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Öğe Can the Glasgow prognostic score predict ischemic stroke in patients with infective endocarditis?(Assoc Medica Brasileira, 2024) Aydin, Cihan; Demirkiran, Aykut; Aykac, Huseyin; Uslu, Nurullah; Alpsoy, SerefOBJECTIVE: The Glasgow prognosis score is a simple parameter calculated using serum levels of albumin and C-reactive protein. The aim of this study was to examine whether this parameter may predict ischemic stroke in patients with infective endocarditis. METHODS: A total of 80 patients who were diagnosed with definitive infective endocarditis according to Duke criteria between 2016 and 2023 were included in the study. Glasgow prognosis score was based on serum levels of albumin and C-reactive protein. In imaging methods, patients were divided into two groups according to whether they had a stroke or not. These two groups were compared in terms of biochemical parameters, and infective endocarditis findings on echocardiography and Glasgow prognosis score. RESULTS: We found that the results were statistically similar except for serum C-reactive protein (Group 1: 54.9 +/- 71.1 and Group 2: 39 +/- 70.7; p=0.03), neutrophil (Group 1: 19.8 +/- 10.8*10(9)/L and Group 2: 13.3 +/- 7.3*109/L; p=0.014), albumin (Group 1: 2.3 +/- 0.6 and Group 2: 2.8 +/- 0.5; p=0.03), and Glasgow prognosis score (Group 1: median 2, min.-max. (1-2) and Group 2: median 1, min.-max. (0-1); p=0.004). In the receiver operating characteristics analysis, Glasgow prognosis score had 82.4% sensitivity and 58.3% specificity in predicting ischemic stroke if the Glasgow prognosis score cutoff was >= 1. In multivariate logistic regression analysis, chronic renal failure [odds ratio (OR): 1.098; 95% confidence interval: 1.054-1.964; p=0.044], age (OR: 1.050; 95%CI 1.006-1.096; p=0.024), and Glasgow prognosis score (OR: 0.695; 95%CI 0.411-0.949; p=0.035) were independent variables in predicting ischemic stroke. CONCLUSION: High Glasgow prognosis score is an independent predictor of ischemic stroke in patients with infective endocarditis. Glasgow prognosis score, determined using albumin and C-reactive protein levels, is a simple and practical index for predicting the prognosis of patients hospitalized with infective endocarditis.Öğe Cerebral emboli as the predictor of mortality in patients with ‘definite’ infective endocarditis(2021) Gür, Demet Özkaramanlı; Uslu, Nurullah; Akyüz, Aydın; Alpsoy, Seref; Gür, Özcan; Doğan, Mustafa; Dınckal, Mustafa HakanInfective endocarditis (IE) is among the most fatal infectious diseases. Since the introduction of various intracardiac devices and interventions, the clinical aspects of IE have rapidly evolved. In this paper, we aim to define the contemporary characteristics of patients diagnosed with definite IE and to identify the predictors associated with mortality. Through retrospective analysis of patients with TEE proven vegetation, those fulfilling the modified Duke criteria for definite IE were identified. Patient characteristics in relation to clinical outcomes and mortality were analyzed. Out of 50 patients (mean age 57±15.9 years, 34% female), 72% was native-valve endocarditis of which only 32% had a predisposing valve disease such as rheumatic valve. The rate of prosthetic-valve IE was 10% and that of device-related IE was 18%. The most common causative organisms were S. aureus (16%), Coagulase-negative Staphylococci (16%), Enterococci (14%) and Viridans streptococci (12%). In-hospital mortality was 24% and was associated with concomitant diabetes, coronary artery disease, higher baseline creatinine, anemia, occurrence of cranial complications and absence of surgery during the index hospitalization. Regression analyses revealed that cerebral emboli were the only predictor of early mortality, possibly through delayed surgical treatment. In conclusion, our small cohort of definite IE patients showed that contemporary characteristics of IE has evolved with higher rates of device-related IE. Within established prognostic factors, cerebral emboli and timing of surgery are intervening factors, which suggests that the timing of surgical treatment, particularly in patients with neurologic complications, needs to be evaluated when shaping future perspectives on IE.Öğe Endocan may predict the presence of coronary slow flow and coronary artery disease(Assoc Medica Brasileira, 2024) Efe, Muhammet Mucip; Akyuz, Aydin; Aydin, Cihan; Demirkiran, Aykut; Alpsoy, SerefOBJECTIVE: Coronary artery disease (CAD) is frequent, but coronary slow flow (CSF) is a less common cardiovascular disease with a significant risk of mortality and morbidity. Endocan is a proinflammatory glycopeptide that has been investigated in cardiovascular diseases as well as some inflammatory diseases in recent years. We planned to compare the levels of endocan in both CAD and CSF in a similar population and examine the relationship of endocan with additional clinical variables. MATERIALS AND METHODS: In the trial, we included 169 consecutive subjects having a coronary angiography indication. According to the results of coronary angiography, 58 people were included in the CAD group, 52 were in the CSF group, and 59 people were in the control group. The control group includes those who did not have any lesions in their epicardial coronary arteries. Thrombolysis in myocardial infarction (TIMI)-frame counts (TFC) were calculated for all patients. RESULTS: Notably, 2.6% of the population in our study had CSF. Both the CAD (555 +/- 223 pg/mL) and CSF (559 +/- 234 pg/mL) groups had higher endocan levels than the control group (331 +/- 252 pg/mL) (p<0.001). There were similar endocan levels between the CAD and CSF groups. Endocan levels were shown to be favorably associated with mean TFC (r=0.267; p0.001). Serum endocan levels (particularly those above 450 pg/mL) and the presence of hyperlipidemia were the most important predictors of both CAD and CSF. CONCLUSION: Endocan levels are higher in CAD and CSF patients than in those with normal coronary arteries.Öğe Evaluation of Tp-e/QTc Ratio in Obesity(Galenos Publ House, 2024) Uyan, Umut; Aydin, Cihan; Demirkiran, Aykut; Karadeniz, Muhammed; Alpsoy, SerefAim: We aimed to detect simple findings that might predict sudden cardiac death in electrocardiography recordings in obese patients. Materials and Methods: Patients were included in our study retrospectively. Two groups with body mass index (BMI) >= 30 kg/m(2) (Group 1) and BMI <30 kg/m(2) (Group 2) were sampled from the study population with similar baseline characteristics, biochemical and echocardiographic features. Ventricular repolarization parameters were compared between the two groups. The Tp-e interval was defined as the period of time between the T waves' peak and their end. Tp-e/QTc ratio was calculated. Results: This study included 190 participants. There were no differences between the two groups in terms of age (p=0.42), diabetes (p=0.238), hypertension (p=0.877), smoking (p=1.000), medical treatment used, laboratory parameters, left ventricular ejection fraction (p=0.673), and left ventricular mass index (p=0.089). The QTc interval was similar between the groups (416.4 +/- 11.6 ms, and 422.1 +/- 14.8 ms; p=0.081). Tp-e, and Tp-e/QTc ratio were greater in Group 1 (93.1 +/- 6.2 ms, and 67.7 +/- 2.5 ms; p=0.00; 0.22 +/- 0.02, and 0.15 +/- 0.01; p=0.001). Twelve months after the first examinations, six deaths were noted in the obese group (p=0.001). Conclusion: Our study results showed that the Tp-e interval and Tp-e/QTc ratio were significantly increased, and sudden cardiac death was more common in patients with BMI >= 30 kg/m(2).Öğe NATRIURETIC PEPTIDE CONCENTRATIONS AND ECHOCARDIOGRAPHY FINDINGS IN PATIENTS WITH MICRO-ATRIAL FIBRILLATION(Russian Heart Failure Soc, 2024) Aykac, Huseyin; Aydin, Cihan; Demirkiran, Aykut; Uslu, Nurullah; Alpsoy, SerefAim Atrial fibrillation (AF) is a rhythm disorder characterized by very rapid and disorganized atrial-derived electrical activations with uncoordinated atrial contractions. Very short periods of AF-like activity (micro-AF) may be precursors of undetected, silent episodes of atrial fibrillation. Here, we examined the relationship between natriuretic peptide concentrations and echocardiography findings in patients with micro-AF. Material and methods The electrocardiograms (ECGs) of patients complaining of palpitations were recorded with a 24-hour Holter monitor, and the patients were consecutively included in the study. Micro-AF was defined as sudden, irregular atrial tachycardia lasting less than 30 sec with episodes of >= 5 consecutive supraventricular depolarizations with the absolute absence of p-waves. After a G-power test, patients were consecutively included in the study: 45 patients in the micro-AF group and 45 patients in the control group. Laboratory parameters, ECG and echocardiographic findings of the two groups were compared. Results N-terminal pro B-type natriuretic peptide (Pro-BNP) and serum troponin T concentrations were higher in the micro-AF group, (375.5 +/- 63.6 pg / ml vs. 63.1 +/- 56.8 pg / ml, p<0.001; 13 +/- 11.4 ng / dl vs. 4.4 +/- 2.4 ng / dl, p<0.001 respectively.) Each 1 pg / ml increase in serum Pro-BNP increased the risk of micro-AF by 1.8 %. In the ROC analysis, the cut-off value of Pro-BNP for the diagnosis of micro-AF was 63.4 pg / ml, with a sensitivity of 91.1 % and a specificity of 73.3 %. Atrial electro-mechanical delay durations were significantly higher in the micro-AF group. To predict micro-AF, the inter-annulus plane electromechanical delay time (inter-annulus plane AEMD) had a cut-off value of 18.5 sec, with a sensitivity of 93.3 % and a specificity of 91.1 %. Left intra-annulus plane electro-mechanical delay time (intra-annulus AEMD LEFT) had a cut-off value of 11.5 sec with a 95.6 % sensitivity and 75.6 % specificity. In the ECG evaluation, maximum P wave duration (Pmax) (113.+/- 10.2 ms vs. 98 +/- 10.4 ms; p<0.001), minimum P wave duration (Pmin) (73.8 +/- 5.5 ms vs.70 +/- 6.3 ms; p<0.001) and P wave dispersion (PWD) (39.1 +/- 7.9 ms vs.28 +/- 7.6 ms; p<0.001) were longer in the micro-AF group. Conclusions Micro-AF in patients may be predicted by evaluating ECG, echocardiographic, and serum natriuretic peptide data.Öğe Ten-Year Outcomes Following Revascularization Strategies for Non-ST-Segment Elevation Myocardial Infarction and Multivessel Disease(Kare Publ, 2025) Demirkiran, Aykut; Aydin, Cihan; Akyuz, Aydin; Alpsoy, SerefObjective: There remain conflicting recommendations regarding revascularization strategies for patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease (MVD). This study aimed to compare the long-term outcomes of different revascularization strategies. Method: Patients with similar characteristics were categorized into three groups: immediate complete revascularization (ICR), staged complete revascularization (SCR), and non-complete revascularization (NCR). The SCR group was further divided based on the time interval between the index and staged procedures: SCR <= 24 hours and SCR > 24 hours. Cardiac composite outcomes included the total number of cardiac deaths and recurrent myocardial infarction during the follow-up period. Results: Out of 14,511 screened patients, 316 were included in the analysis. The results showed a significant difference in risk between SCR and ICR (hazard ratio [HR] (95% confidence interval [CI]): 0.27 (0.15-0.47); P = 0.001). There was no significant difference between NCR and SCR (HR (95% CI): 1.06 (0.61-1.84); P = 0.832). The SCR group was divided into two groups based on the time interval from the first to the second procedure (time interval [TI] <= 24 hours in the SCR1 group, and TI > 24 hours in the SCR2 group). The frequency of cardiac composite outcomes was lower in SCR1 compared to SCR2 (16.7% vs. 47.1%; P = 0.038). Conclusion: Our findings support the use of ICR and SCR completed within 24 hours due to their favorable long-term outcomes in patients with MVD and NSTEMI.
