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Öğe Can increased intestinal permeability and low-grade endotoxemia be the triggering pathogenesis in isolated coronary artery ectasia(Lippincott Williams & Wilkins, 2023) Toprak, Kenan; Kaplangöray, Mustafa; Altıparmak, İbrahim Halil; Taşcanov, Mustafa Begenç; Güngören, Fatih; Fedai, Halil; İnanır, Mehmet; Biçer, Asuman; Demirbağ, RecepPurpose Isolated coronary artery ectasia (ICAE) is a rare coronary artery disease (CAD) encountered during coronary angiography. Although many mechanisms have been suggested today that may be associated with ICAE, the underlying pathogenesis has not been fully understood. In this study, we aimed to reveal the possible relationship between intestinal permeability and ICAE. Methods Of the 12 850 patients who underwent coronary angiography, 138 consecutive patients with ICAE and 140 age- and sex-matched subjects with normal coronary arteries as the control group and 140 subjects with stenotic CAD were included in the study. Results Serum zonulin and lipopolysaccharide levels were significantly higher in patients with ICAE than in the control group and CAD group. Additionally, zonulin and lipopolysaccharide levels were significantly higher in the CAD group than in the ICAE group. In the correlation analysis, serum zonulin levels were correlated with the mean diameter and length of the ecstatic segment. In multivariate analysis, zonulin and lipopolysaccharide were identified as independent predictors for ICAE. Conclusion These results suggest that there may be a pathophysiological relationship between increased intestinal permeability and ICAE.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 Could zonulin and presepsin be biomarkers and therapeutic targets for acute myocarditis?(Arquivos Brasileiros Cardiologia, 2023) Toprak, Kenan; İnanır, Mehmet; Memioğlu, Tolga; Kaplangöray, Mustafa; Palice, Ali; Taşcanov, Mustafa BeğençBackground: The diagnosis of acute myocarditis is usually made with clinical and laboratory parameters. This can sometimes be mixed up with diseases that have similar clinical features, making the diagnosis difficult. Therefore, the use of more specific biomarkers, in addition to the classically used biomarkers such as troponin, will accelerate the diagnosis. In addition, these biomarkers may help us to understand the mechanism of myocarditis development and thus predict unpredictable clinical outcomes.Objective: This study aims to reveal the possible relationship between intestinal permeability and acute myocarditis.Methods: In this study, we wanted to evaluate serum levels of zonulin and presepsin in 138 consecutive subjects, including 68 patients with myocarditis and another 70 as the control group, matched for age, gender, and cardiovascular risk factors. P-values <0.05 were considered to be statistically significant.Results: Compared to the control group, zonulin and presepsin were significantly higher in the patient group with myocarditis (p < 0.001, for all). Zonulin levels were positively correlated with presepsin, peak CK-MB, and peak troponin levels (r = 0.461, p < 0.001; r = 0.744, p < 0.001; r = 0.627, p < 0.001; respectively). In regression analysis, presepsin and zonulin were determined as independent predictors for myocarditis (OR 1.002, 95% CI 1.001-1.003, p = 0.025; OR 12.331, 95% CI 4.261-35.689; p < 0.001; respectively). The predictive value of acute myocarditis of presepsin and zonulin in ROC curve analysis was statistically significant (p < 0.001, for both).Conclusion: This study showed that zonulin and presepsin could be biomarkers that can be used in the diagnosis of myocarditis, and they can also be therapeutic targets by shedding light on the developmental mechanism of myocarditis.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 Is the predictive value of systemic immune-inflammation index superior to traditional markers in ST-elevation myocardial infarction patients?(Lippincott Williams & Wilkins, 2023) Toprak, Kenan; Kaplangöray, Mustafa; Memioğlu, Tolga; İnanır, MehmetWe read with great interest the recently published article ‘Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction’ by Öcal et al [1]. In their valuable, well designed, and presented research, the authors argue that the systemic immune-inflammation index (SII) is superior to traditional markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in predicting in-hospital adverse events in patients with ST-elevation myocardial infarction (STEMI) and they also claim that the discriminative value of SII in predicting in-hospital mortality in STEMI patients is higher than NLR; however, when the whole article is evaluated, we think that some methodological and literary issues should be reviewed by the authors.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.
