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Öğe Association of lower serum irisin levels with diabetes mellitus: Irrespective of coronary collateral circulation, and syntax score(Kare Publ, 2021) Akyüz, Aydın; Mert, Beysim; Özkaramanlı Gür, Demet; Efe, Muhammet Mucip; Aykaç, Hüseyin; Alpsoy, Şeref; Güzel, SavaşOBJECTIVE: Irisin is a myokine thought to be involved in the pathophysiological process of atherosclerosis with its' cardiovascular protective effects. Patients with diabetes mellitus (DM) have lower levels of irisin. Therefore, we investigated whether there is a connection between irisin, DM, coronary collateral circulation (CCC), and SYNTAX scores representing coronary artery disease (CAD) severity. METHODS: This study evaluated 86 patients who have at least one epicardial coronary artery with chronic total occlusion. We included Rentrop 0-1 into the poor CCC group (n=45) and Rentrop 2-3 into the good CCC group (n=41) and measured serum irisin levels. RESULTS: Irisin levels did not differ (17585 [882-37741] pg/ml and (17504 [813-47683] pg/ml, p=0.772) between the two groups. Irisin levels were lower in patients with diabetes (n=41; 14485 [813-29398] pg/ml) than those without diabetes (n=45; 19724 [865-47683] pg/ml (p=0.002). Irisin was not correlated with SYNTAX scores. In multivariate analysis, DM (OR=0.463; CI: 0.184-0.783; p=0.012) was a negative predictor of good CCC development CONCLUSION: Although its level is decreased in patients with diabetes, serum irisin levels have no role in the pathophysiology of collateral development and CAD severity.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 Outcomes of Carotid Artery Stenting in Elderly Patients: A Single Center Retrospective Study: the Effect of Post-dilatation on Outcomes(Ortadoğu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2021) Akyüz, Aydın; Efe, Muhammet Mucip; Özkaramanlı Gür, Demet; Alpsoy, Şeref; Güler, NiyaziObjective: Carotid artery stenting (CAS) is a current treatment approach that has been applied in symptomatic and asymptomatic carotid artery stenosis. In addition to being a minimally invasive method, it has fewer complications and mortality rates, and short hospital stays when compared to carotid endarterectomy. Some studies showed that the risk of stroke or death twice as high after CAS than after carotid endarterectomy among those ?70 years old. In this study, we aimed to investigate the short- and long-term complications, efficacy, and durability of CAS in elderly patients (?70 years old) with carotid artery stenosis with a median follow-up of 5.08 years (interquartile range 3.2-8.1), respectively. Material and Methods: A total of 140 patients who underwent CAS due to atherosclerotic carotid artery stenosis were included in the study. Stroke rates (total n=15[10.7%], n=3[5%] vs n=12[15%], p=0.049) were higher in patients who were ?70 years of age during the follow-up. The two groups (the group with age <70 and the group with age ?70) were compared according to demographic, biochemical data, and clinical outcomes such as stroke and stroke/death. Results: According to multivariate logistic regression analysis, those who were ?70 years, those with a history of earlier stroke, and the patients requiring post-dilatation were at risk of recurrent stroke. Deaths occurred in 5 of 140 patients in the follow-up. The patients who were ?70 years (OR 4.577 [95% CI=1.023-5.544], p=0.043), who have a history of earlier stroke (OR=6.965 [95% CI=1.067-13.115], p=0.038), and those requiring post-dilatation (OR=2.312 [95%CI=1.156-5.775], p=0.022) were at risk of recurrent stroke. Only age ?70 years (OR=4.577 [95% CI=1.210-17.191], p=0.024) was an important risk factor for death/stroke. Conclusion: Although the immediate results of the CAS procedure in patients with age ?70, were successful, they, especially in those with a history of earlier stroke and those requiring post-dilation, had a higher risk of stroke and the combined endpoint of death/stroke in the follow-up. Copyright © 2021 by Türkiye Klinikleri.Öğe Role of Sodium Levels on Atrial Fibrillation in Heart Failure: Active Player or a Bystander?(Arquivos Brasileiros Cardiologia, 2022) Akyüz, Aydın; Baykız, Derya; Gür, Demet Özkaramanlı; Gökçek, Sümeyra; Efe, Muhammet Mucip; Alpsoy, ŞerefBackground: The coexistence of hyponatremia and atrial fibrillation (AF) increases morbidity and mortality in patients with heart failure (HF). However, it is not established whether hyponatremia is related to AF or not. Objective: Our study aims to seek a potential association of hyponatremia with AF in patients with reduced ejection fraction heart failure (HFrEF). Methods: This observational cross-sectional single-center study included 280 consecutive outpatients diagnosed with HFrEF with 40% or less. Based on sodium concentrations <= 135 mEq/L or higher, the patients were classified into hyponatremia (n=66) and normonatremia (n=214). A p-value <0.05 was considered significant. Results: Mean age was 67.6 +/- 10.5 years, 202 of them (72.2%) were male, mean blood sodium level was 138 +/- 3.6 mEq/L, and mean ejection fraction was 30 +/- 4%. Of those, 195 (69.6%) patients were diagnosed with coronary artery disease. AF was detected in 124 (44.3%) patients. AF rate was higher in patients with hyponatremia compared to those with hyponatremia (n=39 [59.1%] vs. n=85 [39.7%), p= 0.020). In the logistic regression analysis, hyponatremia was not related to AF (OR=1.022, 95% CI=0.785-1.330, p=0.871). Advanced age (OR=1.046, 95% CI=1.016-1.177, p=0.003), presence of CAD (OR=2.058, 95% CI=1.122-3.777, p=0.020), resting heart rate (OR=1.041, 95% CI=1.023-1.060, p<0.001), and left atrium diameter (OR=1.049, 95% CI=1.011-1.616, p=0.002) were found to be predictors of AF. Conclusion: AF was higher in outpatients with HFrEF and hyponatremia. However, there is no association between sodium levels and AF in patients with HFrEF.Öğe Serum endokan düzeyleri ile koroner yavaş akımı ve koroner arter hastalığının ilişkisi(Namık Kemal Üniversitesi, 2022) Efe, Muhammet Mucip; Akyüz, AydınAmaç: Koroner arter hastalığı (KAH) sık koroner yavaş akım (KYA) ise daha az görülen ve önemli mortalite ve morbitide riski olan kardiyovasküler hastalıklardandır. Her ikisinin risk faktörleri ile benzerdir ve genelikle her ikisinde de mikrovasküler ateroma ve endotelde inflamasyon bulunur. Endokan son yıllarda özelikle bazı inflamatuar hastalıkların yanısıra kardiyovasküler hastalıklarda da araştırılan bir proinflamatuar glikopeptidtir. Bu nedenlerle bizde endokanın benzer popülasyonda hem KAH hem de KYA daki düzeyleri karşılaştırmayı ve endokanın ilave klinik değişkenlerle ilişkisini incelemeyi planladık. Materyal ve Metot: Çalışmaya ardışık olarak koroner anjiografi endikasyonu alan 169 kişiyi çalışmaya dahil ettik. Koroner anjiografi sonucuna göre KAH grubuna 58, KYA grubuna 52 ve kontrol grubuna 59 kişi alındı. Epikardiyal koroner arterlerinde herhangi bir lezyon olmayanlar kontrol grubuna alındı. Tüm hastalarda TIMI- görüntü kare sayıları (TIMI- GKS) hesaplandı. Normalden yavaş olanlar KYA grubuna alındı. En az bir epikardiyal koroner arterde darlık olan hastalar KAH grubuna alındı. Tüm hastaların demografik ve klinik özellikleri kaydedildi. Endokan ve diğer kan analizleri yapıldı. Veriler toplandıktan sonra SPSS ile istatiksel analizler yapıldı. Bulgular: Çalışmamızdaki popülasyonun %2.6 sı KYA na sahipti. Hem KYA( 559 ± 234 pg/ml) hem de KAH grubu (555 ± 223 pg/ml) kontrol grubundan (331± 252 pg/ml) daha yüksek endokan seviyelerine sahipti ( p<0,001). KYA ve KAH grubu arasında benzer endokan seviyeleri vardı. Endokan düzeyleri ortalama TIMI-GKS ile pozitif yönlü korelasyonlu idi (r=0.267; p<0.001). Serum endokan düzeyleri (özellikle ?450 pg/ml'nin üzerindeki değerler) ve hiperlipidemi varlığı kem KYA hemde KAH varlığının ana öngördürücüleri idi. Sonuç: Endokan KAH ve KYA da benzer oranda normale göre yüksektir. Çalışmamızın sonuçları endokanın hem KAH ve hem de KYA nın patofizyolojisinde benzer proinflamatuar özellikler gösterdiğini düşündürtmektedir. Anahtar Kelimeler: Koroner arter hastalığı, koroner yavaş akım, endokanÖğe Some inflammatory markers and chest computerized tomography in patients with severe acute respiratory syndrome coronavirus infection(Assoc Medica Brasileira, 2021) Akyüz, Aydın; Kurtoğlu Özçağlayan, Tuğba İlkem; Şahin, Gülcan Gucer; Efe, Muhammet Mucip; Özkaramanlı Gür, Demet; Alpsoy, ŞerefOBJECTIVE: We retrospectively assessed whether there was a relationship between lung complications and some easily accessible markers to predict the presence of pulmonary consolidation in patients with coronavirus disease 2019 (COVID-19). METHODS: According to the polymerase chain reaction and chest computerized tomography results, the study was categorized into three groups. Group 1 (n=87) included the patients with polymerase chain reaction (+), group 2 (n=55) included the patients with polymerase chain reaction (-) and chest computerized tomography (+), and group 3 (n=77) included the patients with polymerase chain reaction (-) and chest computerized tomography (-), respectively. RESULTS: High-sensitivity C-reactive protein and increased age were associated with higher computerized tomography (CT) scores. CONCLUSION: Increased age and C-reactive protein (CRP) may suggest pulmonary infiltration on chest CT in patients with COVID-19.Öğe Systemic Immune-Inflammatory Index as a Determinant of Atherosclerotic Burden and High-Risk Patients with Acute Coronary Syndromes(Arquivos Brasileiros Cardiologia, 2022) Gür, Demet Özkaramanlı; Efe, Muhammet Mucip; Alpsoy, Şeref; Akyüz, Aydın; Uslu, Nurullah; Çelikkol, Aliye; Gür, ÖzcanBackground: Systemic immune-inflammatory index (SII), which is derived from neutrophil, platelet and lymphocyte counts, represents the homeostatic balance among inflammatory, immune and thrombotic status. The systemic immune-inflammatory index is superior to indices such as neutrophil-lymphocyte ratio in predicting prognosis in various malignancies, while it is shown to predict future cardiac events better than traditional risk factors after coronary intervention. Objectives: Herein, we aimed to evaluate the relationship of the systemic immune-inflammatory index with atherosclerotic burden and in-hospital complications in acute coronary syndrome patients. Methods: The clinical outcomes, such as extent of myocardial damage, atherosclerotic burden, bleeding, acute kidney injury, duration of hospital stay and in-hospital mortality, were evaluated in a retrospective cohort of 309 consecutive acute coronary syndrome patients. The systemic immune-inflammatory index was calculated as (Platelet X Neutrophil)/Lymphocyte count on admission. Study population was categorized into tertiles with regard to systemic immune-inflammatory index. A p value of <0.05 was considered statistically significant. Results: The highest systemic immune-inflammatory index values were within ST elevation myocardial infarction patients (641.4 in unstable angina pectoris, 843.0 in non-ST elevation myocardial infarction patients and 996.0 in ST elevation myocardial infarction patients; p=0.004). Maximal troponin concentration (0.94 vs. 1.26 vs. 3; p<0.001), number of diseased vessels (1 vs. 2 vs. 2; p<0.001), the SYNTAX (synergy between percutaneous coronary intervention with taxus and coronary artery bypass grafting) score (9 vs. 14 vs. 17.5; p<0.001) and duration of hospital stay (2 vs. 2 vs. 3; p<0.001) also increased with increasing SIItertile (tertile1 vs. tertile 2 vs. tertile 3). Systemic immune-inflammatory index was an independent predictor of SYNTAX score (B: 0.232 [0.001 to 0.003]; p<0.001), extent of myocardial damage (B: 0.152 [0 to 0.001]; p=0.005) and duration of hospital stay (B: 0.168 [0.0 to 0.001]; p=0.003). Conclusions: This study has demonstrated that the systemic immune-inflammatory index, a simple hematological index, is a marker of atherosclerotic burden and longer hospital stay on well-known risk factors in high risk acute coronary syndrome patients.
