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    Investigation of the relationship between modified Glasgow prognostic score and no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction
    (2023) Kaplangoray, Mustafa; Toprak, Kenan; Aydın, Cihan; Aslan, Ramazan
    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 to balloon duration, troponin T, white blood cell (WBC), Syntax score, neutrophil to lymphocyte ratio (NLR), glucose level, C-reactive protein level (CRP), diabetic and female patient ratio were higher, while left ventricular ejection fraction, ST segment resolution ratio at 60 min, and serum albumin level were lower in the NRP group.Logistic regression analysis showed that WBC count [Hazard ratio (HR): 0.816, 95% confidence interval (CI): 0.728-0.914, p < 0.001], NLR (HR: 0.482, CI: 0.355-0.654, p < 0.001), pain-to-balloon time (HR: 0.976, CI:0.960-0.991, p = 0.002) and mGPS (HR: 3.213, CI: 1.643- 6.283, p = 0.001) were independent predictive factors for NRP. Conclusions: Modified GPS is an independent predictive factor for NRP in patients undergoing pPCI for STEMI.
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    Investigation of the Relationship Between Triglycerides-Glucose Index and Coronary Slow Flow: A Retrospective Case-Control Study
    (Arquivos Brasileiros Cardiologia, 2023) Kaplangoray, Mustafa; Toprak, Kenan; Basanalan, Fuat; Palice, Ali; Aydin, Cihan; Demirkiran, Aykut; Cekici, Yusuf
    Background: Coronary slow flow (CSF) refers to delayed distal vessel opacification in the absence of epicardial coronary artery stenosis. The etiopathogenic mechanism of CSF is still unclear.Objectives: This study investigates the relationship between CSF and the triglyceride-glucose (TyG) index.Methods: The study sample consisted of 118 CSF patients and 105 patients with normal coronary flow (NCF). The coronary flow rate was measured via the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method in all patients. The TyG index was calculated as the logarithm of the [fasting triglyceride (mg/dL)xfasting glucose (mg/dL)]/2 value. A significance level of < 0.05 was adopted as statistically significant.Results: The TyG index, low-density lipoprotein (LDL), body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR) and TFC values, male ratio, and the ratio of smokers were higher, whereas high-density lipoprotein (HDL) levels were significantly lower in the CSF group compared to the NCF group (p<0,05). The correlation analysis revealed that CSF was significantly correlated with TyG index, BMI, NLR, and HDL values. The strongest of these correlations was between CSF and TyG index (r= 0.57, p<0.001). Additionally, the multivariate analysis revealed that TyG index, BMI, NLR ratio, and male gender were independent predictors for CSF (p<0.05). Receiver operating characteristic (ROC) curve analysis indicated that a cut-off value of >= 9.28 for the TyG index predicted CSF with a sensitivity of 78% and a specificity of 78.1% [Area under the curve (AUC): 0.868 and 95% Confidence Interval (CI): 0.823-0.914].Conclusion: The findings of this study revealed a very strong relationship between CSF and TyG index.
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    Selvester score and myocardial performance index in acute anterior myocardial infarction
    (Assoc Medica Brasileira, 2023) Kaplangoray, Mustafa; Aydın, Cihan; Toprak, Kenan; Çekici, Yusuf
    BACKGROUND: The simplified Selvester QRS score is a parameter for estimating myocardial damage in ST-elevation myocardial infarction. ST-elevation myocardial infarction leads to varying degrees of impairment in left ventricular systolic and diastolic function. Myocardial performance index is a single parameter that can predict combined left ventricular systolic and diastolic performance. OBJECTIVE: We investigated the relationship between Selvester score and myocardial performance index in patients undergoing primary percutaneous coronary intervention for acute anterior myocardial infarction. METHODS: The study included 58 patients who underwent primary percutaneous coronary intervention for acute anterior myocardial infarction. Selvester score of all patients was also calculated at 72 h. Patients were categorized into two groups according to the Selvester score. Those with a score <6 (low score) were considered group 1 and those with a score >= 6 (high score) were considered group 2. RESULTS: When compared with group 1, patients in group 2 were older (p=0.01) and had lower left ventricular ejection fractions (50.3 +/- 4 vs. 35.6 +/- 6.9, p=0.001), and conventional myocardial performance index (0.52 +/- 0.06 vs. 0.69 +/- 0.08, p=0.001), lateral tissue Doppler-derived myocardial performance index (0.57 +/- 0.08 vs. 0.72 +/- 0.08, p=0.001), and septal tissue Doppler-derived myocardial performance index (0.62 +/- 0.07 vs. 0.76 +/- 0.08, p=0.001) were higher. There was a high correlation between lateral tissue Doppler-derived myocardial performance index and conventional myocardial performance index and Selvester score (r=0.80, p<0.001; r=0.86, p<0.001, respectively) and a moderate correlation between septal tissue Doppler -derived myocardial performance index and Selvester score (r=0.67, p<0.001). CONCLUSIONS: The post-procedural Selvester score can predict lateral tissue Doppler-derived myocardial performance index and conventional myocardial performance index with high sensitivity and acceptable specificity in patients undergoing primary percutaneous coronary intervention for acute anterior myocardial infarction.
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    THE MAPH SCORE PREDICTS CORONARY SLOW FLOW. A RETROSPECTIVE CASE-CONTROLLED STUDY
    (Russian Heart Failure Soc, 2024) Kaplangoray, Mustafa; Toprak, Kenan; Aydin, Cihan; Cekici, Yusuf; Yildirim, Arafat; Abacioglu, Ozge Ozcan
    Aim The MAPH score is a new score that combines mean platelet volume (MPV), hematocrit, and total protein, which are markers of whole blood viscosity (WBV). We aimed to investigate the relationship between the MAPH score and the coronary slow flow phenomenon (CSF). Material and methods A total of 201 patients were included in the study. 105 had CSF and 96 had normal coronary flow (NCF). Coronary flow was measured by the Thrombolysis in Myocardial Infarction frame count (TFC) method. The patients' MPV, age, hematocrit, and total protein were recorded. High (HSR) and low shear rates (LSR) were calculated, based on total protein and hematocrit values. Cut-off values for CSF were determined using the Youden's index, and the score was determined as 0 or 1 according to the cut-off values. The sum of these scores was the MAPH score. Results The mean age of the patients included in the study was 51.1 +/- 7.9 (n=201, 54.2 % male). Hyperlipidemia, DM, and HT rates of both groups were similar, but the mean age of the CSF group was higher (p=0.773; p=0.549; p=0.848; p <0.001, respectively). Total protein, MPV,hematocrit, HSR and LSR were higher in the CSF group (p< 0.001, for all values). Comparative receiver operating characteristic (ROC) curve analysis showed that the performance of the MAPH score in predicting CSF is better than the performance of these parameters separately. Conclusion A new score, the MAPH score, may be used to identify the presence of CSF