Currently, 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... more
Currently, 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) anal...
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Background: Acute heart failure (AHF) is a serious medical problem that necessitates hospitalisation and often results in death. Patients hospitalised to the emergency department (ED) should therefore receive an immediate diagnosis and... more
Background: Acute heart failure (AHF) is a serious medical problem that necessitates hospitalisation and often results in death. Patients hospitalised to the emergency department (ED) should therefore receive an immediate diagnosis and treatment. Unfortunately, there is not yet a fast and accurate laboratory test for identifying AHF. The purpose of this research is to apply the principles of explainable artificial intelligence (XAI) to the analysis of hematological predictors for AHF. Methods: In this retrospective analysis, 425 patients with AHF and 430 healthy individuals served as assessments. Patients' demographic and hematological information was analyzed to determine AHF. Important risk variables for AHF diagnosis were identified using LASSO feature selection. To test the efficacy of the suggested prediction model (XGBoost), a 10-fold cross-validation procedure was implemented. The area under the receiver operating characteristic curve (AUC), F1 score, Brier score, and Pos...
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Objective A Disintegrin and Metalloproteinase with Thrombospondin-9 (ADAMTS-9), one of the ADAMTS enzymes, is expressed in all fetal tissues, unlike other ADAMTS enzymes, and is thus thought to play a role in fetal development. In this... more
Objective A Disintegrin and Metalloproteinase with Thrombospondin-9 (ADAMTS-9), one of the ADAMTS enzymes, is expressed in all fetal tissues, unlike other ADAMTS enzymes, and is thus thought to play a role in fetal development. In this context, the objective of this study is to investigate the relationship between ADAMTS-9 activity and the development of congenital heart diseases (CHD) with a view to using ADAMTS-9 level as a biomarker for CHDs. Study Design Newborns diagnosed with CHD and healthy newborns were included in the study as the CHD and control groups, respectively. Gestational age, maternal age, and mode of delivery information pertaining to the mothers and Apgar score and birthweight information pertaining to the newborns were recorded. Blood samples were taken from all newborns to determine their ADAMTS-9 levels in the first 24 hours of life. Results Fifty-eight newborns with CHD and 46 healthy newborns were included in the study. Median ADAMTS-9 levels were 46.57 (int...
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Introduction: The SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) score (SS) is an angiographic scoring system to determine the severity of coronary artery disease (CAD). As far as we know, studies examining the relationship... more
Introduction: The SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) score (SS) is an angiographic scoring system to determine the severity of coronary artery disease (CAD). As far as we know, studies examining the relationship between SYNTAX Score and Cystatin C (Cys-C) are limited in the literature. In this study, we aimed to investigate the relationship between Cys-C level and SS in patients presenting with ST-elevation myocardial infarction (STEMI). Patients and Methods: One hundred ninety-two patients who underwent coronary angiography for STEMI between June 2021 and December 2021 in our center were included in the study. The patients were divided into two groups according to their SS values: Group 1 included patients with SS<22, and Group 2 included patients with SS≥ 22. The two groups were compared in terms of baseline characteristics and serum Cys-C levels. Results: Patients in Group 2 had significantly higher Cys-C levels than those in Group 1 (1.7 ± 0.53 vs 1.3...
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Contrast-induced nephropathy (CIN) is an important cause of morbidity and mortality, in patients with diabetes who undergo coronary angiography (CAG). It is known that serum C-peptide has renoprotective effects in diabetic nephropathy.... more
Contrast-induced nephropathy (CIN) is an important cause of morbidity and mortality, in patients with diabetes who undergo coronary angiography (CAG). It is known that serum C-peptide has renoprotective effects in diabetic nephropathy. Patients with diabetes (n = 552) who underwent CAG in our center between January 2020 and December 2021 were included, retrospectively. The patients were divided into 2 groups: not-developing CIN (group 1) and developing CIN (group 2). CIN developed in 128 (23.1%) of the patients with diabetes who underwent CAG. C-peptide, albumin, hemoglobin, hematocrit, initial creatinine, ejection fraction (EF), were significantly lower in the group that developed CIN compared with the group that did not ( P < .05, for all). In correlation analysis, creatinine increase rate (ΔCr) was negatively correlated with C-peptide, hematocrit, and ejection fraction (r = −.241, P < .001; r = −.135, P < .001; r = −.194, P = .001; respectively). In logistic regression a...
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Amaç: Akut koroner sendromlar tüm dünyada ölümün en sık nedenleri arasındadır. İnflamasyon akut koroner sendrom (AKS) etyoloji ve patogenezinde önemli bir yere sahiptir. Bugüne kadar inflamasyonu değerlendirmek için bir çok farklı... more
Amaç: Akut koroner sendromlar tüm dünyada ölümün en sık nedenleri arasındadır. İnflamasyon akut koroner sendrom (AKS) etyoloji ve patogenezinde önemli bir yere sahiptir. Bugüne kadar inflamasyonu değerlendirmek için bir çok farklı parametre kullanılmıştır. Monosit /HDL-C oranı (MHO) son yıllarda kullanıma giren yeni bir inflamasyon belirtecidir. Çalışmamızın amacı, AKS ile başvuran hastalarda MHO’nun klinik önemini saptamaktır. Materyal ve metod: Bu retrospektif çalışmaya, akut koroner sendrom tanısıyla kliniğimize başvurmuş ve koroner anjiyografi yapılmış 195 hasta dahil edildi. Tüm hastaların rutin hematolojik ve biyokimyasal parametreleri geriye dönük olarak incelendi. Monosit sayısının HDL kolesterole bölünmesi ile MHO elde edildi. Hastalar MHO tertillerine göre 3 gruba ayrıldı. Her 3 grup, anjiyografik özellikler ve MHO açısından karşılaştırıldı. Bulgular: Her 3 grup arasında bazal demografik karakteristikler açısından anlamlı bir farklılık saptanmadı. Ancak, MHO arttıkça 3 dam...
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We aimed to identify the best diagnostic cutoff value of the atherogenic index of plasma (AIP) for coronary artery disease (CAD) and its correlation with the SYNTAX score (SS). From January 2016 to December 2019, 2253 patients with CAD... more
We aimed to identify the best diagnostic cutoff value of the atherogenic index of plasma (AIP) for coronary artery disease (CAD) and its correlation with the SYNTAX score (SS). From January 2016 to December 2019, 2253 patients with CAD and 1347 non-CAD patients with complete data were included in the study. Coronary angiography was performed using the Judkins technique, and the SS was calculated using network software. There were differences in age, body mass index, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol levels, and AIP between groups (all P < .01). Multivariate logistic regression analysis showed that AIP was an independent risk factor for CAD and a high SS (SS ≥ 23) with adjusted odds ratios of 2.248 (95% CI: 1.666-3.032, P < .01) and 1.623 (95% CI: 1.118-2.358, P < .01) per standard deviation increase. Receiver operating characteristic curve analysis revealed that the best diagnostic cutoff value of AIP ...
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The presence of silent cerebral infarction (SCI) increases the risk of transient ischemia attack, symptomatic stroke, cardiovascular disease and dementia. Increased viscosity is associated with aging, obesity, carotid intima-media... more
The presence of silent cerebral infarction (SCI) increases the risk of transient ischemia attack, symptomatic stroke, cardiovascular disease and dementia. Increased viscosity is associated with aging, obesity, carotid intima-media thickness, metabolic syndrome, hypertension, diabetes, ischemic heart disease, and stroke. The purpose of the study was to assess the hemorheological parameters levels in SCI patients. A cross-sectional study was conducted to evaluate the association between hemorheological parameters and SCI in 1487 subjects (868 men and 619 women) undergoing medical check-up. The participants with SCI had higher whole blood viscosity (WBV) levels at low shear rate than those without SCI (10.34 ± 1.77 mPa.s vs. 8.98 ± 0.88 mPa.s; P < 0.001). Moreover, the subjects with a high WBV had a higher prevalence of SCI. Logistic regression analysis revealed that a significant association of WBV levels with the risk of SCI after adjustment for confounding factors (OR: 2.025; 95%...
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Objectives Angiographic 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... more
Objectives Angiographic 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. Methods 1202 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. Results HCR values wer...
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Objectives: No-reflow phenomenon (NRP) is a complication associated with poor clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). The modified... more
Objectives: No-reflow phenomenon (NRP) is a complication associated with poor clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). The modified Glasgow prognostic score (mGPS) is a novel immune-inflammatory index, derived from C-reactive protein (CRP) and serum albumin levels and has been shown to be associated with prognosis in heart disease. In this study we aimed to investigated the relationship between mGPS and NRP in patients undergoing pPCI for STEMI. Methods: A total of 379 patients (aged 59 ± 9.9 years; 54.9% male) were enrollled. The patients were divided into 2 groups:no-reflow (n = 72) and reflow (n = 307). No-reflow was defined as thrombolysis in myocardial infarction (TIMI) ≤ 2 flow. The mGPS of all patients was calculated from blood samples at admission. Logistic regression analysis was performed to determine the independent predictive factors for NRP. Results: Mean age, pain ...
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BACKGROUND: İncreased whole blood viscosity (WBV) is associated with increased infarct area, impaired microvascular circulation and mortality in patients with ST-elevation myocardial infarction (STEMI). OBJECTIVES: We aimed to analyze the... more
BACKGROUND: İncreased whole blood viscosity (WBV) is associated with increased infarct area, impaired microvascular circulation and mortality in patients with ST-elevation myocardial infarction (STEMI). OBJECTIVES: We aimed to analyze the association between the WBV and thrombus burden (TB) in STEMI patients. METHODS: This cross-sectional study included 167 STEMI patients who received primary percutaneous coronary intervention. WBV values were assessed using hematocrit and total protein values, and low shear rate(LSR) and high shear rate(HSR) were calculated. Angiographic TB was assessed according to the definition of the Thrombolysis in Myocardial Infarction (TIMI) study group. The cases were dichotomized into low TB (grade 1-3) (n = 87) and high TB (grade 4-5) (n = 80) groups. RESULTS: The mean HSR and LSR values of the high TB group were significantly increased compared to the low TB group (p < 0.001, for each). In ROC analysis,for prediction of TB, a cut-off value of 3.83 WB...
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: Nitrates 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... more
: Nitrates 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 &lt; 0.001) and WBV at low shear rate (r = 0.687; P &lt; 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.
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Purpose 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... more
Purpose 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 e...
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IntroductionCOVID-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... more
IntroductionCOVID-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 methods553 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 ın-hospital mortality.ResultsSCUBE1 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).ConclusionsSCUBE1 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.
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Background. Coronary artery ectasia (CAE) is an entity frequently associated with atherosclerotic coronary artery disease (CAD) in clinical practice. Although it has common risk factors with atherosclerotic CAD in its development, the... more
Background. Coronary artery ectasia (CAE) is an entity frequently associated with atherosclerotic coronary artery disease (CAD) in clinical practice. Although it has common risk factors with atherosclerotic CAD in its development, the pathophysiology of CAE is not fully known and it is not seen in every CAD suggesting that different determinants may play a pivotal role in the development of CAD. This study aimed to reveal the impact of C-peptide and diabetes mellitus (DM) on CAE and the effect of C-peptide and coronary ectasia on long-term outcomes in patients who underwent coronary angiography. Methods. A total of 6611 patients who underwent coronary angiography were followed up retrospectively, and their major adverse cardiovascular event (MACE) status of an average of sixty months was recorded. According to their angiographic features, the patients were divided into two groups those with and without CAE. MACE development was accepted as the primary endpoint. Results. A total of 5...
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The relationship between C-reactive protein (CRP) to albumin ratio (CAR) and contrast-induced nephropathy (CIN) in patients with acute coronary syndrome has been reported. However, the relevance of CAR in patients with stable angina... more
The relationship between C-reactive protein (CRP) to albumin ratio (CAR) and contrast-induced nephropathy (CIN) in patients with acute coronary syndrome has been reported. However, the relevance of CAR in patients with stable angina pectoris (SAP) has not been clarified. We hypothesized that CAR might predict the development of CIN in patients with SAP undergoing coronary angiography (CAG). Patients ( n = 554) with SAP who underwent CAG were included in the study. CIN was defined as a ≥25% increase in serum creatinine compared with baseline value within 72 h of CAG. Participants were divided into two groups: CIN ( n = 87) and non-CIN ( n = 467). Age, CRP, CAR, mean corpuscular volume (MCV), urea, uric acid, contrast medium volume, the percent of percutaneous coronary intervention were significantly greater, whereas albumin and high-density lipoprotein were significantly lower in the CIN group than non-CIN group ( p < .05, for all). Multivariate analysis showed that CAR was the on...