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    Is Glasgow prognostic score a predictor of mortality in infective endocarditis?
    (2022) Aydın, Cihan; Emlek, Nadir; Özyıldız, Ali Gökhan; Şahin, Müjgan Ayşenur; Ergül, Elif
    Objectives: 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.
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    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, Cihan
    Objectives: 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.
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    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, Cihan
    Aim: 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.