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Öğe Could the systemic immune-inflammation index be a predictor to estimate cerebrovascular events in hypertensive patients?(Lippincott Williams & Wilkins, 2022) Aydın, Cihan; Alpsoy, Şeref; Akyüz, Aydın; Özkaramanlı Gür, Demet; Emlek, Nadir; Şahin, Ayhan; Aykac, HüseyinBackground and objectives Hypertension is one of the most important risk factors for cardiovascular and cerebrovascular events. Inflammatory processes occupy an important place in the pathogenesis of hypertension. Many studies have studied inflammatory markers responsible for the onset of hypertension and organ damage. In this study, we investigated whether the systemic immune-inflammation index (SII) (platelet x neutrophil/lymphocyte), - one of the new inflammatory markers - can be used to predict cerebrovascular events in hypertensive patients. Methods Ambulatory blood pressure monitoring results between January 2019 and June 2020 of approximately 379 patients followed up with hypertension were retrospectively analyzed. These patients were divided into two groups as with or without a previous cerebrovascular event in the analyzed database. In all patients, complete blood count and biochemistry test results just before the cerebrovascular event were found from the database. SII, atherogenic index, neutrophil-lymphocyte ratio were calculated from the complete blood count. Forty-nine patients with stroke (group 1: 12.9%; mean age: 64.3 +/- 14.6) and 330 patients without stroke (group 2: 87.1%; mean age: 50.8 +/- 14.4). Results Ambulatory blood pressure measurements were lower in group 1. Lipid parameters were also lower in this group. Receiver operating characteristic curve analysis showed that SII had a sensitivity of 85.7% and specificity of 84.8 % for stroke in individuals who participated in the study when the cutoff value of SII was 633.26 x 10(3) (P = 0.0001) area under curve (95%); 0.898 (0.856-0.941). In multivariate logistic regression analysis, age and SII were significantly associated with a higher risk of stroke. Age, (hazard ratio:1.067; 95% CI, 1.021-1.115), SII (hazard ratio:1.009; 95% CI, 1.000-1.009), respectively. Conclusions In conclusion, SII is a simple, useful new inflammatory parameter for predicting stroke from hypertension. We found that the high SII levels increase the risk of stroke in hypertensive patients.Öğe Is Glasgow prognostic score a predictor of mortality in infective endocarditis?(2022) Aydın, Cihan; Emlek, Nadir; Özyıldız, Ali Gökhan; Şahin, Müjgan Ayşenur; Ergül, ElifObjectives: The inflammation-based Glasgow prognostic score (GPS), which comprises elevated serum C-reactive protein (CRP) and decreased albumin concentration, is the most valid inflammatory risk score in cancer. New prognostic markers are needed to predict high-risk infective endocarditis (IE) patients. In the present study, we investigated the in-hospital mortality estimation of GPS in infective endocarditis patients. Methods: The retrospectively designed study included 53 IE patients diagnosed according to Duke criteria. Demographic and clinical data of the patients were recorded and GPS levels were measured. Patients were divided into two groups according to in-hospital mortality outcomes. Glasgow prognostic score was rated as 0, 1, or 2 points based on serum albumin and C-reactive protein levels. Results: The nonsurvivor group was older and the number of patients with kidney failure or diabetes was higher in this group. Glasgow prognostic score was higher in the nonsurvivor group, while albumin levels were lower. Thirty-four patients died during intensive care unit follow-up, and the mean follow-up period was 24.1 ± 18.6 days. ROC analysis showed that the Glasgow prognostic score had a sensitivity of 82.4% and a specificity of 36.8% at a cut-off value of ?1.5 in predicting in-hospital mortality. Chronic renal failure (OR: 6.720; 95% CI: 1.907-23.684; p = 0.003) and age (OR: 1.040; 95% CI: 1.001-1.081; p = 0.044) were the independent variables of the mortality prediction in univariate logistic regression analysis. In multivariate logistic regression analysis, only chronic renal failure (OR: 0.153; 95% CI: 0.036-0.653; p = 0.011) was found to be a significant predictor of mortality. Kaplan–Meier survival analysis revealed that long-term survival was reduced in patients with a high GPS (Log-rank: p = 0.003). Conclusions: Glasgow prognostic score level is associated with increased in-hospital mortality in IE patients. Chronic renal failure and GPS are the independent predictors of mortality.Öğe LIVER FIBROSIS SCORES AND CORONARY ARTERY ECTASIA(Russian Heart Failure Soc, 2023) Aydin, Cihan; Emlek, Nadir; Ergul, ElifBackground Although scoring systems showing liver fibrosis using non-invasive methods have been accepted as effective tools for predicting cardiovascular risk, their role in predicting coronary ectasia (CAE) has not been evaluated. This study investigated whether aprison (APRI) and fibrosis-4 indices (FIB-4), which are indicators of fibrosis in nonalcoholic fatty liver disease (NAFLD), are associated with CAE. Material and methods A retrospective, cross-sectional study consisted of 215 patients, 108 with CAE and 107 without CAE, as diagnosed by angiography. The mean age of all patients was 61.8 +/- 9.9 yrs, and 171 (78.8 %) were males. The relationships between APRI, FIB-4, NAFLD, and Bard scores and CAE were evaluated. Results APRI, FIB-4, NAFLD, and Bard scores were independent predictors of CAE. Fib 4, APRI, NAFLD, and Bard scores were higher in the CAE patients. There were a moderate, positive correlations for FIB-4, APRI, and NAFLD scores with coronary ectasia (r=0.55, p<0.001; r=0.52, p<0.001; r=0.51, p<0.001, respectively). A weak-moderate positive correlation was observed between the Bard score and CAE (r=0.34, p<0.001). Univariate and multivariate regression analysis showed that APRI score, low HDL, and Bard score were independent risk factors for CAE ectasia (p<0.001). Cut-off values to predict CAE as determined by ROC curve analysis were: FIB-4 index >= 1.43 (AUC=0.817, 95 % confidence interval (CI): 0.762 to 0.873, p<0.001), APRI index =0.25 (AUC=0.804, 95% CI: 0.745 to 0.862, p<0.001), NAFLD score >=-0.92 (AUC=0.798, 95% CI: 0.738 to 0.857.p<0.001), Bard score >= 2 (AUC=0.691, 95% CI: 0.621 to 0.761, p<0.001). Conclusion APRI, FIB-4, NAFLD, and Bard scores are associated with CAE.Öğe Non-alcoholic faty liver disease and liver fibrosis score have an independent relationship with the presence of mitral annular calcification(Springer, 2023) Ergul, Elif; Emlek, Nadir; Yilmaz, Ahmet Seyda; ozturk, Muhammet; Aydin, Cihan; Durak, Huseyin; Cetin, MustafaNon-alcoholic faty liver disease (NAFLD) and liver fibrosis score (FIB 4) are associated with increased mortality from cardiovascular causes. NAFLD and cardiac diseases are different manifestations of systemic metabolic syndrome. In this study, we aimed to reveal the relationship between NAFLD and FIB 4 liver fibrosis scores and mitral annular calcification (MAC). One hundred patients were included in the study. Blood samples and echocardiography measurements were obtained from each subject. The two groups were compared in terms of demographic and echocardiographic characteristics. Thirty-one men and 69 women with a mean age of 48.6 +/- 13.1 years were included in the analysis. The patients were divided into two groups as those with MAC (n = 26) and those without (n = 74). The baseline demographic and laboratory data for the two groups were compared. In the group with MAC (+) age, serum creatinine levels, FIB4 and NAFLD Scores; HL, DM rates, angiotensin converting enzyme (ACE) inhibitor and statin usage rates were higher, with statistical significance. NAFLD and FIB 4 liver fibrosis scores have an independent relationship with MAC.Öğe The association of new atherosclerosis markers with coronary collaterals in chronic total occlusion patients(2022) Özyıldız, Ali Gökhan; Ergül, Elif; Öğütveren, Muhammed Mürsel; Öztürk, Muhammet; Emlek, Nadir; Aydın, CihanObjectives: In the present study, we investigated the relationship between mentioned markers and chronic total occlusion collateral development. Patients and methods: A total of 243 patients (210 males, 33 females; mean age: 63.3±11.5; range, 51 to 76 years) who underwent coronary angiography due to typical chest pain or myocardial ischemia detected in noninvasive stress tests and diagnosed with ?1 major coronary artery occlusion between January and September 2020 were included in the cross-sectional observational study. The angiographic collateral index was determined according to the Cohen-Rentrop classification. The patients were divided into two groups according to the sufficiency of collateral development: the well-developed collaterals group (n=155) and the poor-developed collaterals group (n=88). Results: Statistically significant parameters in univariate logistic regression analysis were evaluated with multivariate (stepwise) logistic regression analysis; as a result, presence of chronic total occlusion in left anterior descending artery (odds ratio [OR]=2.447; 95% confidence interval [CI], 1.160-5.162; p=0.019), total number of occlusions (OR=3.503; 95% CI, 1.445-8.494; p=0.006), left ventricular ejection fraction (OR=1.056; 95% CI, 1.022-1.091; p=0.001), and the atherogenic index of plasma (OR=0.017; 95% CI, 1.022-1.091; p<0.001) were independently associated with well-developed collaterals. Although the triglyceride-glucose index had statistical significance in the univariate analysis, it was not detected as an independent variable in the multivariate analysis. The monocyte-lymphocyte ratio was not significant in the univariate analysis. Conclusion: Of the new atherosclerosis markers, only the atherogenic index of plasma had an independent association with poor collateral development.Öğe The relationship between intracoronary thrombus burden and atherogenic index in patients with ST-elevation myocardial infarction(Verduci Publisher, 2022) Emlek, Nadir; Duman, H.; Öğütveren, Muhammed Mürsel; Ergül, E.; Koç, H.; Durak, H.; Aydın, Cihan- OBJECTIVE: Increased coro-nary thrombus load is a strong predictor of ad-verse cardiovascular (CV) outcomes. Identifying predictors of intracoronary thrombus burden may contribute to the management of ST -seg-ment elevation myocardial infarction (STEMI)Öğe The relationship between nondipper hypertension and triglyceride glucose index(Lippincott Williams & Wilkins, 2022) Emlek, Nadir; Aydın, CihanNondipper hypertensive patients have an increased incidence of damage to end organs, including the brain, heart, and kidney, and a worse cardiovascular prognosis. The triglyceride glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to the traditional risk factors of cardiovascular disease. To the best of our knowledge, whether there is a relationship between the TyG index and impaired diurnal blood pressure (BP) has not been investigated. This study aimed to compare the TyG index between normotensive, nondipper, and dipper hypertensive patients. A total of 1037 patients grouped according to the results of ambulatory BP monitoring were included, with group 1 including dipper hypertensive (n = 368), group 2 including nondipper hypertensive (n = 496), and group 3 including normotensive control (n = 173) patients. In both the univariate and multivariate logistic regression analyses, TyG index [odds ratio (OR), 4.656; 95% confidence interval (CI), 3.014-7.193; P < 0.001], age (OR, 1.011; 95% CI, 1.002-1.021; P = 0.018), and glomerular filtration rate (GFR) (OR, 0.979; 95% CI, 0.971-0.987; P < 0.001) were independent predictors of nondipper hypertension (HT). In the ROC analysis, a TyG index cutoff value of at least 4.74 predicted nondipper hypertensive patients with a sensitivity of 59.7%, and a specificity of 59.9% [area under the curve = 0.647 (0.614-0.680); 95% CI; P < 0.001]. We showed that TyG index, age, and GFR are independent predictors in patients with nondipper HT. TyG index, a simple, cost-effective, and rapid tool can predict the nondipper pattern in essential HT.Öğe The Relationship Between Uric Acid to High-Density Lipoprotein Cholesterol Ratio and Collateral Index in Patients with Chronic Total Occlusion(Russian Heart Failure Soc, 2021) Aydın, Cihan; Emlek, NadirBackground High serum uric acid (UA) levels and low high-density lipoprotein cholesterol (HDL- C) levels are accepted as risk factors for cardiovascular mortality. Hyperuricemia and low HDL-C levels were associated with an increased risk of cardiovascular mortality and the development of diabetes and hypertension. However, the association of UA with cardiovascular (CV) mortality,collateral index are undetermined in patients with chronic total occlusion (CTO). Material and methods 124 patients who underwent coronary angiography with the diagnosis of stable or unstable angina pectoris and had chronic total occlusion were included in our study. Blood samples were collected from all patients before the angiography procedure. Coronary collateral circulation (CCC) was graded according to the Rentrop grading system of 0-3. Rentrop grades of 0 and 1 indicated low-grade CCC group, whereas grades 2 and 3 indicated high- grade CCC group. We divided our patients into two groups as low-grade CCC and high-grade CCC and examined these two groups in terms of uric acid / HDL ratios. Group 1: Rentrop classification grade 0-1 (mean age, 63,9 +/- 9,9), Group 2: Rentrop classification grade 2-3 (mean age, 62,1 +/- 9,4). Results The baseline characteristics were similar in both groups. Uric acid/ High density lipoproteincholesterol ratios and uric acid levels were higher in group 1 with poor collateral circulation [group 1; 0,21 (0,07-0,39) vs. group 2; 0,16 (0,08-0,31), group 1; 8,2 (3,4-10,4) vs. group 2; 5,85 (3,5-7,7), p<0,001, p<0,001 respectively]. Conclusions We found that high Uric acid/ High-density lipoprotein-cholesterol ratios and high uric acid levels are associated with poor collateral circulation.Öğe The relationship of serum asymmetric dimethylarginine concentrations and lung involvement in patients with COVID-19 infection(2021) Emlek, Nadir; Yılmaz, Ahmet Seyda; Ergül, Elif; Gündoğdu, Hasan; Arpa, Medeni; Koç, Haldun; Aydın, CihanAim: COVID-19 infections the tissue through angiotensin converting enzyme 2 receptor, which is also expressed on endothelial cells. Endothelial dysfunction may be associated with lung involvement. Asymmetric dimethylarginine (ADMA) is an indirect marker of endothelial dysfunction. The aim of our study was to evaluate ADMA concentrations and to identify its association with lung involvement in patients with COVID 19 disease. Methods: We included 42 patients with COVID-19 infection and lung involvement (Group 1). Forty-two age and sex matched patients without pneumonia acted as the control group (Group 2). All patients gave blood samples for ADMA at the 1st month control visit after discharge. We compared C-reactive protein (CRP) and ADMA concentrations in addition to routine biochemical parameters between groups. Results: Patients with lung involvement had higher admission glucose, CRP, and ADMA concentrations, and displayed lower hemoglobin concentration and lymphocyte count compared to patients without lung involvement. Although patients with lung involvement had higher ADMA concentrations with respect to those without; plasma ADMA levels were also higher than normal values in control group. Multivariate analysis identified log CRP concentration (OR= 3.047, 95% CI=1.881-5.023, p<0.001) as the independent predictor for lung involvement. And, there was a correlation between ADMA and CRP (r: 0.318, p: 0.003). Conclusion: We revealed elevated ADMA concentrations as the surrogate of endothelial dysfunction in COVID-19 patients whether they have pneumonia or not.
