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Öğe Comparative evaluation of intermountain risk score with Mehran risk score for risk estimation of contrast-induced nephropathy and short-term mortality in ST-segment elevation myocardial infarction patients(Sage Publications Inc, 2023) Toprak, Kenan; Kaplangöray, Mustafa; Memioğlu, Tolga; İnanir, Mehmet; Ermiş, Mehmet Fatih; Toprak, İbrahim Halil; Acar, OsmanContrast-induced nephropathy (CIN) has become one of the most important causes of in-hospital acute renal failure with the increasing use of contrast-mediated imaging tools. This significantly increases the morbidity and mortality of the affected subjects and causes a financial burden on the health system. In this context, prediction of CIN is important and some risk scores have been developed to predict CIN. The most frequently used and popular among these is the Mehran Score (MS), which is based on a number of hemodynamic and metabolic parameters. The Intermountain Risk Score (IMRS) is a recently developed risk score that highly predicts short-term mortality based on common laboratory parameters, and many parameters of this risk score have been found to be closely associated with CIN. In this context, we aimed to compare MS and IMRS in terms of CIN and short-term mortality estimation. The study included 931 patients who underwent percutaneous coronary intervention. CIN developed in 21.5% of patients. Both MS and IMRS independently predicted CIN. In receiver operating characteristic analysis, IMRS was found to be non-inferior to MS in predicting CIN and IMRS was superior to MS in predicting short-term mortality. IMRS and MS were independently associated with short-term mortality.Öğe Does periodontitis affect mean platelet volume(MPV) and plateletcrit (PCT) levels in healthy adults?(Assoc Medica Brasileira, 2020) Ustaoğlu, Gülbahar; Erdal, Emrah; İnanir, MehmetOBJECTIVE: Periodontitis may stimulate infectious and immune response and cause the development of atherogenesis, coronary heart disease, and myocardial infarction. The aim of this study was to compare the plateletcrit (PCT) and mean platelet volume (MPV) levels derived from complete blood count (CBC) tests in patients suffering from stage 3 periodontitis with those of healthy individuals without periodontal disease. METHODS: The study included 57 patients (28 females and 29 males) with Stage 3 Periodontitis and 57 volunteering individuals (31 females and 26 males) who were periodontally healthy. The age of study participants ranged from 18 to 50 years. Their periodontal condition was investigated with probing depth (PD), clinical attachment level, bleeding on probing, and plaque index. Leukocyte (WBC) and erythrocyte count (RBC), hemoglobin (Hb) and hematocrit (HCT) levels, mean corpuscular volume (MCV) and red cell distribution width (RDW), thrombocyte count, mean platelet volume (MPV), plateletcrit (PCT), and neutrophil and lymphocyte counts were evaluated based on the CBC test results of the study participants. RESULTS: PCT, WBC, Neutrophil, and MPV values were found to be significantly higher in the periodontitis group (p<0.05). There were no significant differences in RBC counts, Hb, HCT, MCV, RDW, and platelet and lymphocyte counts between the two study groups (p>0.05). CONCLUSIONS: PCT and MPV levels may be a more useful marker to determine an increased thrombotic state and inflammatory response in periodontal diseases.Öğe Effects of sleeve gastrectomy surgery on electrocardiographic ventricular arrhythmia markers(Bayrakol Medical Publisher, 2022) İnanir, Mehmet; Memioğlu, Tolga; Yılmaz, Fatih; Eren, Hayati; Toprak, Kenan; Şengül, NerimanAim: Severely obese patients are known to be at risk of malignant arrhythmias. The frequency of ventricular arrhythmia and sudden death is increasing in morbidly obese patients. Ventricular depolarization and repolarization parameters on the electrocardiogram can predict mortality and morbidity. Electrocardiographic (ECG) markers of ventricular depolarization and repolarization parameters like QT, QTc, QTd, QTdc, JT, JTc and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios were evaluated before and after sleeve gastrectomy surgery. Material and Methods: ECG recordings of 35 (24 females and 11 males) morbid obese patients without evident cardiovascular disease were analyzed before and 20.3 +/- 9.6 (6-36) months after sleeve gastric surgery. QT, QRS, JT, and Tp-e intervals were measured. QTc, QTd, QTdc, and JTc intervals and Tp-e/QT, Tp-e/ QTc, Tp-e/JT and Tp-e/JTc ratios were calculated. Results: Body mass index (48.29 +/- 7.65 to 31.38 +/- 4.94 kg/m2, p<0.001), QTc interval (405.6 +/- 17.3 to 389.2 +/- 16.6 milisecond (ms), p<0.001), QTd (27.5 +/- 12.4 to 18.3 +/- 9.0 ms, p<0.001), QTdc (30.7 +/- 14.4 to 19.1 +/- 9.1 ms, p<0.001), JTc interval (315.0 +/- 19.0 to 301.2 +/- 20.4 ms, p=0.001), Tp-e interval (81.6 +/- 7.8 to 69.5 +/- 9.3 ms, p<0.001), Tp-e/QT ratio (0.22 +/- 0.03 to 0.19 +/- 0.02, p<0.001), Tp-e/QTc ratio (0.20 +/- 0.02 to 0.18 +/- 0.02, p<0.001), Tp-e/JT ratio (0.29 +/- 0.04 to 0.24 +/- 0.03, p<0.001) and Tp-e/JTc ratio (0.26 +/- 0.03 to 0.23 +/- 0.03, p<0.001) were significantly decreased after sleeve gastrectomy surgery. Discussion: QTc, QTd, QTdc, JTc, and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios, which are potential ECG ventricular arrhythmia predictors were significantly decreased. Therefore weight reduction with sleeve gastrectomy surgery may be associated with decreased malign arrhythmia tendency and sudden cardiac death.Öğe How effective is the systemic inflammatory immune index in the etiopathogenesis of isolated coronary artery ectasia?(Arquivos Brasileiros Cardiologia, 2023) Toprak, Kenan; Kaplangöray, Mustafa; İnanir, Mehmet; Memioğlu, TolgaIsolated coronary artery ectasia (ICAE) is frequently encountered in clinical practice with increasing invasive imaging methods, and our knowledge about its etiology, prognosis, and treatment approaches is increasing daily.1,2 We read with great interest the recent retrospective study of Dindas et al.,3 which deals with the relationship between the Systemic Immune Inflammation Index (SII) and ICAE.3 It has been suggested that SII neutrophils, platelets, and lymphocytes collected in a single fraction may be a good indicator of inflammation and immune response.4 Various studies have shown that SII may have a more potent prognostic value than conventional inflammatory markers such as Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR).5 We would like to comment on the well-designed and presented article, which we think will contribute significantly to the literature.Öğe Right ventricular early inflow-outflow index-a new method for echocardiographic evaluation of right ventricle dysfunction in acute pulmonary embolism(Wiley, 2020) Acar, Emrah; İzci, Servet; İnanir, Mehmet; Yılmaz, Mehmet Fatih; İzgi, İbrahim Akın; Kırma, CevatIntroduction Acute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life-threatening. Several risk graduation algorithms may be applied to delineate short-term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow-outflow (RVEIO) index, which is a Doppler-based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism. Methods In the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI < 1 (n = 88) and sPESI >= 1 (n = 72). Echocardiographic parameters, including the RVEIO index, were measured. Results There were no significant differences between the groups in age and gender distribution, or the presence of diabetes mellitus, hypertension, smoking, and history of coronary artery disease. There was a positive correlation with the mortality rate and RVEIO index; the mortality was higher in patients with a higher RVEIO index(<0.001). In receiver operating characteristic (ROC) curve analysis using a cutoff level of 14.39, RVEIO index predicted mortality with a sensitivity of 80.4% and specificity of 57.6%(ROC area under curve:0.694; 95%CI, 0.581-0.814; P < .001). RVEIO index was higher in the sPESI >= 1(n:72) than in the patients with sPESI < 1(14.27 +/- 2.13 vs 10.63 +/- 2.09; P < .001). There was a positive correlation between RVEIO index and sPESI score(+0.428; P < .001). Conclusion As well as predicting the degree of tricuspid regurgitation (TR), the RVEIO index is well-correlated with sPESI score and is associated with mortality in patients with APE. This easily measurable parameter may be used to predict short-term mortality in APE patients.Öğe SCUBE1 is associated with thrombotic complications, disease severity, and in-hospital mortality in COVID-19 patients(Pergamon-Elsevier Science Ltd, 2022) Toprak, Kenan; Kaplangöray, Mustafa; Palice, Ali; Taşcanov, Mustafa Beğenç; İnanir, Mehmet; Memioğlu, Tolga; Kök, ZaferIntroduction: COVID-19 disease, which has recently become an important cause of mortality and morbidity all over the world, is remarkably associated with thrombotic complications. Although many factors are responsible for these increased thrombotic complications in COVID-19 disease, its relationship with a marker that increases the risk of thrombosis such as Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1) has not yet been clarified. This is the first study to examine the potential diagnostic and prognostic value of SCUBE1 levels in patients with COVID-19. In this study, we aimed to clarify the relationship between the increased risk of thrombosis and SCUBE1 in the course of COVID-19 disease. Materials and methods: 553 patients with COVID-19 and 553 healthy controls were compared in terms of SCUBE1 levels. Additionally, patients with COVID-19 were divided into two groups according to their SCUBE1 levels and compared in terms of severity of disease, thrombotic complications and in-hospital mortality. Results: SCUBE1 levels were significantly higher in patients with COVID-19 compared to the control group (p < 0.001). Plasma SCUBE1 levels were significantly higher in patients with severe disease and thrombotic complications, those with mild to moderate disease, and those without thrombotic complications (p < 0.001, for both). In addition, SCUBE1 was found to be an independent predictor of in-hospital mortality (p < 0.001). Conclusions: SCUBE1 may be one of the major determinants of thrombotic complications, which is an increased cause of mortality and morbidity in COVID-19 patients so inhibition of this peptide may be among the therapeutic targets in patients with COVID-19.Öğe Time interval between E and E' waves can predict complicated clinical course in patients with acute pulmonary embolism(Wiley, 2021) Acar, Emrah; Kılıçgedik, Alev; İzci, Servet; İnanir, Mehmet; Yılmaz, Mehmet Fatih; Gökçe, MustafaPurpose Acute pulmonary embolism is a life-threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism. Material and methods Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow-up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30-day follow-up, the patients were allocated either into the benign or in the complicated clinical course group. Results The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E-wave velocity, E/A ratio, A ' wave velocity, E/E ' ratio, and time interval between E and E ' waves (P < .05), but lower values of tricuspid annular plane systolic excursion, A-wave velocity, isovolumetric relaxation time, deceleration time, E ', and E '/A ' (P < .05). Complicated clinical course was associated with shorter isovolumetric relaxation time (r = .564, P < .001), E/E ' (r = .495, P < .001), and TE-E ' (r = .596, P < .001). Receiver operator characteristic curve analysis showed that TE-E ' had the largest area under curve (TE-E ' 0.82, IVRT 0.77, E/E ' 0.72). A cut-off value of TE-E ' = 70 milliseconds had an 81.1% sensitivity and 71.4% specificity for the prediction of the complicated clinical course. Conclusion The assessment of the right ventricle diastolic function could predict the complicated clinical course in patients with acute pulmonary embolism.
