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Öğe Assessment of serum prolidase levels in patients with coronary artery in-stent restenosis: Serum prolidase levels in stent restenosis(Bayrakol Medical Publisher, 2021) Memioğlu, Tolga; Ayhan, Selim; Dönmez, İbrahimAim: Prolidase is an enzyme, which plays a role in the formation of a new matrix, collagen metabolism and cell development. It is known that the most Important mechanism underlying in-stent restenosis is neointimal hyperplasia. Neointimal hyperplasia is associated with collagen synthesis and matrix proteins. The objective of our study was to reveal the relationship between serum prolidase levels and in-stent restenosis. Material and Methods: This study included a total of 70 patients who were identified to be at a moderate and high risk as a result of clinical or non-invasive tests in the cardiology and emergency clinics of the Abant Izzet Baysal University training and Research Hospital and who underwent angiography. In-stent restenosis was identified in 40 patients. In the remaining 30 patients, there was no angiographically determined critical lesion. Serum prolidase levels were measured in all patients. Results: The mean serum level of prolidase was found to be statistically significantly higher in the in-stent restenosis group compared to the restenosis-free group (p=0.02). The mean serum level of prolidase level was significantly higher in smokers compared to the non-smoker patients (p=0.04). It was observed that serum prolidase levels statistically significantly increased proportionally to the in-stent restenosis percentage (p=0.04). Discussion: The results of this study indicate that prolidase enzyme levels may enable timely and correct assessment of in-stent restenosis, and may contribute to the decision for changing the treatment or timing to increase the intensity of the treatment in patients undergoing percutaneous coronary intervention (PCI) with coronary stenting.Öğe Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose(Springer, 2012) Ayhan, Selim; Öztürk, Serkan; Alçelik, Aytekin; Özlü, Mehmet Fatih; Erdem, Alim; Memioğlu, Tolga; Özdemir, Mesut; Yazıcı, MehmetProlonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography. Thirty patients with IFG (19 males and 11 females; age, 46.9 +/- 9.5 years) and 30 control subjects (18 males and 12 females; age, 46.7 +/- 8.2 years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area-length method. LA mechanical function parameters were calculated. LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p < 0.001 and p < 0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p < 0.001 and 15.0 [8.5] vs. 7.5 [2.0], p < 0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r = 0.76, p < 0.001 and r = 0.68, p < 0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (beta = 0.753, p < 0.001). We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.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 Comparison of the effect of uric acid/albumin ratio on coronary colleteral circulation with other inflammation-based markers in stable coronary artery disease patients(Sage Publications Ltd, 2023) Memioğlu, Tolga; Toprak, Kenan; Yılmaz, Rüstem; Kaplangoray, Mustafa; İnanır, Mehmet; Akyol, SelahattinBackground: The Uric acid/Albumin ratio (UAR) has recently been identified as a prominent marker in cardiovascular diseases. In this study, we aimed to reveal the effect of UAR on coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD) patients by comparing it with conventional inflammation-based markers.Methods: In this study, 415 consecutive patients who underwent coronary angiography for stable angina pectoris and were found to have chronic total occlusion in at least one coronary artery were retrospectively included. The study population was divided into two groups as good CCC (Rentrop 2-3) and poor CCC (Rentrop 0-1) according to the Rentrop classification, and the groups were compared in terms of UAR and other traditional inflammation-based markers.Results: In the poor CCC group, C-reactive protein/albumin ratio (CAR), monocyte/high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and UAR were found to be significantly high (p < .05, for all). UAR negatively correlated with rentrop classification (r = -0.383, p < .001). In multivariate regression analysis, MHR, NLR, SII and UAR were determined as independent predictors for poor CCC (p < .05, for all). The ability of UAR to predict poor CCC was superior to uric acid and albumin alone (p < .0001, for both). In addition, UAR was found to be superior to other inflammation-based markers in predicting poor CCC (p < .005, for all).Conclusion: UAR was identified as a strong and independent predictor of CCC. In this context, UAR may be a useful biomarker in the risk prediction of patients with stable CAD.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 Effect of hand dominance on radial artery spasm and occlusion: A prospective observational study(SAGE Publications Inc., 2024) Toprak, Kenan; İnanır, Mehmet; Memioğlu, Tolga; Palice, Ali; Kaplangöray, Mustafa; Yeşilay, Asuman Biçer; Taşcanov, Mustafa BeğençTransradial access has become the most commonly used method for cardiac catheterization. Many medical and technical applications have been proposed to reduce TRA complications. The aim of this study is to examine the effect of hand dominance on radial artery spasm and radial artery occlusionin subjects undergoing CC via TRA. Between April 2020 and August 2022, 1713 subjects who underwent CC via TRA were included in the study. Patient data were obtained in terms of hand dominance of the catheterized side and RAS and RAO during a 1-month follow-up period. RAS was seen in 9.6% of the subjects. The RAS in patients catheterized by the dominant hand was significantly higher than that performed by the non-dominant hand (12 vs 7.8%; P =.004). RAO was seen in 1% of the subjects. RAO was significantly higher in the spasm side than in the no-spasm side (3 vs.8%; P =.009). Hand dominance was determined as an independent predictor of radial artery spasm (P =.006). In our study, RAS and RAO were more common on the dominant hand side than on the non-dominant side. Choosing the non-dominant hand for TRA for CC may reduce the incidence of RAS and RAO. © The Author(s) 2023.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 Evaluation of the effects of 3D mapping ablation on atrial conduction times in patients with paroxysmal atrial fibrillation(Bayrakol Medical Publisher, 2022) Dönmez, İbrahim; Memioğlu, Tolga; Acar, Emrah; Erdem, FatmaAim: Atrial fibrillation (AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra-and interatrial conduction time, indicates structural and electrical remodeling in the atrium. This study aimed to evaluate the effect of pulmonary vein isolation applied with radiofrequency ablation (RF) therapy on intra-and interatrial conduction time and to investigate the structural and electrically remodeling after treatment.Material and Methods: Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 +/- 11.731; mean left atrial diameter: 36.79 +/- 4.318) who underwent CARTO (R) 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra-and inter-atrial electromechanical delay was measured in all patients using tissue doppler echocardiography before and three months after RF ablation.Results: All intra-and interatrial conduction times were significantly decreased 3 months after RF ablation procedure (PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029).Discussion: The results of our study suggest that providing stable sinus rhythm with RF ablation may slow down, stop or even improve structural remodeling at substrate level secondary to AF even in patients with paroxysmal AF who did not yet develop atrial fibrosis and permanent structural changes.Öğe HbA1c/C-peptide ratio is associated with angiographic thrombus burden and short-term mortality in patients presenting with ST-elevation myocardial infarction(Lippincott Williams & Wilkins, 2023) Toprak, Kenan; Kaplangoray, Mustafa; Memioğlu, Tolga; İnanır, Mehmet; Omar, Bahadır; Taşcanov, Mustafa BegençObjectivesAngiographic high thrombus burden (HTB) is associated with increased adverse cardiovascular events in patients with ST-elevation myocardial infarction (STEMI). HbA1c and C-peptide are two interrelated bioactive markers that affect many cardiovascular pathways. HbA1c exhibits prothrombogenic properties, while C-peptide, in contrast, exhibits antithrombogenic effects. In this study, we aimed to demonstrate the value of combining these two biomarkers in a single fraction in predicting HTB and short-term mortality in patients with STEMI.Methods1202 patients who underwent primary percutaneous coronary intervention (pPCI) for STEMI were retrospectively included in this study. The study population was divided into thrombus burden (TB) groups and compared in terms of basic clinical demographics, laboratory parameters and HbA1c/C-peptide ratios (HCR). In addition, short-term mortality of the study population was compared according to HCR and TB categories.ResultsHCR values were significantly higher in the HTB group than in the LTB group (3.5 & PLUSMN; 1.2 vs. 2.0 & PLUSMN; 1.1; P < 0.001; respectively). In the multivariable regression analysis, HCR was determined as an independent predictor of HTB both as a continuous variable [odds ratio (OR): 2.377; confidence interval (CI): 2.090-2.704; P < 0.001] and as a categorical variable (OR: 5.492; CI: 4.115-7.331; P < 0.001). In the receiver operating characteristic (ROC) analysis, HCR predicted HTB with 73% sensitivity and 72% specificity, and furthermore, HCR's predictive value for HTB was superior to HbA1c and C-peptide. The Kaplan-Meier cumulative survival curve showed that short-term mortality increased at HTB. In addition, HCR strongly predicted short-term mortality in Cox regression analysis.ConclusionsIn conclusion, HCR is closely associated with HTB and short-term mortality in STEMI patients.Öğe The HbA1c/C-peptide ratio is associated with the no-reflow phenomenon in patients with ST-elevation myocardial infarction(Sage Publications Inc, 2023) Toprak, Kenan; Kaplangoray, Mustafa; Memioğlu, Tolga; İnanır, Mehmet; Omar, Bahadır; Ermiş, Mehmet FatihCurrently, the gold standard treatment for ST-elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI), but even after successful pPCI, a perfusion disorder in the epicardial coronary arteries, termed no-reflow phenomenon (NR), can develop, resulting in short- and long-term adverse events. The present study assessed the relationship between NR and HbA1c/C-peptide ratio (HCR) in 1834 consecutive patients who underwent pPCI due to STEMI. Participants were divided into two groups according to NR status and the demographic, clinical and periprocedural characteristics of the groups were compared. NR developed in 352 (19.1%) of the patients in the study. While C-peptide levels were significantly lower in the NR group, HbA1c and HCR were significantly higher (P < .001, for all). In multivariable analysis, C-peptide, HbA1c, and HCR, were determined as independent predictors for NR (P < .05, for all). In Receiver Operating Characteristic (ROC) analysis, HCR predicted the NR with 80% specificity and 77% sensitivity. In STEMI patients, combining HbA1c and C-peptide in a single fraction has a predictive value for NR independent of diabetes. This ratio may contribute to risk stratification of STEMI patients.Öğe Hematological parameters and coronary collateral circulation in patients with stable coronary artery disease(Pulsus Group Inc, 2013) Ayhan, Selim; Öztürk, Serkan; Erdem, Alim; Fatih, Mehmet Fatih; Memioğlu, Tolga; Özyaşar, Mehmet; Yazıcı, MehmetBACKGROUND: Although hematological parameters have been associated with prognosis in patients with various cardiovascular diseases, their relationship with coronary collateral (CC) circulation in patients with stable coronary artery disease (CAD) is unknown. OBJECTIVE: To investigate the relationship between hematological parameters and CC vessel development in patients with stable CAD. METHODS: A total of 96 patients who underwent coronary angiography were retrospectively enrolled. All study participants had at least one occluded major coronary artery. Development of CCs was classified using the method of Rentrop. Rentrop grades of 0 and 1 indicate poor CCs, whereas grades 2 and 3 indicate good CCs. Hematological parameters, including mean platelet volume (MPV) and neutrophil/lymphocyte (N/L) ratio, were measured. Multivariate logistic regression analysis was performed to identify independent variables. RESULTS: The MPV and N/L ratio were significantly higher in the poor CC group compared with the good CC group. Negative correlations were found in the analyses comparing Rentrop score with MPV and N/L ratio (r=-0.274; P=0.012 and r=-0.339; P=0.001, respectively). In multivariate analysis, the N/L ratio was independently related to CC circulation (OR 0.762 [95% CI 0.587 to 0.988]; P=0.04). CONCLUSION: The results suggest that N/L ratio and MPV are associated with poor CCs, and a high N/L ratio is a significant predictor of poor CC development in patients with stable CAD.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 Increased whole blood viscosity is associated with primary idiopathic complete atrioventricular block and poor clinical outcomes in these patients(IOS Press, 2023) Toprak, Kenan; Kaplangoray, Mustafa; Palice, Ali; İnanır, Mehmet; Memioğlu, Tolga; Kök, ZaferBACKGROUND: Complete atrioventricular block is most commonly caused by age-related degeneration and fibrosis in the cardiac conduction system and is called primary idiopathic complete atrioventricular (iCAVB). Although many factors affect this situation, which increases with age in the cardiac conduction system, the relationship between whole blood viscosity (WBV) and iCAVB has not been clarified until now. In this study, we aim to reveal the relationship between iCAVB and WBV. METHODS AND RESULTS: 141 patients with dual-chamber permanent pacemaker implanted for iCAVB and 140 ageand sex-matched subjects were included in this study. The WBV values of the study groups were compared in both high shear rate (HSR) and low shear rate (LSR). Both WBV at HSR and WBV at LSR were significantly higher in the iCAVB group compared to the control group (16.11 [15.14-16.89] vs 14.40 [13.62-15.58]; 39.82 [17.43-55.23] vs 1.38 [-13.14-26.73]; p < 0.001, respectively). The patient population was followed up for an median of 38 months for all-cause mortality. Higher mortality rates were found in higher WBV at HSR and WBV at LSR (p < 0.001,for both). CONCLUSIONS: In this study, WBV was found to be an independent predictor for iCAVB, and in these patients WBV was associated with poor clinical outcomes.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 Koroner arter stent restenozlu hastalarda serum prolidaz düzeyinin değerlendirilmesi(Bolu Abant İzzet Baysal Üniversitesi, 2014) Memioğlu, Tolga; Ayhan, SelimKoroner arter stent restenozu, koroner revaskülarizasyon sırasında oluşan hasarlanmaya karşı, damar çapında azalma ile ortaya çıkan olumsuz yanıt olarak tanımlanabilir. Prolidaz, kollajen metabolizmasında yeni matriks oluşumunda ve hücre büyümesinde rol alan bir enzimdir. Kollajen oluşumunda etkisi olan serum prolidaz enziminin stent içi restenozda etkili olabileceği düşünülerek bu çalışma planlandı. Bildiğimiz kadarıyla günümüzde stent içi restenoz (SİR)'lu hastalarda serum prolidaz enziminin değerini araştıran bir çalışma yapılmamıştır. Bu nedenle çalışmamızın amacı stent içi restenoz ile serum prolidaz seviyesi arasındaki ilişkiyi ortaya koymaktır. Abant İzzet Baysal Üniversitesi Araştırma ve Uygulama Hastanesi Kardiyoloji ve Acil polikliniklerine 2013-2014 yılları arasında klinik veya non-invaziv testler sonucunda orta ve yüksek riskli olduğu tespit edilen ve anjiyografi uygulanan 70 hasta çalışmaya dahil edildi. 40 hastada stent içi restenoz saptanırken kalan 30 hastada anjiyografik olarak kritik lezyon saptanmadı. 70 hastanın da serum prolidaz düzeyleri ölçüldü. Serum prolidaz düzeyi, SİR olan grupta olmayan gruba kıyasla anlamlı derecede yüksek ölçüldü ve istatistiksel olarak anlamlı bulundu (p=0.02). SİR, sigara içen grupta içmeyen gruba göre anlamlı derece fazla bulundu (p=0.04). Restenotik stent yüzdesi artışı ile serum prolidaz düzeyleri arasında yapılan karşılaştırmada ise restenotik stent yüzde oranı arttıkça serum prolidaz düzeyinin de arttığı saptandı, istatistiksel olarak anlamlı bulundu (p=0.04). Bu çalışmadan elde edilen veriler, serum prolidaz enzim düzeylerinin stent restenozuyla yakından ilişkili ve restenoz ciddiyetinin bağımsız bir öngördürücüsü olduğunu göstermektedir. Bulgularımız, koroner stentle PKG yapılan hastalarda prolidaz enzim düzeylerinin stent restenozunun erken ve doğru değerlendirilmesine imkan sağlayacağına, mevcut tedavinin değiştirilmesi ya da yoğunlaştırılması zamanının belirlenmesine katkı sağlayabileceğini düşündürmektedir.Öğe The non-HDL-C/HDL-C ratio is a strong and independent predictor of the no-reflow phenomenon in patients with ST-elevation myocardial infarction(Taylor & Francis Ltd, 2024) Toprak, Kenan; Kaplangöray, Mustafa; Akyol, Selahattin; İnanır, Mehmet; Memioğlu, Tolga; Taşcanov, Mustafa Beğenç; Altıparmak, İbrahim HalilBackground: No-reflow (NR) is the inability to achieve adequate myocardial perfusion despite successful restoration of attegrade blood flow in the infarct-related artery after primary percutaneous coronary intervention. The non-HDL-C/HDL-C ratio has been shown to be superior to conventional lipid markers in predicting most cardiovascular diseases. In this study, we wanted to reveal the predictive value of the NR by comparing the Non-HDL-C/HDL-C ratio with traditional and non-traditional lipid markers in patients who underwent primary percutaneous coronary intervention (pPCI) due to ST-elevation myocardial infarction (STEMI).Methods: A total of 1284 consecutive patients who underwent pPCI for STEMI were included in this study. Traditional lipid profiles were detected and non-traditional lipid indices were calculated. Patients were classified as groups with and without NR and compared in terms of lipid profiles.Results: No-reflow was seen in 18.8% of the patients. SYNTAX score, maximal stent length, high thrombus burden, atherogenic index of plasma and non-HDL-C/HDL-C ratio were determined as independent predictors for NR (p < 0.05, for all). The non-HDL-C/HDL-C ratio predicts the development of NR in STEMI patients with 71% sensitivity and 67% specificity at the best cut-off value. In ROC curve analysis, the non-HDL-C/HDL-C ratio was superior to traditional and non-traditional lipid markers in predicting NR (p < 0.05, for all).Conclusion: The non-HDL-C/HDL-C ratio can be a strong and independent predictor of NR in STEMI patients and and therefore non-HDL-C/HDL-C ratio may be a useful lipid-based biomarker that can be used in clinical practice to improve the accuracy of risk assessment in patients with STEMI.Öğe Proksimal sağ koroner arterden köken alan sirkumfleks koroner arter anomalisi: İki olgu sunumu(2014) Duran, Arif; Öztürk, Serkan; Memioğlu, Tolga; Ocak, TarıkKonjenital koroner anomaliler yaklaşık %1-2 oranında görülebilmektedir. Koroner anjiyografi yaygınlaştıktan sonra bu anomalilerle daha sık karşılaşılmaktadır. Koroner anomaliler asemptomatik olabileceği gibi anjina, senkop, miyokard enfarktüsü ve özellikle gençlerde ölüme yol açabilmektedir. Bu yazıda koroner arter anomalisi olan, kararsız anjina kliniği ve elektrokardiyografide inferiyor ST değişikliği ile acil servise başvuran iki hastayı sunuyoruz.Öğe Proksimal sağ koroner arterden köken alan sirkumfleks koroner arter anomalisi; İki olgu sunumu(2014) Duran, Arif; Öztürk, Serkan; Memioğlu, Tolga; Ocak, TarıkKonjenital koroner anomaliler yaklaşık %1-2 oranında görülebilmektedir. Koroner anjiyografiyaygınlaştıktan sonra bu anomalilerle daha sık karşılaşılmaktadır. Koroner anomaliler asemptomatikolabileceği gibi anjina, senkop, miyokard enfarktüsü ve özellikle gençlerde ölüme yol açabilmektedir. Buyazıda koroner arter anomalisi olan, kararsız anjina kliniği ve elektrokardiyografide inferiyor ST değişikliğiile acil servise başvuran iki hastayı sunuyoruz.Öğe The relationship between nitrate-induced headache and -blood viscosity: An observational prospective study(Lippincott Williams & Wilkins, 2023) Toprak, Kenan; Kaplangoray, Mustafa; Memioğlu, Tolga; İnanır, Mehmet; Biçer, Asuman; Demirbağ, Recep; Erdoğdu, HamzaNitrates are one of the most prescribed medications in the treatment of angina pectoris today. Headache is the most common side effect of nitrates, and there is limited prospective data on the determinants of this effect. Our aim in this study is to open a foresight window for clinicians in clinical practice by explaining the possible relationship between nitrate-induced headache and whole-blood viscosity (WBV). After coronary revascularization treatment, 869 patients with angina who were prescribed nitrate preparations were divided into groups according to the development of headache or not and categorized according to the 4-grade scale level. Those who had no headache during nitrate use were graded as grade 0, those who felt mild headache were grade 1, those who felt moderate headache were grade 2, and those who described severe headache were graded as grade 3. The groups were compared according to WBV values. A total of 869 participants were included in the study. Most patients (82.1%) experienced some level of headache. Headache severity correlated with both WBV at high shear rate (r = 0.657; P < 0.001) and WBV at low shear rate (r = 0.687; P < 0.001). In multivariate analysis, WBV was determined as an independent predictor of headache experience. WBV predicted nitrate-induced headache with 75% sensitivity and 75% specificity at high shear rate and 77% sensitivity and 77% specificity at low shear rate. WBV seems to be one of the major determinants for nitrate-induced headache. WBV may be a guide for initiating alternative antianginal drugs without prescribing nitrates to the patient to increase patient compliance.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.
