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ULUGANYAN, MAHMUT

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ULUGANYAN
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Author: Uyarel, Huseyin ×

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Now showing 1 - 9 of 9
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    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, MAHMUT
    We 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.
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    PublicationOpen 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, MAHMUT
    Background: 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.
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    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, MAHMUT
    Health 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.
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    PublicationOpen 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, MAHMUT
    Background: 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.
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    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, MAHMUT
    Objectives 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.
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    PublicationOpen 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, MAHMUT
    Objective: 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.
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    The Reliability of Computed Tomography-Derived SYNTAX Score Measurement
    (2015-02-01) Ugur, Murat; Uluganyan, MAHMUT; Cicek, Gokhan; Bozbay, Mehmet; Ekmekci, Ahmet; Koroglu, Bayram; Karaca, Gurkan; Murat, Ahmet; Tusun, Eyyup; Kalaycioglu, Ezgi; Uyarel, Huseyin; Eren, Mehmet; ULUGANYAN, MAHMUT
    The Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (SS) was developed for evaluation of coronary artery disease complexity. We aimed to compare the SS calculated by conventional coronary angiography (CAG) and computed tomography angiography (CTA). Retrospectively, 107 patients were recruited (mean age 55.9 +/- 12.4 years). The SS measured by conventional CAG was divided into 3 groups (group 1 SS 22, group 2 SS > 22 to <32, and group 3 SS 32). The SS calculated by both methods has a high correlation (r = .972 and P < .001). The analysis showed a substantial agreement between both imaging modalities. Computed tomography angiography highly predicted conventional CAG lesions (area under curve 0.96, 95% confidence interval 0.92-0.99, and P < .001). The SS measured by CTA is highly correlated with conventional CAG. Therefore, we propose that prior to coronary revascularization, CTA-derived SS could be used for risk stratification.
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    Admission serum potassium level is associated with in-hospital and long-term mortality in ST-elevation myocardial infarction
    (2016-01-01) Uluganyan, MAHMUT; Ekmekci, Ahmet; Murat, Ahmet; Avsar, Sahin; Ulutas, Turker Kemal; Uyarel, Huseyin; Bozbay, Mehmet; Cicek, Gokhan; Karaca, Gurkan; Eren, Mehmet; ULUGANYAN, MAHMUT
    Objective: Current guidelines recommend a serum potassium (sK) level of 4.0-5.0 mmol/L in acute myocardial infarction patients. Recent trials have demonstrated an increased mortality rate with an sK level of >4.5 mmol/L. The aim of this study was to figure out the relation between admission sK level and in-hospital and long-term mortality and ventricular arrhythmias.
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    The relationship between platelet to lymphocyte ratio and the clinical outcomes in ST elevation myocardial infarction underwent primary coronary intervention
    (2014-12-01) Ugur, Murat; Gul, Mehmet; Bozbay, Mehmet; Cicek, Gokhan; Uyarel, Huseyin; Koroglu, Bayram; Uluganyan, MAHMUT; Aslan, Serkan; Tusun, Eyyup; Surgit, Ozgur; Akkaya, Emre; Eren, Mehmet; ULUGANYAN, MAHMUT
    The platelet to lymphocyte ratio (PLR) has been investigated as a new predictor for cardiovascular risk. The aim of the present study was to investigate the prognostic role admission PLRat admission in predicting in-hospital and early mortality in patients presenting with ST segment elevation myocardial infarction (STEMI). A total of 639 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PCI) were included. The study population was divided into tertiles on the basis of PLR values at the admission. A high PLR (N=213) was defined as a value in the upper third tertile (PLR >174.9) and a low PLR (N=426) was defined as any value in the lower two tertiles (PLR 174.9). The patients were followed for clinical outcomes for up to 6 months after discharge. In Kaplan-Meier survival analysis, the rate of 6-month all-cause deaths was 7% in the high PLR group versus 3% in the low PLR group (P=0.03). In multivariate analyses, a significant association was noted between high PLR levels and the adjusted risk of 6-month all-cause deaths (odds ratio=2.51, 95% confidence interval=1.058-5.95; P=0.03). PLR is a readily available clinical laboratory value associated with 6-month all-cause death in patients with STEMI who undergo primary PCI.