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    Analysis of all-cause mortality and coronary events in the Turkish Adult Risk Factor Survey 2005
    (Turkish Soc Cardiology, 2006) Onat, Altan; Karabulut, Ahmet; Esen, Ali Metin; Uyarel, Huseyin; Ozhan, Hakan; Albayrak, Sinan; Keles, Ibrahim
    Objectives: To analyze all-cause and coronary mortality as well as newly diagnosed coronary heart disease (CHD) in the cohort of the Turkish Adult Risk Factor Study which was surveyed in the summer of 2005 and included individuals residing essentially in the regions of Marmara and Central Anatolia. Study design: Information on the mode of death was obtained from first-degree relatives and/or health personnel of local health offices. Diagnosis of coronary heart disease was based on history, physical examination, and 12-lead electrocardiograms. New coronary events were defined as those that developed after the last survey, including fatal or nonfatal myocardial infarction, stable angina and/or myocardial ischemia. Results: Of 1646 participants, 1078 subjects (mean age 54.8 +/- 11.8 years) were examined; information alone was gathered for 507 subjects; 43 subjects (28 men, 15 women) had died, and 18 subjects were lost to follow-up. Incorporation of 3104 person-years of follow-up raised the total follow-up of the survey to 42,600 personyears. Twenty-three deaths were classified as CHD-related. New coronary events were identified in 37 participants. Annual mortality and coronary mortality rates were 13.9 and 7.4 per 1000 adults, respectively. Overall mortality per 1000 person-years was 16.3 in rural areas and 12.0 in urban areas. The high share of coronary deaths among all deaths persisted. In the age bracket of 45 to 74 years, overall mortality declined to 10.6 (p= 0.09) and coronary mortality to 5.5 per 1000 person-years, thus supporting the presence of a consistently decreasing trend of all-cause mortality and coronary mortality. Estimated fatal and nonfatal new coronary events appeared to be high with 18 per 1000 person-years. Conclusion: A rising trend persists in the incidence of coronary mortality and its share in overall mortality as well as in new coronary events. The occurrence of coronary deaths among women seems to be gradually shifting to older ages.
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    Assessment of cardiac functions in patients with adenotonsillar hypertrophy
    (Duzce University Medical School, 2011) Ordu, Serkan; Ozhan, Hakan; Uzun, Hakan; Alemdar, Recai; Erden, Ismail; Yazici, Mehmet; Gultekin, Erol
    Background: The aim of this study is to compare cardiac function in children with and without adenotonsillar hypertrophy (ATH). Materials and methods: Ninety-one children (26 female 65 male) who were diagnosed as ATH in the pediatric outpatient clinic and twenty-three completely healthy, age-sex matched children (10 female 13 male) were included in the study. All patients underwent a complete twodimensional transthoracic echocardiographic and Doppler study. Results: Mean mitral E, A and deceleration time were significantly longer in ATH group. Also chamber areas and volumes were bigger. Pulmonary and mitral regurgitation were statistically more frequent in ATH group. Adenotonsillar grade was positively related with mean pulmonary arterial pressure (r: 0.44 p: <0.001). Mitral valve thickness was strongly correlated with tonsillar hypertrophy grade (r: 0.73; p.<0.001). Conclusions: ATH may lead to mild diastolic dysfunction and chamber dilatation. Mitral valve thickness was strongly correlated with adenotonsillar grade. © 2011 Düzce Medical Journal.
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    Association between BNP and in Stent Restenosis in Patients who had Undergone Coronary Angioplasty
    (Aves, 2007) Kaya, Ahmet; Kaya, Yasemin; Ordu, Serkan; Albayrak, Enver Sinan; Satilmisoglu, M. Hulusi; Erkan, Melih Engin; Ozhan, Hakan
    Introduction: Brain natriuretic peptide (BNP) is a highly sensitive and specific diagnostic tool used in prediction of cardiovascular events in patients with ischemic and non-ischemic cardiovascular heart disease. In this study, we sought to test the efficacy of BNP in predicting restenosis rate in patients who had undergone PCI. Materials and Methods: Seventy-three consecutive stable angina and acute coronary syndrome patients who were admitted to cardiology department and performed percutaneous coronary intervention (PCI) were included in this study. The study was performed in Duzce University School of Medicine, Dept of Cardiology between 2006 and 2008. Pre and post PCI BNP levels were measured in all the patients. The patients were followed up for stent restenosis. Results: Sixteen out of 23 patients who were screened for restenosis with coronary angiography were found to have restenosis. The differences between the mean BNP levels measured before and after PCI were not statistically significant. Conclusion: BNP measured before and after PCI could not predict restenosis.
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    Association between mild renal dysfunction and insulin resistance or metabolic syndrome in a random nondiabetic population sample
    (Karger, 2007) Onat, Altan; Hergenc, Gulay; Uyarel, Huseyin; Ozhan, Hakan; Esen, A. Metin; Karabulut, Ahmet; Albayrak, Sinan
    Aims: The association of mild renal dysfunction (estimated glomerular filtration rate [eGFR] 60-89.9 ml/min/1.73 m(2)) with insulin resistance (IR) or metabolic syndrome (MS) needs be investigated in a population in which MS prevails. Methods: After excluding subjects with diabetes mellitus, 1,678 subjects from a representative cohort (median age 52 years) were studied cross sectionally. eGFR was based on serum creatinine concentrations using the quadratic GFR equation and categorized by 90 and 60 ml/min/1.73 m(2) as limits. MS was identified using the modified criteria of the Adult Treatment Panel-III. Results: In men, whereas MS was not significantly associated with a reduced eGFR category when controlled for homeostatic model assessment (HOMA), HOMA adjusted for MS or for its components was significantly associated with the likelihood of a reduced eGFR. This likelihood was increased by 14% with a doubling of HOMA in men. Age was the dominant correlate of reduced eGFR in women, whereby an association with HOMA was not significant. Conclusion: Mildly impaired kidney function is common in nondiabetic adults among whom MS prevails, and in men it is mainly associated with IR but not with central obesity and MS-related dyslipidemia. The quadratic GFR equation enables an acceptable estimation of GFR in a general population. Copyright (c) 2007 S. Karger AG, Basel.
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    Carbohydrate antigen-125 and N-terminal pro-brain natriuretic peptide levels: Compared in heart-failure prognostication
    (2012) Ordu, Serkan; Ozhan, Hakan; Alemdar, Recai; Aydin, Mesut; Caglar, Onur; Yuksel, Hatice; Kandis, Hayati
    Carbohydrate antigen-125 (CA-125) is emerging as a prognostic biomarker of risk in heart failure. In a prospective study, we compared the prognostic values of CA-125 and aminoterminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable heart failure. We enrolled 102 consecutive chronic, stable, systolic-heart-failure patients (68 men and 34 women; median age, 71 yr) from November 2008 through February 2010. We measured baseline NT-proBNP and CA-125 levels and compared their prognostic values. The primary endpoint was all-cause death and other major adverse events, defined as hospitalization for decompensated heart failure or acute coronary syndrome. During a mean follow-up period of 14 ± 2 months, 12 patients died and 35 others sustained major adverse events. We found that CA-125 level significantly correlated with New York Heart Association functional class, pulmonary artery pressure, microalbuminuria, creatine kinase-MB fraction, and hemoglobin, albumin, and NT-proBNP levels. Upon receiver operating characteristic curve analysis, CA-125 and NT-proBNP had similar accuracy in predicting major adverse events and death: for major adverse events, area under the curve (AUC) was 0.699 for CA-125 (P=0.002) and 0.696 for NT-proBNP (P=0.002); for death, AUC was 0.784 for CA-125 (P=0.003) and 0.824 for NT-proBNP (P=0.001). Multivariate Cox regression analysis showed that CA-125 levels greater than 32 U/mL and NT-proBNP levels greater than 5,300 pg/mL had independent prognostic value for major adverse events and death. We conclude that baseline CA-125 and NT-proBNP levels are comparably reliable as heart-failure markers, and that CA-125 can be used for prognosis prediction in heart failure. © 2012 by the Texas Heart® Institute, Houston.
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    A case of acute stent thrombosis treated successfully with intracoronary tirofiban
    (Via Medica, 2010) Erden, Ismail; Ozhan, Hakan; Ordu, Serkan
    Acute stent thrombosis (AST) is occasionally observed during percutaneous coronary intervention in patients with acute coronary syndrome (ACS). It may jeopardize hemodynamic status. Currently, there is no adequate solution for this problem. We report our experience with an ACS patient who developed AST associated with cardiogenic shock after percutaneous coronary stent deployment. Intracoronary administration of tirofiban immediately restored the coronary flow of the target vessel, and the disastrous condition was reversed. Our experience suggests that intracoronary administration of tirofiban can be considered as an option in cases of AST during percutaneous coronary intervention.
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    Efficacy of nebivolol on flow-mediated dilation in patients with slow coronary flow
    (2009) Albayrak, Sinan; Ordu, Serkan; Yuksel, Hatice; Ozhan, Hakan; Yazgan, Ömer; Yazici, Mehmet
    Slow coronary flow (SCF) is the phenomenon of slow progression of angiographic contrast in the coronary arteries in the absence of stenosis in the epicardial vessels in some patients presenting with chest pain. There are no definite treatment modalities for patients with SCF. Our aim was to investigate the efficacy of nebivolol in patients with slow coronary flow by monitoring its effects on endothelial function and different markers of inflammation. Forty-two patients (16 females, 26 males; mean age, 55±10) with slow coronary flow (SCF) were included in the study. After baseline assessment, the patients were administered nebivolol 5 mg once daily. After 12 weeks of nebivolol therapy, the biochemical and ultrasonographic examinations were repeated. Chest pain relief was detected in 38 patients after treatment (90%). Systolic and diastolic blood pressure and high sensitive CRP were significantly decreased after nebivolol therapy. Among brachial artery dilation variables that reflect endothelial function, basal resistive index (RI), post-flow mediated dilation RI, and post-nitrate mediated dilation RI were significantly decreased after therapy. Nebivolol is effective at improving endothelial function in patients with SCF. It controls chest pain, decreases CRP, and has favorable effects on brachial artery dilation variables in patients with coronary slow flow.
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    Efficacy of olmesartan therapy on fibrinolytic capacity in patients with hypertension
    (2011) Bulur, Serkan; Ozhan, Hakan; Erden, Ismail; Alemdar, Recai; Aydin, Mesut; Caglar, Onur; Basar, Cengiz
    The efficacy of olmesartan on fibrinolytic capacity has not been studied yet. Therefore, the aim of the present study was to investigate the efficacy of olmesartan on hemostatic/fibrinolytic status by measuring plasma level of plasminogen activator inhibitor-1 (PAI-1) and soluble thrombomodulin levels in patients with hypertension. Forty-two consecutive, newly diagnosed (25 women and 17 men with a mean age of 48 ± 8 years) patients with untreated essential hypertension were included in the study. Olmesartan medoxomil (20 mg/day) was started and the patients were followed up for 6 months. Baseline biochemical variables, thrombomodulin, and PAI-1 levels were compared with the levels of these variables measured at the end of the 6-month follow-up period. After 6 months of treatment with olmesartan medoxomil, there was a significant reduction in systolic and diastolic blood pressure (from 159.5 ± 10.9 to 134.6 ± 12.7 mmHg and from 98.0 ± 6.3 to 83.9 ± 7.0 mmHg, respectively). Mean plasma PAI-1 and thrombomodulin levels were also significantly decreased (59.73 ± 41.91 vs. 48.60 ± 33.65 ng/ml, P = 0.001 and 8.09 ± 2.29 vs. 6.92 ± 1.42 ?g/l, P < 0.001, respectively). Olmesartan medoxomil decreased plasma PAI-1 and thrombomodulin levels after 6 months of therapy, indicating a favorable effect on fibrinolytic capacity in patients with essential hypertension. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
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    ENOXAPARIN INDUCED MASSIVE RECTUS SHEATH HEMATOMA
    (Istanbul Univ, Faculty Medicine, Publishing Office, 2012) Basar, Cengiz; Ozhan, Hakan; Caglar, Sabri Onur; Yalcin, Subhan; Aslantas, Yusuf; Ekinozu, Ismail
    Rectus sheath hematoma is an uncommon complication of anticoagulation that generally presents as sudden onset of abdominal pain. Enoxaparin; a widely used low molecular weight heparin in acute coronary syndrome may rarely cause about abdominal wall hematoma. This complication is potentially fatal and needs prompt recognition and treatment. We report here a case of rectus sheath hematoma due to enoxaparin with the diagnosis of acute coronary syndrome. The potential diagnostic and treatment modalities were discussed in the light of the literature .
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    Family income in shaping cardiometabolic risk profile: a prospective analysis including gender-related differences
    (Turkish Soc Cardiology, 2006) Onat, Altan; Ozhan, Hakan; Can, Guay; Hergenc, Gulay; Karabulut, Ahmet; Albayrak, Sinan
    Objectives: We investigated the extent to which family income predicts smoking, metabolic syndrome (MS) and its components, elevated levels of apolipoprotein (hyperapo) B and C-reactive protein (CRP), and incident coronary heart disease (CHD), with reference to gender-related differences. Study design: A total of 3,273 participants (1610 males, 1630 females; mean age 48.3 +/- 12 years, minimum age 28 years) of the TEKHARF surveys 1997/98 and 2002/03 were prospectively evaluated during a mean of 5.9 years. Monthly family incomes were grouped into four categories. Elevated apoB and CRP levels were based on the cutoff values of 120 mg/dl and 3 mg/l, respectively. Identification of MS was made according to the Adult Treatment Panel III criteria modified by the TEKHARF study. Diagnosis of CHD was based on history, physical examination, and the Minnesota coding of resting electrocardiograms. Results: In age-adjusted logistic regression analyses, men with higher income brackets had an increased incidence of diabetes, hypertension, and elevated hyperapo B. In women, income was positively associated with smoking and elevated hyperapo B, and inversely related with obesity, abdominal obesity, and - at borderline significance - triglyceride/HDL dyslipidemia; diabetes and hypertension were not predicted by income. Lower income brackets (<910 NTL) predicted elevated CRP levels in both genders (relative risk 1.47, p<0.002). Income exhibited an insignificant relative risk (1.27) for incident CHD. Conclusion: The level of family income contributes to the development of an adverse risk profile in Turks. Given increased smoking in women and its inhibitory effect on (abdominal) obesity, rising income seems to predict improvement in some elements of the cardiometabolic risk profile.
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    Independent prediction of metabolic syndrome by plasma fibrinogen in men, and predictors of elevated levels
    (Elsevier Ireland Ltd, 2009) Onat, Altan; Ozhan, Hakan; Erbilen, Enver; Albayrak, Sinan; Kucukdurmaz, Zekeriya; Can, Guenay; Keles, Ibrahim
    The role of plasma fibrinogen levels in predicting metabolic syndrome (MetS) and assessment of determinants of these levels were investigated. A total of 2234 men and women, aged 49 +/- 12 years, representative of Turkish adults who had plasma fibrinogen determinations, were prospectively evaluated and followed for a mean of 6.6 years. The modified Clauss method was used for assays. MetS was defined by ATPIII criteria modified for male abdominal obesity. MetS cases at baseline were excluded in prospective analyses. Median (interquartile range) fibrinogen values were 2.87 (2.29; 3.56) g/L. Fibrinogen levels predicted significantly newly developing MetS in men (RR 1.40 [95%CI 1.07; 1.83] for a 2-fold increment), after adjustment for age and smoking status, and (RR 1.32 [95%CI 0.95; 1.83] again for doubling), after additional adjustment for all 5 components of MetS. MetS was not significantly predicted by fibrinogen levels in women in either multivariable model. By regression analysis of eight covariates, not waist circumference, but systolic blood pressure, current smoking and C-reactive protein (CRP) in men, and age in women were predictors of elevated (>3.0 g/L) fibrinogen at follow-up (p<0.05 in all). Conclusions: Plasma fibrinogen predicts MetS independently of its components in men, in contradistinction to women, and, hence, is likely one of its components. Hyperfibrinogenemia representing an inflammatory state is postulated as the underlying mechanism. Central obesity is linked to elevation in fibrinogen mainly through the mediation of blood pressure, CRP, and via being affected by cigarette smoking. Crown Copyright (C) 2008 Published by Elsevier Ireland Ltd. All rights reserved.
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    Mean platelet volume in patients with non-alcoholic fatty liver disease
    (2010) Ozhan, Hakan; Aydin, Mesut; Yazici, Mehmet; Yazgan, Omer; Basar, Cengiz; Gungor, Adem; Onder, Elif
    Mean platelet volume (MPV) is an indictor of platelet activation. Platelet activation and aggregation are central processes in the pathophysiology of coronary heart disease. Non-alcoholic fatty liver disease (NAFLD) is present up to onethird of the general population and the majority of patients with cardio-metabolic risk factors such as abdominal obesity, type 2 diabetes and other components of the metabolic syndrome (MS). The aim of the current study was to investigate the MPV in patients who had NAFLD. MPV values of the patients with NAFLD and of the patients without fatty liver disease were compared. NAFLD patients had significantly higher body mass index compared to the control cases. Among biochemical variables, fasting plasma glucose and triglyceride were significantly higher in the NAFLD group. NAFLD cases also had lower platelet count and higher MPV (10.43 ± 1.14 vs. 9.09 ± 1.25; p < 0.001, respectively). MPV was positively correlated with AST (r: 0.186, p < 0.042), ALT level (r: 0.279; p 0.002) and the presence of NAFLD (0.492; p < 0.001) but negatively correlated with platelet number (r: -0.26; p 0.004) and creatinine (r: -0.255; p 0.005). In logistic regression analysis (age, gender, NAFLD, body mass index, high-density lipid (HDL) cholesterol, systolic and diastolic blood pressure, triglyceride and fasting plasma glucose were used as covariates) only NAFLD was found to be the independent predictor of MPV (Odds Ratio (OR) 21.98) [95% confidence interval (CI): 2.404-201.048; p: 0.006]. We have shown for the first time in the literature that, patients with NAFLD have higher MPV. It may have prognostic value in NAFLD patients indicating a possible cardiovascular disease (CVD) risk increase. © 2010 Informa UK Ltd.
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    OUTCOME OF PRIMARY PERCUTANEOUS INTERVENTION IN PATIENTS WITH INFARCT RELATED CORONARY ARTERY ECTASIA
    (Elsevier Ireland Ltd, 2010) Erden, Ismail; Ordu, Serkan; Alemdar, Recai; Aydin, Mesut; Ozhan, Hakan; Yazici, Mehmet; Basar, Cengiz
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    Performance of Bioelectrical Impedance Analysis in the Diagnosis of Metabolic Syndrome
    (Bmj Publishing Group, 2012) Ozhan, Hakan; Alemdar, Recai; Caglar, Onur; Ordu, Serkan; Kaya, Ahmet; Albayrak, Sinan; Turker, Yasin
    Objective: Central obesity is a prerequisite for the diagnosis of metabolic syndrome (MetS). Precise measurement of visceral fat by bioelectrical impedance analysis (BIA) has been validated. The aim of this study was to investigate the diagnostic performance of BIA in MetS and validate the best cutoff in a large adult cohort. Materials and Methods: The study was performed on the MELEN Study cohort-a prospectively designed survey on the prevalence of cardiometabolic risk factors in Turkish adults. The final cohort consisted of 2219 participants. Weight and visceral body composition were measured without shoes in light indoor clothes using a bioimpedance analyzer (Omron BF 510; Omron Corp, Kyoto, Japan). Plasma concentrations of cholesterol, insulin, fasting triglycerides, high-density lipoprotein cholesterol, glucose, and other biochemical variables were measured. The diagnostic performance of visceral fat measurement by BIA in patients with MetS was assessed. Results: Metabolic syndrome was detected in 751 participants (520 women and 231 men with a mean age of 55 [12] years; 34% of the whole study population). Total body fat and visceral fat levels were higher in subjects with MetS. Correlation analyses showed that there were significant correlations between anthropometric and BIA measurements. Receiver operating curve characteristics of visceral adiposity revealed the best cutoff values as greater than 12% for men and greater than 9% for women. The diagnostic performance was good in both sexes (the sensitivity/specificity and area-under-the-curve values were 76%/75% and 0.83 for men and 83%/67% and 0.81 for women, respectively). Conclusions: Visceral fat measured with BIA is an easily applicable and useful method for identifying people with MetS. The best cutoff values were higher than 12% for men and higher than 9% for women.
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    Pioglitazone improves ventricular diastolic function in patients with diabetes mellitus: A tissue Doppler study
    (Acta Cardiologica, 2010) Ordu, Serkan; Ozhan, Hakan; Alemdar, Recai; Aydin, Mesut; Basar, Cengiz; Caglar, Onur; Yazici, Mehmet
    Objective - Pioglitazone treatment in type 2 diabetes mellitus produced significant improvements in glycaemic control, plasma lipids, blood pressure and inflammation. The aim of this study was to investigate the effect of pioglitazone on systolic and diastolic function in diabetic patients. Methods and results - Forty-nine diabetic patients were included in the study.The patients had never received thiazolidinedione therapy before. Clinical and echocardiographic variables were measured. 30 mg pioglitazone were administered. The patients were followed up for six months and all the measurements were re-evaluated for comparison. Body mass index (BMI) significantly increased after treatment. Fasting glucose, HbA1c and systolic blood pressure decreased. Insulin resistance improved and the HOMA-IR index decreased after pioglitazone treatment. Mean aortic diameter, left atrial systolic and diastolic volumes significantly decreased after therapy. Among diastolic function variables mitral E wave, E/A, ejection time and pulmonary vein peak reverse flow velocity (PVA) significantly increased whereas isovolumetric relaxation time (IVRT), isovolumetric contraction time (IVCT), deceleration time, E/E' and pulmonary vein late systolic flow (PVS2) decreased after pioglitazone therapy. Among tissue Doppler variables early (E) ventricular inflow velocities measured from the tricuspid lateral annulus, the mitral septal and lateral annulus, the anterior, inferior and posterior free wall significantly increased. Late (A) ventricular inflow velocities measured from the anterior, inferior free wall and the mitral septal annulus also increased. Conclusion - Pioglitazone treatment in type 2 diabetes mellitus produced significant improvements in measures of glycaemic control and diastolic ventricular function.
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    The prognostic value of mean platelet volume in decompensated heart failure
    (2011) Kandis, Hayati; Ozhan, Hakan; Ordu, Serkan; Erden, Ismail; Caglar, Onur; Basar, Cengiz; Yalcin, Subhan
    Background: Congestive heart failure (CHF) is a major public health problem that is related to substantial morbidity, impaired quality of life and diminished survival. Mean platelet volume (MPV) is an indicator of platelet activation. Aim: To investigate whether there is a difference of MPV in patients with decompensated and stable heart failure (SHF), and test the prognostic value of MPV in decompensated heart failure (DHF). Methods: 136 consecutive patients with DHF were enrolled. 71 with SHF were also enrolled for comparison. Patients were followed up for a mean of 18±12 months. The primary endpoint was death from any cause. Clinical characteristics of patients with DHF who died during follow-up were compared with the those of the survivors. Results: MPV was significantly higher in DHF group than in the SHF group. 71 patients died during the follow-up period (18±12 months). Comparison with survivors revealed that mortality was associated with age, systolic blood pressure, pulmonary artery pressure, serum creatinine, urea and MPV. MPV was determined as an independent risk factor for mortality (OR 1.553, 95% CI 1.024 to 2.354, p=0.038). Receiver operating characteristic analysis showed that MPV level on admission was a predictor of mortality (area under the curve (AUC) for in-hospital mortality was 0.716 (95% CI 0.632 to 0.789, p=0.003) and AUC for 6-month mortality was 0.815 (95% CI 0.74 to 0.877, p<0.001), respectively). Conclusion: MPV is increased in patients with DHF. Also, MPV on admission is an independent predictor of in-hospital mortality and 6-month mortality.
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    Serum apolipoprotein B is superior to LDL-cholesterol level in predicting incident coronary disease among Turks
    (Kare Publ, 2007) Onat, Altan; Ozhan, Hakan; Can, Guenay; Hergenc, Guelay; Karabulut, Ahmet; Albayrak, Sinan
    Objective: To investigate the relative roles of serum apolipoprotein (apo) B and low density lipoprotein (LDL)-cholesterol levels in predicting incident coronary heart disease (CHID). Whether apo B/apo A-I ratio has advantage over apo B in this prediction constitutes a secondary aim. Methods: Prospective evaluation of 1138 men and 1210 women, aged 28-74 years participating in the TEKHARF survey 1997/98 with a mean 5.9-years' follow-up in whom serum apo B was determined. Tertiles of LDL-cholesterol were formed by cut points of 130 and 100 mg/dl, and of apo B by 120 and 95 mg/dl. Metabolic syndrome was defined by modified ATPIII criteria. Nonfatal CHD diagnosis was based on history of angina and myocardial revascularization, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Results: Apolipoprotein B showed significant correlations with a greater number of parameters than did LDL-cholesterol. Incident CHID was not significantly predicted in age-adjusted logistic regression by LDL-cholesterol but by apo B concentrations in men with a relative risk (RR) 1.005. Apolipoprotein B level >120 vs <95 mg/dl retained significance in both genders combined, even after adjustment for waist girth and log C-reactive protein. The top (>1.02) compared with the bottom bracket of apo B/A-I ratio, though not reaching significantly predictive values among women, did significantly predict in men incident CHID with a RR 1.89. Conclusions: Apolipoprotein B, which marks small, dense LDL particles in plasma is a better predictor of incident CHID than LDL-cholesterol among Turkish adults. While in the prediction of CHID apo B level should be preferred in women, an apo B/A-I ratio >11.02 has advantages over the latter in men. It is time to create the environment (at least in our cities) for measuring in equipped laboratories apo B, which has advantages over measurements that permit calculation of LDL-cholesterol.