (area under the curve, 0.659; 95% CI, 0.562-0.756; P= .01); moreover, daytime SD of SBP > 16.4 had sensitivity of 62% and specificity of 61% (AUC, 0.687; 95% CI, 0.591-0.782; P< .001).:Conclusion Increased short-term BPV is independently associated with AAD and may be recommended as a remarkable factor risk for AAD in HT patients.


Assuntos
Aorta/fisiopatologia , Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Monitorização Ambulatorial da Pressão Arterial , Dilatação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Tamanho do Órgão , Curva ROC , Estatísticas não Paramétricas , Sístole
4.
Eur J Clin Invest ; 50(11): e13271, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32592511

RESUMO

OBJECTIVE: Bleeding is one of the most important causes of mortality in patients with acute coronary syndrome (ACS). This study therefore aimed to investigate bleeding risk in patients with ACS who were scheduled to receive dual antiplatelet therapy (DAPT) in Turkey. METHODS: This was a multicentre, observational, cross-sectional cohort study. The study population included 963 patients with ACS from 12 centres in Turkey. We used the Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score to predict the bleeding risk for all the patients. The patients were divided into high (≥25) or low (˂25) bleeding risk groups based on their PRECISE-DAPT scores. RESULTS: The mean PRECISE-DAPT score was 21.9. Overall, 32.2% of the patients had high PRECISE-DAPT scores (≥25). Compared with the male patients, the female patients had higher PRECISE-DAPT scores (28.2 ± 15.7 vs 18.4 ± 13.6, P Ë‚ .001). Among the females, the rate of patients with a PRECISE-DAPT score ≥25 was 53%, while among the male patients, the score occurred at a rate of 22%. The female patients had lower haemoglobin (Hb) levels than the male patients (12.1 ± 1.7 vs 13.8 ± 1.9, P Ë‚ .001) and lower creatinine clearance (70.7 ± 27.5 vs 88.7 ± 26.3, P Ë‚ .001). The in-hospital bleeding rates were higher among the patients with high PRECISE-DAPT scores than among those who did not have high scores. Furthermore, the patients with high PRECISE-DAPT scores had a higher in-hospital mortality rate compared with those with low PRECISE-DAPT scores (1% vs 0%, P = .11). CONCLUSIONS: The mean PRECISE-DAPT score was high among the patients with ACS in this study, indicating that the bleeding tendency was high. This study showed that the PRECISE-DAPT score may help physicians determine the type and duration of DAPT, especially in patients with ACS in Turkey.


Assuntos
Síndrome Coronariana Aguda/terapia , Terapia Antiplaquetária Dupla/efeitos adversos , Hemorragia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Anemia/epidemiologia , Anemia/metabolismo , Creatinina/metabolismo , Feminino , Hemoglobinas/metabolismo , Hemorragia/induzido quimicamente , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea , Hemorragia Pós-Operatória/induzido quimicamente , Hemorragia Pós-Operatória/epidemiologia , Sistema de Registros , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/metabolismo , Medição de Risco , Fatores de Risco , Prevenção Secundária , Fatores Sexuais , Turquia
5.
BMC Cardiovasc Disord ; 20(1): 142, 2020 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-32192428

RESUMO

BACKGROUND: Ascending aortic aneurysms are one of the major causes of mortality. In recent years, there is a growing interest of epicardial adipose tissue (EAT) and related diseases. The aim of this study was to investigate the relationship of EAT, and PAT with ascending aortic dilatation (AAD). METHODS: We included 934 patients with hypertension in this study. The patients were evaluated by a complete transthoracic echocardiographic examination, including measurements of EAT, PAT, and aortic dimensions. Aortic size index (ASI) was used for diagnosing AAD. The patients were divided into two groups: dilated ascending aorta diameter (ASI ≥ 21 mm / m2, n = 102) or normal aortic diameter (ASI < 21 mm / m2, n = 832) according to the ASI. Characteristics of these patients were compared before and after propensity score matching analysis. RESULTS: Patients with AAD were older (72.3 ± 11.6 vs. 61.7 ± 12.7 years, p <  0.001), had more female gender (66% vs. 54%,p = 0.021) than patients with normal ascending aorta (AA). After propensity score matching analysis (77 vs. 77), EAT [OR:1.461, %95CI (1.082-1.974), p = 0.013] was independently associated with AAD in multivariate logistic regression analysis. In ROC curve analysis, EAT > 0.45 cm had 51.9% sensitivity and 62.3% specificity [AUC = 0.617, P = 0.012, 95% CI (0.529-0.707)]. CONCLUSION: Based on our findings, increased EAT may be suggested as an independent risk factor for AAD due to local or systemic effects in hypertensive patients.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Aorta/diagnóstico por imagem , Aneurisma Aórtico/etiologia , Ecocardiografia , Hipertensão/complicações , Remodelação Vascular , Idoso , Idoso de 80 Anos ou mais , Aorta/fisiopatologia , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/patologia , Estudos Transversais , Dilatação Patológica , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Pericárdio , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
6.
Med Sci Monit ; 26: e921553, 2020 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-32388532

RESUMO

BACKGROUND Epicardial adipose tissue (EAT) has been shown to be associated with diabetes mellitus (DM), hypertension (HT), coronary artery calcification, and atherosclerotic disease. Mitral annular calcification (MAC) is also associated with atherosclerosis. The purpose of this study was to assess the relationship between EAT and severe MAC. MATERIAL AND METHODS The study enrolled 102 patients who had severe MAC and 107 patients who did not have MAC, as determined by echocardiographic examination. EAT was measured by transthoracic echocardiography. The parasternal long-axis view was used to measure the maximal EAT thickness. RESULTS Patients with severe MAC were older (p<0.001) and were more likely to be female (p<0.001). Epicardial adipose tissue (p=0.001) and urea (p=0.004) were also higher and eGFR was lower (p<0.001) in patients with severe MAC. EAT (OR: 15.96, CI %: 1.04 - 24.604, p<0.05), female sex, CAD, DM, eGFR, and age were independent predictors of severe MAC. The AUC for the EAT to predict severe MAC was 0.699 (95%, CI: 0.625 - 0.774, p<0.001). CONCLUSIONS Our data suggest that EAT is an independent predictor for the presence of severe MAC. Routine echocardiographic assessment of EAT is a cheap and noninvasive method for evaluating patient cardiovascular risk classification.


Assuntos
Tecido Adiposo/patologia , Calcinose/diagnóstico , Valva Mitral/patologia , Idoso , Idoso de 80 Anos ou mais , Calcinose/fisiopatologia , Doença da Artéria Coronariana/complicações , Ecocardiografia/métodos , Feminino , Cardiopatias Congênitas/complicações , Doenças das Valvas Cardíacas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Pericárdio/patologia , Prognóstico , Fatores de Risco
7.
Echocardiography ; 37(9): 1374-1381, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32815581

RESUMO

AIM: Doppler echocardiography has become the standard imaging modality for diastolic function and provides pathophysiological insight into systolic and diastolic heart failure. In this study, we aimed to obtain normal echocardiographic Doppler parameters of healthy Turkish population. METHODS: Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination and The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used for echocardiographic Doppler measurements. RESULTS: A total of 967 healthy participants were enrolled in this study after applying exclusion criteria. Echocardiographic examination was obtained from all subjects following predefined protocols. Mitral E wave velocity and E/A ratio were higher in females and decreased progressively in advancing ages. E wave deceleration time and A wave velocity were increased with aging. Assessment of tissue Doppler velocities showed that left ventricular lateral e', septal e', and septal s' were higher in younger subjects and in females. E/e' ratio was increased progressively with advancing decades. Right ventricular e' and s' were decreased but a' was increased with increasing age. Septal e' lower than 8 cm/s was 1.9% in the fifth decade and 13.7% in ages older than 50 years. The E/e' ratio greater than 15 (and also 13) was not found. CONCLUSION: This study, for the first time, provides echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population which will be useful in routine clinical practice as well as in future clinical trials.


Assuntos
Ecocardiografia , Idoso , Idoso de 80 Anos ou mais , Diástole , Feminino , Humanos , Pessoa de Meia-Idade , Valores de Referência , Sístole , Turquia
8.
Clin Exp Hypertens ; 42(8): 692-699, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32530318

RESUMO

BACKGROUND: The exaggerated morning blood pressure surge (MS) is a risk factor for cardiovascular diseases. Inflammation is associated with the pathogenesis of hypertension. We aimed to investigate the association between fibrinogen, albumin, fibrinogen to albumin ratio (FAR), and exaggerated MS, and which of those variables is a better predictor for identifying an exaggerated MS in newly diagnosed treatment-naive hypertensive patients. MATERIAL AND METHODS: The study included 249 treatment-naive patients who were newly diagnosed with hypertension in both clinical and ambulatory blood pressure (BP) monitoring measurements. Morning BP was defined as the mean of BPs measured during the first 2 hours after wake-up. The lowest BP was defined as the mean of 3 BP measurements focused on the lowest nighttime computations. The MS was calculated as the morning systolic BP minus the lowest systolic BP. Fibrinogen and albumin levels were measured from venous blood. FAR was obtained by dividing the fibrinogen to the albumin. RESULTS: Patients with higher-value MS had a higher fibrinogen, FAR, and a lower albumin than those with low-value MS. MS was positively correlated with fibrinogen and FAR, and negatively correlated with albumin (for all, p < .001). Fibrinogen, albumin, and FAR were independent predictors of exaggerated MS. FAR was a more powerful predictor than fibrinogen (p < .001) and albumin (p = .02) in determining exaggerated MS. CONCLUSION: Patients with exaggerated MS had a higher fibrinogen and FAR, and a lower albumin level than those without exaggerated MS. FAR may be a better predictor than fibrinogen and albumin for determining exaggerated MS.


Assuntos
Pressão Sanguínea , Fibrinogênio/análise , Hipertensão/diagnóstico , Albumina Sérica/análise , Idoso , Monitorização Ambulatorial da Pressão Arterial , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
9.
Medicina (Kaunas) ; 56(3)2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32120867

RESUMO

Background: The aim of this study was to investigate whether there is a relationship between coronary collateral circulation (CCC) and contrast associated nephropathy (CAN) in very elderly patients. Methods: Patients aged 90 years or older with at least one major occlusion of the coronary artery proximal or mid-section were included in the study. CCC was graded according to the Rentrop classification. CAN was defined as an increase in blood creatinine value of 25% or more on the second day after coronary angiography. Results: Thirty-six patients who met the study criteria were included in the study. In the study group, CAN developed in 12 patients (CAN (+) group), 24 patients did not develop CAN (CAN (-) group). The creatinine levels before coronary angiography were 1.05 ± 0.12 in the CAN (-) group and 1.22 ± 0.14 in the CAN (+) group. Baseline creatinine values were significantly higher in the CAN (+) group (p = 0.001). The contrast agent used in the CAN (+) group was significantly higher (p = 0.001). In the CAN (+) group, nine patients (43%) had poor collateral circulation, whereas only three patients (20%) had well-developed collateral circulation. In a logistic regression analysis, the collateral class was not a risk factor for CAN, whereas contrast agent volume and basal creatinine were independent predictors of CAN. Conclusion: We found that CCC grade was not associated with the development of CAN in very old patients, but the amount of contrast agent and pre-procedure creatinine values were independent variables in the development of CAN.


Assuntos
Circulação Colateral , Meios de Contraste/efeitos adversos , Doença da Artéria Coronariana/fisiopatologia , Circulação Coronária , Nefropatias/induzido quimicamente , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/complicações , Creatinina/análise , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores de Risco
10.
Medicina (Kaunas) ; 55(9)2019 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-31500243

RESUMO

Background and Objectives: The aim of this study was to investigate the prognostic value of soluble ST2 (sST2) in predicting postoperative adverse events in patients with impaired left ventricular (LV) function undergoing coronary artery bypass graft (CABG) surgery. Materials and Methods: This study included 80 consecutive patients with stable coronary artery disease (CAD) and impaired LV function (ejection fraction ≤ 45%) undergoing on-pump coronary artery bypass graft surgery. The patients were divided into the "high" or "low" group according to their ST2 levels (≥35 or <35 ng/mL). Results: Postoperative adverse events were more common in patients with high sST2 levels than in patients with low sST2 levels (100% vs 26%, p < 0.0001). Multivariate analysis showed that sST2 level was an independent predictor of the presence of postoperative adverse events (OR: 1.117 (95% CI: 1.016-1.228), p = 0.022). The receiver operating characteristic curve (ROC) analysis of sST2 revealed an area under the curve (AUC) of 0.812 (95% CI: 0.710-0.913, p < 0.001) in predicting postoperative adverse events. An sST2 level of 26.50 ng/ml was identified as the optimal cut-off value, with a sensitivity and specificity of 74.1% and 75.3%, respectively. Conclusion: Higher sST2 levels were associated with adverse outcomes after CABG in patients with impaired LV and stable CAD.


Assuntos
Ponte de Artéria Coronária/efeitos adversos , Proteína 1 Semelhante a Receptor de Interleucina-1/análise , Complicações Pós-Operatórias/diagnóstico , Função Ventricular Esquerda/fisiologia , Idoso , Área Sob a Curva , Biomarcadores/análise , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Ponte de Artéria Coronária/métodos , Ponte de Artéria Coronária/estatística & dados numéricos , Feminino , Humanos , Proteína 1 Semelhante a Receptor de Interleucina-1/sangue , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/fisiopatologia , Período Pós-Operatório , Prognóstico , Curva ROC , Estatísticas não Paramétricas
11.
Pediatr Nephrol ; 31(9): 1469-76, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27011219

RESUMO

BACKGROUND: Heat shock proteins (HSPs) are a multi-family group of proteins which are upregulated by the cell in response to exposure to hazardous (stress) factors, including infectious agents, to prevent changes in protein structure. The aim of our study was to assess whether urine levels of the 70-kDa family of HSPs (HSP70s) increase in children with urinary tract infection (UTI) and to determine the optimal urine (u) HSP70 cut-off level to predict UTI in children. METHODS: Forty patients with symptomatic UTI (UTI group), 30 healthy children (control group), 21 asymptomatic patients with proven bacterial contamination in their urine culture (contamination group) and 30 patients with fever caused by other infections (non-UTI infection group) were enrolled in the study. Random urine samples were obtained for measurement of HSP70 and creatinine (Cr) from all groups. Urine was collected prior to the treatment of UTI at the time of presentation and after treatment. Urine HSP70 levels were measured by enzyme-linked immunosorbent analysis. A dimercaptosuccinic acid (DMSA) scan was performed at 5-7 days after presentation in UTI group to distinguish patients with acute pyelonephritis from those with cystitis; based on this scan, no patients had acute pyelonephritis. Patients were classified with pyelonephritis in the presence of all of the following signs: axillary fever of ≥39 °C, leukocytosis and positivity for C-reactive protein. RESULTS: The mean urine HSP70:Cr ratio (uHSP70/Cr) prior to treatment was significantly higher in the UTI group (449.86 ± 194.33 pg/mg) than in the control, contamination and non-UTI infection groups (39.93 ± 47.61, 32.43 ± 9.09 and 45.14 ± 19.76, respectively; p = 0.0001). Using a cut-off of 158 pg/mg uHSP70/Cr for the prediction of UTI, the sensitivity and specificity of the assay were 100 and 100 %, respectively (area under the time-concentration curve = 1). The uHSP70/Cr was highest in the patients with clinical pyelonephritis (p = 0.001). Mean uHSP70/Cr after treatment decreased to 60.68 ± 51.11 pg/mg in UTI group (p = 0 .0001). CONCLUSIONS: Our findings suggest that elevated uHSP70/Cr may be a useful biomarker for the prediction of UTI in children, with a high sensitivity and specificity, and that they may help to distinguish UTI from other infections as well as bacterial contamination of the urine.


Assuntos
Proteínas de Choque Térmico HSP70/urina , Pielonefrite/diagnóstico , Infecções Urinárias/diagnóstico por imagem , Biomarcadores , Criança , Humanos , Estudos Prospectivos , Pielonefrite/diagnóstico por imagem
12.
Anatol J Cardiol ; 2024 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-38168010

RESUMO

BACKGROUND: Endocan is an indicator of many pathologies accompanied by inflammation, endothelial cell activation, and dysfunction. In this study, we examined the relationship between degenerative aortic sclerosis, which progresses in a similar pathophysiologic mechanism as atherosclerosis, and serum inflammatory markers and endocan levels. METHODS: A total of 155 patients without known coronary artery disease, aged between 65 and 80 years, were consecutively included in the prospective cross-sectional study. The study population was analyzed in 4 different groups. The control group consisted of patients with normal aortic valve structure, while patients with aortic stenosis were classified as mild aortic stenosis (2-2.9 m/s), moderate aortic stenosis (3-3.9 m/s), and severe aortic stenosis (≥ 4 m/s) according to their aortic velocity. While there were 39 patients in the control group, there were 58, 24, and 34 patients in the mild, moderate, and severe aortic stenosis groups, respectively. RESULTS: There was no statistically significant difference between the groups in terms of patient distribution and characteristics. History of dyspnea and angina was correlated with the severity of aortic stenosis (P <.001). In this study, no statistically significant correlation was found between serum endocan levels and the severity of aortic stenosis (control group: 17.3 ± 6.3 ng/mL, mild aortic stenosis: 17.6 ± 8.7 ng/mL, moderate aortic stenosis: 16.3 ± 3.8 ng/mL, severe aortic stenosis: 15.2 ± 5.9 ng/mL, P =.396). However, it was figured out that there was a positive correlation between endocan levels and hemoglobin (Hg) (r = 0.308, P =.001), platelet (PLT) (r = 0.320, P <.001), and albumin (Alb) (r = 0.206, P =.026). CONCLUSION: In this study, no significant correlation was found between serum endocan levels and the severity of aortic stenosis. On the other hand, there was a positive correlation between endocan levels and Hg, PLT, and Alb.

15.
Angiology ; : 33197231193223, 2023 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-37553838

RESUMO

Nutritional status and its index (Prognostic Nutritional Index, PNI) is an important prognostic factor for ST-segment elevation myocardial infarction (STEMI). The present study investigated whether PNI it is associated with no-reflow in patients with STEMI. In this retrospective study, 404 patients with STEMI and underwent primary percutaneous coronary intervention (pPCI) were consecutively included, between January 2016 and December 2018. No-reflow phenomenon (NRP) was detected in 103 (25.4%) patients. In multivariate logistic regression analysis C-reactive protein (CRP) (odds ratio (OR): 1.693, 95% confidence interval (CI): 1.126-2.547, P = .011), left ventricle ejection fraction (LVEF) (OR: 0.777, 95% CI: 0.678-0.891, P < .001), SYNTAX score (OR: 1.114, 95% CI: 1.050-1.183, P = .001), low density lipoprotein cholesterol (LDL-C) (OR: 1.033, 95% CI: 1.013-1.055, P = .002), hemoglobin level (OR: 0.572, 95% CI: 0.395-0.827, P = .003), PNI (OR: 0.554, 95% CI: 0.448-0.686, P < .001) were associated with NRP. The area under curve of PNI was significantly higher than albumin (z = 4.747, P < .001) and lymphocyte values (z = 3.481 P < .001). PNI was associated with no-reflow occurrence and mortality. So, PNI may be useful to predict NRP risk in patients with STEMI before pPCI.

16.
Turk Kardiyol Dern Ars ; 49(4): 328-333, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34106067

RESUMO

The occurrence of acute coronary syndrome (ACS) following a scorpion sting has been very rarely reported in literature, and most of the cases presented had a normal coronary angiogram. The possible pathogenetic mechanisms include imbalance in blood pressure and coronary spasm caused by a combination of sympathetic excitation with subsequent thrombosis of coronary vessels developed after the release of vasoactive, inflammatory, and thrombogenic substances contained in the scorpion venom. In this report, we present a case of a scorpion sting complicated by ACS, called Kounis syndrome (KS). His coronary angiogram revealed the presence of significant stenosis of the left anterior descending artery. He was treated successfully with percutaneous transluminal coronary angioplasty, antivenom serum, and supportive therapy.


Assuntos
Síndrome Coronariana Aguda/etiologia , Estenose Coronária/diagnóstico por imagem , Síndrome de Kounis/etiologia , Picadas de Escorpião/complicações , Síndrome Coronariana Aguda/terapia , Doença Crônica , Estenose Coronária/terapia , Vasoespasmo Coronário/complicações , Antebraço , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/terapia , Masculino , Pessoa de Meia-Idade , Picadas de Escorpião/terapia , Stents
17.
Bosn J Basic Med Sci ; 21(4): 502, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-33160301

RESUMO

We appreciate the comments made by Dr Bedel and colleagues. NLR, PLR and LMR are affected by various diseases such as oncological, collagen tissue, inflammatory, or severe renal/liver diseases [1]. Because of this, we have listed some of the above-mentioned disorders in the tables. Hematological diseases, collagen tissue disease, inflammatory diseases, congenital heart disease, or severe renal/liver disease were therefore excluded from the study. However, the presence of malignancy did not affect our results in regression analysis. Platelets swell until 120 minutes in ethylene diamine tetra acetic (EDTA) and until 60 minutes in citrate [2]. Authors suggest that optimal measuring time should not exceed 120 minutes. The blood samples of the patients were taken within 1 hour after their emergency admission. All blood samples in our study were tested within 1 hour of collection [3]. We used EDTA for whole blood anticoagulation. The mean duration of symptoms prior to admission was 5.04 ± 6.9 days. The drugs such as corticosteroids affect inflammatory parameters. Therefore, we excluded inflammatory diseases without emphasizing corticosteroids or other anti-inflammatory drugs.


Assuntos
Linfócitos , Embolia Pulmonar , Humanos , Monócitos , Neutrófilos , Prognóstico , Estudos Retrospectivos
18.
Turk Pediatri Ars ; 55(3): 236-243, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061750

RESUMO

AIM: Tuberculosis is one of the oldest and most contagious diseases of human history. One- quarter of the world's population is infected with the tuberculosis bacillus. Childhood tuberculosis does not have a standard clinical and radiologic description. Herein, we aimed to evaluate the clinical, laboratory, and radiologic findings of childhood tuberculosis. MATERIAL AND METHODS: The medical records of 216 patients hospitalized and treated with a diagnosis of TB between January 2015 and July 2019 in the Division of Pediatric Infectious Diseases in our hospital, were examined retrospectively. RESULTS: One hundred twenty-nine (59.7%) of 216 patients who were diagnosed as having TB were female and 87 (40.3%) were male. The age distribution of the patients was 12.3 (range, 0.33-18) years. One hundred sixty-nine patients (78.2%) had pulmonary, 34 (15.7%) had extrapulmonary, 13 had (6%) both pulmonary and extrapulmonary. One hundred forty-three (66.2%) patients had tuberculin skin test positivity. Acid-resistant bacteria were observed in 46 (21.3%) body fluid samples, and culture positivity was observed in 42 (19.4%) samples. The association of pulmonary tuberculosis and extrapulmonary tuberculosis was found with a higher rate in individuals who lived on minimum wage and in patients who had growth and developmental retardation (p=0.001, p<0.001). The hospitalization time was longer in these patients (p=0.027). The hemoglobin and sodium levels were significantly lower in patients who had extrapulmonary tuberculosis (p=0.044, p=0.002). CONCLUSION: Although the diagnosis of childhood tuberculosis is difficult due to the nonspecific signs and symptoms, it is a preventable and treatable disease.

19.
Bosn J Basic Med Sci ; 20(2): 248-253, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31724521

RESUMO

Pulmonary embolism (PE) is associated with significant morbidity and mortality. New biological markers are being investigated for estimating the prognosis of PE patients. Since PE is closely associated with inflammatory status, the neutrophil-lymphocyte (NLR), platelet-lymphocyte (PLR), and lymphocyte-monocyte (LMR) ratios were suggested to be useful in predicting patient outcomes. This study aimed to evaluate the prognostic role of NLR, PLR, and LMR in PE. A total of 103 PE cases from a cardiology department were included in the study. We retrospectively evaluated demographic and clinical characteristics, treatments, laboratory and imaging findings, and outcomes of patients. The median follow-up of PE patients was 39 months, and the 5-year overall survival probability was 73.8%. Out of 103 patients, 20 were classified as high risk PE cases (19.4%). Thrombolytic treatment was administered to 23 patients (22.3%). Systolic pulmonary arterial pressure was measured during one year, showing a significant decrease from 51.7 ± 15.7 mmHg at admission to 26.6 ± 4.0 mmHg at first year assessment. Age (OR: 1.06, p < 0.001) and NLR (OR: 1.52, p < 0.0019) were significantly associated with the disease status. The independent prognostic factors in moderate-low and low risk PE groups were NLR (HR: 1.17, p = 0.033) and LMR (HR: 1.58, p = 0.046). In moderate-high and high risk PE patients, the independent prognostic factors were age (HR: 1.07, p = 0.014) and PLR (HR: 1.01, p = 0.046). NLR, PLR, and LMR were associated with the prognosis of PE patients. The clinical severity of PE should be considered when utilizing these markers to assess patient outcomes.


Assuntos
Contagem de Linfócitos , Monócitos , Neutrófilos , Contagem de Plaquetas , Embolia Pulmonar/sangue , Embolia Pulmonar/diagnóstico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Embolia Pulmonar/mortalidade , Estudos Retrospectivos , Taxa de Sobrevida , Terapia Trombolítica
20.
Angiology ; 71(8): 740-746, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32527139

RESUMO

Carotid artery stenosis (CAS), mainly caused by carotid atherosclerosis, is related to ischemic stroke. We investigated whether C-reactive protein (CRP) to albumin ratio (CAR) was associated with increased severity of carotid stenosis in patients undergoing carotid angiography. A total of 269 patients who were undergoing carotid angiography were included in this study. The patients were divided into 2 groups with respect to the severe CAS: group 1 (stenosis < 70%, n = 189) or group II (stenosis ≥ 70%, n = 80). C-reactive protein to albumin ratio was higher in group II compared to group I (0.56 ± 0.25 vs 0.14 ± 0.01, P < .001). The CAR (odds ratio [OR]: 1.051, 95%CI: 1.027-1.076, P < .001), neutrophil to lymphocyte ratio (NLR), and total cholesterol levels were independent predictors of severe CAS. The area under the receiver operating characteristic curve (area under the curve) for the CAR to predict severe CAS was 0.798 (95% CI: 0.741-0.854, P < .001). C-reactive to protein albumin ratio was an independent risk factor of severe CAS. Therefore, CAR might be considered a potential index in the severity of carotid artery disease.


Assuntos
Proteína C-Reativa/análise , Estenose das Carótidas/sangue , Albumina Sérica Humana/análise , Idoso , Angiografia , Biomarcadores/sangue , Estenose das Carótidas/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Índice de Gravidade de Doença
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