2019-01-01T00:00:00Z, Bakshaliyev, N, Karacop, E, Cosansu, K, Huyut, MA, Turna, F, Enhos, A, Nadir, A, Ozdemir, R, Uluganyan, MAHMUT, ENHOŞ, ASIM, KARAÇÖP, ERDEM, BAKHSALIYEV, NIJAD, NADİR, AYDIN, ÖZDEMİR, RAMAZAN, ULUGANYAN, MAHMUT

Background: Assessing the monocyte to high-density lipoprotein ratio (MHR) is a new tool for predicting inflamation, which plays a major role in atherosclerosis. Myocardial bridge (MB) is thought to be a benign condition with development of atherosclerosis, particularly at the proximal segment of the brigde. Objective: To evaluate the relationhip between MHR and the presence of MB. Methods: We consecutively scanned patients referred for coronary angiography between January 2013- December 2016, and a total of 160 patients who had a MB and normal coronary artery were enrolled in the study. The patients’ angiographic, demographic and clinic characteristics of the patients were reviewed from medical records. Monocytes and HDL-cholesterols were measured via complete blood count. MHR was calculated as the ratio of the absolute monocyte count to the HDL-cholesterol value. MHR values were divided into three tertiles as follows: lower (8.25 ± 1.61), moderate (13.11 ± 1.46), and higher (21.21 ± 4.30) tertile. A p-value of < 0.05 was considered significant. Results: MHR was significantly higher in the MB group compared to the control group with normal coronary arteries. We found the frequency of MB (p = 0.002) to increase as the MHR tertiles rose. The Monocyte-HDL ratio with a cut-point of 13.35 had 59% sensitivity and 65.0% specificity (ROC area under curve: 0.687, 95% CI: 0.606-0.769, p < 0.001) in accurately predicting a MB diagnosis. In the multivariate analysis, MHR (p = 0.013) was found to be a significant independent predictor of the presence of MB, after adjusting for other risk factors. Conclusion: The present study revealed a significant correlation between MHR and MB.

2023-07-01, Nadir A., Uluganyan M., NADİR, AYDIN, ULUGANYAN, MAHMUT

Objective: The transradial approach (TRA) has been widely used for coronary procedures. The rate of complications such as bleeding, hematoma and pseudoaneurysm is reduced with TRA. The purpose of this study is to search the treatment role of anti-aggregants and low molecular weight heparins (LMWH) in situation of radial artery occlusion (RAO). Methods: A total of 239 patients (140 men, 58.6%) were included. Of the patients 159 (66.5%) were elective, and 80 (33.5%) had acute coronary syndrome. When RAO was detected, patients were treated with 2 weeks of LMWH. Results: In 23 (9.6%) of 239 patients, RAO was observed. From the 23 patients with RAO, 12 (52.8%) were using anti-aggregants, and the remaining 11 (47.8%) did not use. In terms of RAO, a statistically significant difference was observed between antiaggregant users and non-users (p<0.001). In the group using antiaggregants and LMWH a statistically significant improvement was observed in the radial flow compared with the group treated withLMWH alone (p<0.001). Conclusion: In the present study, we showed that the addition of anti-aggregants to anti-coagulants decreased RAO rate, declined the symptoms of RAO, also potentiated the effects of anti-coagulants and resulted in better recanalization rate of RAO

2018-11-01, Ay, Nuray Kahraman, ENHOŞ, ASİM, AY, YASİN, Ozdemir, Razaman, NADİR, AYDIN, KARAÇÖP, ERDEM, ÇELİKKALE, İLKE, ULUGANYAN, MAHMUT, Goktekin, Omer, KAHRAMAN AY, NURAY, ENHOŞ, ASIM, AY, YASİN, BAKHSALIYEV, NIJAD, NADİR, AYDIN, KARAÇÖP, ERDEM, ÇELİKKALE, İLKE, ULUGANYAN, MAHMUT, ÖZDEMİR, RAMAZAN

Background Although transcatheter aortic valve implantation (TAVI) can successfully correct aortic narrowing, pre-existing pathophysiological alterations in the left ventricle are still a concern in terms of long-term mortality. This study aimed to examine the predictive role of fQRS morphology on long-term prognosis in patients undergoing TAVI due to severe aortic stenosis. Methods A total of 117 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned into two groups based on the presence (n = 36) or absence (n = 81) of fQRS. Predictors of long-term survival were estimated. Results In-hospital mortality was higher in fQRS group (5.5% vs. 1.2%, p = 0.0224). In the long-term, fQRS (OR: 3.06, 95% CI 1.29–7.27, p: 0.01), LVEF <50% (OR: 2.54, 95% CI 1.07–6.02, p: 0.03) and presence of atrial fibrillation (OR: 2.42, 95% CI 1.05–5.60, p: 0.03) emerged as significant independent predictors of short survival. Conclusion Presence of fQRS on ECG, an indirect indicator of myocardial fibrosis, seems to have the potential to be used as a prognostic marker after TAVI procedure. Large prospective studies are warranted.

2022-01-01, Nasifov M., Ozmen E., Deniz C., NADİR A., Ozden O., Bingol G., Jafarov P., Asil T., Goktekin O., Sari I., NADİR, AYDIN

Introduction: The CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease and sex) score is a simple risk stratification algorithm to estimate stroke/thromboembolic risk in patients with non-valvular atrial fibrillation (AF). Higher pre-stroke CHA2DS2-VASc score is known to be associated with greater stroke severity and poorer outcomes. AF patients generally have higher CHA2DS2-VASc scores than non-AF patients. The Modified Thrombolysis in Cerebral Infarction (mTICI) score is the most widely used grading system to assess the result of recanalizing therapies in acute ischemic stroke (AIS). mTICI 2c and mTICI 3 are conventionally accepted as successful recanalization. Aim: We investigated whether pre-stroke CHA2DS2-VASc score is associated with mTICI recanalization score in AIS patients with and without AF undergoing percutaneous thrombectomy. Material and methods: One hundred fifty-nine patients with the diagnosis of AIS who were admitted within 6 h from symptom onset were included in the study (mean age: 65.7 ±12.9). All subjects underwent endovascular treatment. CHA2DS2-VASc scores of the participants were calculated. Subjects were grouped according to mTICI scores achieved after endovascular treatment. mTICI 2c and mTICI 3 were accepted as successful recanalization. Results: Successful reperfusion was observed in 130 (81.8%) of all patients who underwent endovascular treatment (mTICI flow ≥ 2c) and first-pass reperfusion was observed in 107 (67.3%) patients. When the patients with successful (mTICI flow ≥ 2c) and unsuccessful (mTICI flow ≤ 2b) reperfusion were divided into groups, no significant difference was observed between the patients in terms of comorbidities such as AF, hypertension, hyperlipidemia, coronary artery disease and cerebrovascular accident history. Patients with unsuccessful reperfusion were older than patients with successful reperfusion (71.4 ±11.2 vs. 64.5 ±13.01, p = 0.006), with a higher CHA2DS2-VASc score (4.1 ±1.5 vs. 3.04 ±1.6, p = 0.002). In addition, the duration of the procedure was longer in the unsuccessful reperfusion group (92.4 ±27.2 min vs. 65.0 ±25.1 min, p < 0.001). CHA2DS2-VASc score significantly correlated with successful recanalization (correlation coefficient; 0.243, p = 0.002). Multivariate logistic regression analysis revealed that only CHA2DS2-VASc score (OR = 1.43, 95% CI: 1.09-1.87, p = 0.006) and procedure time (OR = 1.03, 95% CI: 1.01-1.05, p < 0.001) were independent predictors of successful reperfusion. The receiver-operating characteristic (ROC) curve was used to determine the cut-off value for the CHA2DS2-VASc score that best predicts successful reperfusion. The optimal threshold was 3.5, with a sensitivity of 58.6% and specificity of 59.2% (area under the curve (AUC): 0.669, p = 0.005). Conclusions: For the first time in the literature, we investigated and demonstrated that pre-stroke CHA2DS2-VASc score was associated with success of recanalization as assessed with mTICI 2c and mTICI 3 in a cohort of AIS patients regardless of AF presence who underwent endovascular treatment. Our findings deserve to be tested with large scale long term studies.