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Öğe Association Between Plasma Levels of Fibrinogen and the Presence and Severity of Coronary Artery Ectasia(2020) Ozde, Cem; Kayapinar, Osman; Afşin, HamdiObjective The aim of this study was to investigate the plasma fibrinogen levels in patients with isolated coronary artery ectasia (CAE).Materialsand MethodsThe study population included 154 patients, of whom 52 had isolated CAE, 52 had stable coronary artery disease (CAD) and 50 had normal coronary arteries (NCA). Theseverity of isolated CAE was determined using the Markis classification. All the subjects underwent complete physical examinations, including a detailed medical history,complete blood count and biochemical parameters. Plasma fibrinogen levels also were measured in all subjects.Results The baseline characteristics of the three groups were similar. Plasma fibrinogen levels were significantly higher in the CAE group and CAD group than in the NCA group(383.3 ± 53.0 mg/dl and 400.8 ± 50.6 mg/dl vs 324.0 ± 56.4 respectively, p < 0.001). No difference was found between the CAE and CAD groups. The fibrinogen level wassignificantly higher in the type 1 Markis subgroup than in the type 2 and type 3 subgroups (P <0.001). In multivariate logistic regression analyses, fibrinogen level wasindependently and significantly associated with isolated CAE. Receiver operating characteristic curve analysis revealed that fibrinogen levels > 325 mg/dl identified patientswith isolated CAE.Conclusions Plasma fibrinogen is an easily measurable systemic inflammatory biomarker that is independently associated with CAE presence and severity. This suggests that fibrinogenmay be involved in the pathophysiology of CAE.Öğe Complete dissection of left anterior descending artery in a young woman after myocardial infarction(2012) Özhan, Hakan; Bulur, Serkan; Kayapinar, Osman; Türker, YasinSpontaneous coronary artery dissection (SCAD) is a rare clinical condition that causes acute coronary syndrome and sudden cardiac death. Herein, we report a case of left anterior descending artery dissection after myocardial infarction. On the third day of myocardial infarction after successful thrombolysis, the patient had recurrent chest pain without any ST wave elevation. She was referred to our clinic for coronary angiography which showed completely dissected left anterior descending (LAD) artery. She was referred to a tertiary centre with intravascular ultrasonography (IVUS) capability. Her control angiogram showed restored flow with only minimal dissection (so IVUS was not performed) in the mid LAD. The lesions in the distal and mid LAD were stented. The final angiogram showed TIMI-III flow. Percutaneous coronary intervention is the first choice of treatment in patients with single-vessel spontaneous coronary artery dissection with ongoing signs of ischemia.Öğe The relationship between the level of serum uric acid and no-reflow phenomenon after primary percutaneous coronary intervention in patients with St segment elevated myocardial infarction(2010) Erden, Ismail; Erden, Emine Çakcak; Sözen, Serhat Bahadir; Kayapinar, Osman; Ça?lar, Sabri Onur; Başar, CengizNo-reflow phenomenon is the absence of myocardial perfusion despite adequate dilatation of the infarct related coronary artery during percutaneous coronary intervention. Uric acid (UA) release during ischemia and washout from the ischemic zone during reperfusion is adenine nucleotide breakdown product. Therefore uric acid may play reperfusion injury and no-reflow. İn this study, we aimed to compare serum uric acid value of ST segment elevated Mİ patients groups whith no-reflow phenomenon and normal miyocardial perfusion after primary coronary intervention. 47 patients was enrolled consecutively to this study. During hospital admission, patients blood samples were taken for serum uric acid value. Patients was grouped as no reflow and normal perfusion groups according to myocardial blush grades (MBG). Patient with myocardial blush grades 0-1 were accepted as no-reflow group, patients with MBG 2-3 normal perfusion group. When the serum uric acid value of no-reflow and normal perfusion groups was compared, there was statistificaly significant difference (respectively 6,680±1,11 mg/dl versus 5,066±0,68 mg/dl. p<0,05). A significant correlation was found between the serum uric acid level and the presence of no-reflow phenomenon (r=0.598; p<0.025). Multivariate logistic regression analysis showed an independent relationship between no-reflow phenomenon and serum uric acid level (OR 1.815; 95% CI 1.098-1.493; p<0.031). In ST segment elevated Mİ patients with higher serum uric acid value before primary coronary intervention, no-reflow phenomenon is developed more frequently. Uric acid may play important role in mechanism of no-reflow phenomenon. © 2010 Düzce Medical Journal.Öğe Silent interrupted aortic arch in an elderly patient(Via Medica, 2011) Erden, Ismail; Kayapinar, Osman; Erden, Emine C.; Yalçin, SubhanPatients with complete interruption of the aortic arch (IAA) very rarely reach late adulthood without having undergone surgical intervention. Only a few cases of IAA in adults have beenne surgical intervention. Only a few cases of IAA in adults have been reported in the medical literature. In this case report, we present a late diagnosis of interrupted aortic arch in a 68 year-old male. Our patient was relatively asymptomatic until he presented with fatigue after walking quickly. A guidewire could not be passed to the aortic arch via the femoral approach; descending thoracic aortography revealed complete occlusion of the descending thoracic aorta. Cardiac catheterization via the right brachial artery confirmed the diagnosis of a complete interruption of the aortic arch distal to the left subclavian artery and showed distinct collateral circulation predominantly via the internal mammary arteries. Also, magnetic resonance angiography showed cuttings that reveal the interruption in the aortic arch and the prominent collateral vessels to the descending aorta. This case report was also interesting in that pressure measurements at a proximal point of the interrupted aortic arch were not hypertensive. Using both catheters, placed proximally and distally to the point of the interruption, by simultaneous pressure measurement, it was measured as 120/75 mm Hg at the proximal point, 60/40 mm Hg at the distal point. © 2011 Via Medica.Öğe Spontaneous Coronary Artery Dissection in the Post-Partum Period(Duzce Univ, 2011) Caglar, Onur; Kayapinar, Osman; Aydin, Mesut; Alemdar, Recai; Albayrak, Sinan; Ozhan, Hakanpregnancy. Spontaneous coronary artery dissection is the most common cause of myocardial infarction in this period. Although the exact etiology could not be resolved, hemodynamic stress and connective tissue trauma induced by pregnancy are the potential causes. Optimal treatment modalities have not been defined yet in spontaneous coronary artery dissections encountered in the postpartum period. The most suitable way of treatment among medical therapy, surgery and percutaneous intervention should be preferred. Herein, we report a case of non-ST wave elevation myocardial infarction in a 35-year old lady at the second week of her delivery, turned out to be a circumflex artery dissection. The treatment modalities were also discussed in the light of the literature.
