Person: ULUGANYAN, MAHMUT
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Publication Metadata only Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Combination Can Predict Prognosis in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention(2015-05-01) Cicek, Gokhan; Acikgoz, Sadik Kadri; Bozbay, Mehmet; Altay, Servet; Ugur, Murat; Uluganyan, MAHMUT; Uyarel, Huseyin; ULUGANYAN, MAHMUTWe assessed the effect of combination of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in predicting in-hospital and long-term mortality in patients (n = 2518) undergoing primary percutaneous coronary intervention (pPCI). Cutoff values for NLR and PLR were calculated with receiver-operating characteristic (ROC) curves. If both PLR and NLR were above the threshold, patients were classified as high risk. If either PLR or NLR was above the threshold individually, patients were classified as intermediate risk. High-risk (n = 693) and intermediate-risk (n = 545) groups had higher in-hospital and long-term mortality (7.2 4% vs 0.7%, P < .001; 14.1, 9.5% vs 4.5%, P < .001, respectively). Classifying patients into intermediate-risk group (hazards ratio [HR]: 1.492, 95% confidence interval [CI]: 1.022-2.178, P = .038) and high-risk group (HR: 1.845, 95% CI: 1.313-2.594, P < .001) was an independent predictor of in-hospital and long-term mortality. The combination of PLR and NLR can be useful for the prediction of in-hospital and long-term mortality in patients undergoing pPCI.Publication Open Access Combination of hemoglobin and left ventricular ejection fraction as a new predictor of contrast induced nephropathy in patients with non-ST elevation myocardial infarction(2014-06-12) Ugur, Murat; Uluganyan, MAHMUT; Ekmekci, Ahmet; Bozbay, Mehmet; Karaca, Gurkan; Cicek, Gokhan; Koroglu, Bayram; Tusun, Eyup; Murat, Ahmet; Turan, Burak; Uyarel, Huseyin; Orhan, Ahmet Lutfi; Eren, Mehmet; ULUGANYAN, MAHMUTBackground: Hemoglobin concentration (Hb) and left ventricular ejection fraction (EF) are known predictors of contrast induced nephropathy (CIN). We hypothesized that combination of Hb concentration and left ventricular EF is superior to either variable alone in predicting contrast induced nephropathy in patients with acute coronary syndrome (ACS). Material and methods: Consecutive patients with ACS were prospectively enrolled. Patients considered for invasive strategy were included. Baseline creatinine levels were detected on admission and 24, 48 and 72 hours after coronary intervention. 25% or 0,5 umol/L increase in creatinine level was considered as CIN. Results: 268 patients with ACS (mean age 58±11 years, 77% male) were enrolled. Contrast induced nephropathy was observed in 26 (9.7%) of patients. Baseline creatinine concentration, left ventricular EF, and Hemoglobin was significantly different between two groups. Contrast volume to estimated glomerular filtration rate ratio (OR: 1.310, 95% CI: 1.077-1.593, p=0.007) and the combination of Hb and left ventricular EF (OR: 0.996, 95% CI: 0.994-0.998, p=0.001) were found to be independent predictors for CIN. Hb × LVEF ≤690 had 85% sensitivity and 57% specificity to predict CIN (area under curve: 0.724, 95% CI: 0.625-0.824, p<0.001). In addition, Hb × LVEF ≤690 had a negative predictive value of 97% in our analysis Conclusions: The combination of Hb and left ventricular EF is better than either variable alone at predicting CIN in patients with ACS that undergone percutaneous coronary intervention. The prediction was independent of baseline renal function and volume of contrast agent.Publication Metadata only Predictors of Prolonged In-Hospital Stay After Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction(2016-09-01) Isik, Turgay; Ayhan, Erkan; Uluganyan, MAHMUT; Gunaydin, Zeki Yuksel; Uyarel, Huseyin; ULUGANYAN, MAHMUTHealth care costs increase with prolonged in-hospital stays. Many factors influence the length of stay for patients with ST-elevation myocardial infarction (STEMI). In this study, we aimed to determine the differences between long-stay and early discharged patients with STEMI. For this retrospective study, a total of 2486 consecutive patients with STEMI (mean age: 56.2 +/- 11.7 years, 16.5% female) who had undergone primary percutaneous coronary intervention (pPCI) were enrolled. Patients were divided into 2 groups based on mean in-hospital stay: <6 days and 6 days. Anterior STEMI (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.02-2.54; P = 0.03), angiographic failure (OR: 2.89, 95% CI: 1.19-7.01; P = .01), and peripheral vascular complications (PVCs; OR: 4.18, 95% CI: 1.16-15.03; P = .02) were found to be independent predictors of 6-day in-hospital stay. The incidence of long-term total mortality and composite end point for death, reinfarction, and target vessel revascularization were significantly higher in 6-day in-hospital stay patients. Anterior STEMI, angiographic failure, and PVCs were found to be independently associated with prolonged in-hospital stay for patients with STEMI following pPCI.Publication Open Access ST-Segment Elevation of Right Precordial Lead (V4R) Is Associated with Multivessel Disease and Increased In-Hospital Mortality in Acute Anterior Myocardial Infarction Patients(2015-07-01) Tusun, Eyyup; Uluganyan, MAHMUT; Ugur, Murat; Karaca, Gurkan; Osman, Faizel; Koroglu, Bayram; Murat, Ahmet; Ekmekci, Ahmet; Uyarel, Huseyin; Sahin, Osman; Eren, Mehmet; Bolca, Osman; ULUGANYAN, MAHMUTBackground: ST segment elevation of chest lead V4 R is associated with worse prognosis in acute inferior ST-elevation myocardial infarction (STEMI). This study tried to determine the relationship between ST elevation in the right precordial lead V4 R and acute anterior STEMI. Methods: Prospective study of 144 consecutive anterior STEMI patients: all had 15-lead ECG recordings (12 conventional leads and V3 R-V5 R) obtained. Patients were classified into two groups on the basis of presence (Group I, 50 patients) or absence (Group II, 94 patients) of ST-segment elevation ≥0.5 mm in lead V4 R. Results: Multivessel involvement was significantly higher in Group I compared with Group II (54% and 23% respectively, P < 0.001). Major adverse cardiac events and in-hospital mortality was also significantly higher for those in Group I (P < 0.02 for both). A significant correlation was found between in-hospital mortality and those in Group I (P = 0.03, OR: 6.27, CI: 1.22-32.3). There was an independent relationship between in-hospital mortality and V4 R-ST elevation (P = 0.03, OR: 11.64, CI: 1.3-27.4). Conclusion: ST segment elevation in chest lead V4 R is associated with multivessel disease and increased in-hospital mortality in patients with anterior STEMI that had undergone primary percutaneous coronary intervention to the left anterior descending artery.Publication Metadata only Relation of the metabolic syndrome with proarrhythmogenic electrocardiographic parameters in patients without overt diabetes(2012-04-01) Isik, Turgay; Tanboga, Ibrahim H.; Kurt, Mustafa; Kaya, Ahmet; Ekinci, Mehmet; Ayhan, Erkan; Uluganyan, MAHMUT; Ergelen, Mehmet; Guvenc, Tolga S.; Altay, Servet; Uyarel, Huseyin; ULUGANYAN, MAHMUTObjectives We aimed to observe the relationship of the metabolic syndrome and proarrythmogenic ECG parameters and to evaluate a possible correlation of these parameters to the metabolic syndrome score in patients without overt diabetes mellitus. Methods The study population consisted of 142 patients with the metabolic syndrome and 170 age- and gender-matched control subjects. In the ECG recordings, resting heart rate, QRS duration, corrected QT duration and corrected QT dispersion were measured. Patients were classifi ed into three groups based on number of fulfi lled metabolic syndrome criteria: group 1 (three metabolic syndrome criteria), group 2 (four metabolic syndrome criteria) and group 3 (fi ve metabolic syndrome criteria). Results Patients with the metabolic syndrome had a higher increased resting heart rate, QTcd, prolonged QRS and QTc duration. Resting heart rate increases signifi cantly parallel to the increase in the metabolic syndrome score across the groups, whilst QRS duration remained unchanged. QTc duration and QTc dispersion were signifi cantly higher in groups 2 and 3 when compared to group 1. However, no signifi cant diff erences were observed between groups 2 and 3. Conclusion We demonstrated that the metabolic syndrome and its score related with increased resting heart rate and prolonged repolarization durations in patiens without overt diabetes mellitus. These pro arrhythmogenic parameters could be used in the development of risk stratifi cation schemes for sudden cardiac death in patients with the metabolic syndrome.Publication Open Access Impact of admission blood glucose levels on prognosis of elderly patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention(2013-01-01) Ekmekci, Ahmet; Uluganyan, MAHMUT; Tufan, Fatif; Uyarel, Huseyin; Karaca, Gurkan; Kul, Seref; Gungor, Baris; Ertas, Gokhan; Erer, Betul; Sayar, Nurten; Gul, Mehmet; Eren, Mehmet; ULUGANYAN, MAHMUTObjective: Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events. We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients (> 65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction. Methods: We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ± 5.4). Patients were divided into two groups according to admission blood glucose levels. Group 1: low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose > 168 mg/dL. Results: In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P < 0.001). Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI < 3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P < 0.001). Conclusions: Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality.