Person: ENHOŞ, ASIM
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Publication Open Access Impact of Antecedent Aspirin Use on Infarct Size, Bleeding and Composite Endpoint in Patients with de Novo Acute Myocardial Infarction(2021-01-01T00:00:00Z) ENHOŞ, Asim; KARAÇÖP, ERDEM; ENHOŞ, ASIM; KARAÇÖP, ERDEMBackground: The study aimed to evaluate the impact of antecedent aspirin use on infarct size, bleeding and composite endpoint in patients with de novo acute myocardial infarction. Patients and methods: A total of 562 consecutive patients with de novo acute myocardial infarction were included in this prospective cohort study. Patients were assigned into two groups based on presence (n=212) and absence (n=350) of prior aspirin use. Primary endpoint was myocardial infarct size, as estimated by troponin I peak. In-hospital mortality, bleeding and composite clinical endpoint including cardiogenic shock, stroke, in-hospital mortality and major bleeding were also evaluated. Results: Although GRACE and CRUSADE scores were higher, troponin I peak was lower in prior aspirin users. This result was maintained after adjustment for baseline ischemic risk profile and other major confounders including MI type and location. Despite high CRUSADE score, there was no increase in major and minor bleeding. Minimal bleeding was higher in antecedent aspirin users. When it was adjusted for the CRUSADE score, a similar risk was reported. Conclusion: Patients with de novo acute myocardial infarction using aspirin for primary prevention have an unexpectedly smaller infarct size and similar bleeding rates.Publication Open Access Assessment of the Relationship between Monocyte to High-Density Lipoprotein Ratio and Myocardial Bridge.(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, MAHMUTBackground: 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.Publication Open Access P Wave Duration/P Wave Voltage Ratio Plays a Promising Role in the Prediction of Atrial Fibrillation: A New Player in the Game(2021-05-01T00:00:00Z) KARAÇÖP, ERDEM; ENHOŞ, Asim; BAKHSALIYEV, NIJAD; ÖZDEMİR, Ramazan; KARAÇÖP, ERDEM; ENHOŞ, ASIM; BAKHSALIYEV, NIJAD; ÖZDEMİR, RAMAZANBackground. Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. Identification of patients at risk for developing AF and the opportunity for early targeted intervention might have a significant impact on morbidity and mortality. Prolonged P wave duration and decreased P wave voltage have been shown to be independent predictors of AF. The present study aimed to investigate the role of P wave duration/P wave voltage in predicting new-onset AF. Methods. We screened a total of 640 consecutive patients who admitted to cardiology outpatient clinic with a complaint of palpitation between 2012 and 2014. 24-h Holter monitoring, echocardiography, and electrocardiography (ECG) recordings were reviewed to identify new-onset AF. Patients were assigned into two groups based on presence (n = 150) and absence (n = 490) of new-onset AF. Previous ECGs with sinus rhythm were analyzed. P wave duration was measured in inferior leads, and P wave voltage was measured in lead one. P wave duration/P wave voltage was also calculated for each patient. Results. One hundred fifty subjects (23.4%) had new-onset AF among 640 patients. P wave duration (123.27 +/- 12.87 vs. 119.33 +/- 17.39 ms, p=0.024) and P wave duration/P wave voltage (1284.70 +/- 508.03 vs. 924.14 +/- 462.06 ms/mV, p<0.001) were higher, and P wave voltage (0.12 +/- 0.04 vs. 0.13 +/- 0.04 mV, p<0.001) was significantly lower in the new-onset AF group compared with non-AFs. P wave duration/P wave voltage, with a cut off of 854.5 ms/mV, had 83.3% sensitivity and 62.0% specificity in a receiver operating characteristic curve (AUC 0.728, 95% CI 0.687-0.769; p<0.001). Their negative and positive predictive values were 78.7% and 68.6%, respectively. In a univariate regression analysis, age, smoking, C-reactive protein, brain natriuretic peptide, left atrial diameter, left atrial volume index, P wave duration, P wave voltage, and P wave duration/P wave voltage were significantly associated with the development of new-onset AF. Moreover, smoking (OR 4.008, 95% CI 1.707-9.409; p=0.001), left atrial volume index (OR 7.108, 95% CI 4.400-11.483; p<0.001), and P wave duration/P wave voltage (OR 1.002, 95% CI 1.000-1.003; p=0.044) were found to be significant independent predictors of new-onset AF in a multivariate analysis, after adjusting for other risk parameters. Conclusion. The P wave duration/P wave voltage ratio is a practical, easy-to-use, cheap, and reliable electrocardiographic parameter, which can play a promising role for both in predicting and elucidating a mechanism of new-onset AF.Publication Open Access Predictive role of ventricular repolarization parameters for the occurrence of complete heart block in patients undergoing transcatheter aortic valve implantation(2020-07-01T00:00:00Z) KARAÇÖP, ERDEM; ENHOŞ, Asim; KARAÇÖP, ERDEM; ENHOŞ, ASIMBackground We investigated the role of ventricular repolarization parameters to predict complete atrioventricular block in patients undergoing transcatheter aortic valve implantation (TAVI). Methods A total of 150 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned in two groups based on the presence (n: 49) or absence (n: 101) of complete atrioventricular block after TAVI. Ventricular repolarization intervals (QT, QTc, JT, JTc, TP-E), indices (QT dispersion), and ratios (TP-E/QT, TP-E/QTc, TP-E/JTc) were measured. Results Electrocardiographic repolarization parameters such as Tp-e interval: 74.2 +/- 5.1 versus 59.2 +/- 6.1 ms,p < .001; QTc interval: 397.6 +/- 3.4 versus 368.1 +/- 7.8 ms,p < .001; JTc interval: 317.4 +/- 11.3 versus 291.1 +/- 6.7 ms,p < .001; Tp-e/QT ratio: 0.28 +/- 0.04 versus 0.20 +/- 0.04,p < .001; Tp-e/QTc ratio: 0.29 +/- 0.04 versus 0.19 +/- 0.03,p < .001; Tp-e/JT ratio: 0.32 +/- 0.03 versus 0.23 +/- 0.03,p < .001; Tp-e/JTc ratio: 0.30 +/- 0.02 versus 0.2 +/- 0.03,p < .001; and QT dispersion: 34.4 +/- 3.0 versus 17.8 +/- 3.6 ms,p < .01 were significantly higher in post-TAVI permanent pacemaker group. In a univariate regression analysis, pulmonary artery pressure, heart rate, coronary artery disease, Tp-e/QTc, Tp-e/JTc, and PR interval were significantly associated with complete heart block. Tp-e/JTc (OR 0.373,p = .067) and PR interval (OR 0.898,p = .079) were found to be independent predictors of these type of arrhythmias in a multivariate analysis. But it is not statistically significant. Conclusion Our results suggest that repolarization parameters may play a role in predicting complete atrioventricular block. Tp-e/JTc was found to be potential independent risk marker for this setting.Publication Open Access The prognostic value of fragmented QRS in patients undergoing transcatheter aortic valve implantation(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, RAMAZANBackground 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.Publication Open Access The effect of 5-day course of hydroxychloroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patients(2020-09-01T00:00:00Z) Bakhshaliyev, Nijad; ULUGANYAN, Mahmut; ENHOŞ, Asim; KARAÇÖP, ERDEM; ÖZDEMİR, Ramazan; BAKHSALIYEV, NIJAD; ULUGANYAN, MAHMUT; ENHOŞ, ASIM; KARAÇÖP, ERDEM; ÖZDEMİR, RAMAZANBackground: The combination of Hydroxychloroquine (HCQ) and azithromycin showed effectiveness as a treat-ment for COVID-19 and is being used widely all around the world. Despite that those drugs are known to cause prolonged QT interval individually there is no study assessing the impact of this combination on electrocardiography (ECG). This study aimed to assess the impact of a 5-day course of HCQ and azithromycin combination on ECG in non-ICU COVID19(+) patients.