Browsing by Author "Ütük, O"

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    Endothelial dysfunction in patients with primary Sjogren's syndrome
    Pirildar, T; Tikiz, C; Özkaya, S; Tarhan, S; Ütük, O; Tikiz, H; Tezcan, UK
    \The aim of this study was to determine the endothelial function in patients with primary Sjogren's syndrome ( SS). We also aimed to determine whether endothelial ( dys) function correlates with extraglandular manifestations, specific autoantibodies and the severity of salivary gland involvement of SS. Endothelium dependent vasodilation and endothelium- independent vasodilation of the brachial artery were assessed by a high- resolution ultrasound on 25 patients with primary SS and on 29 healthy controls. Patients with primary SS had significantly less mean endothelium- dependent vasodilation than did controls ( 3.0 +/- 0.4% vs 4.2 +/- 0.3%; p= 0.012). Endothelium- independent vasodilation induced by sublingual glycerol trinitrate was not different between the two groups ( 12.9 +/- 1.4% vs 14.1 +/- 1.2%; p= 0.86;). We concluded that endothelium- dependent vasodilation was impaired in primary SS patients, in particular those presenting with Raynaud's phenomenon, when compared with the healthy controls and this impairment was not associated with the presence of RF, ANA, anti- Ro/ SS- A, anti- La/ SS- B and with the other extraglandular manifestations of the disease.
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    Effects of High-Dose Rocuronium on the QTc Interval During Anaesthesia Induction in Patients Undergoing Coronary Artery Bypass Graft Surgery
    Agdanli, D; Öztürk, T; Ütük, O; Keles, GT
    Objective: Existing myocardial damage in coronary artery disease patients causes prolonged QT syndrome. The primary objective of this trial is to explore the effects of different doses of the muscle relaxant agent rocuronium (0.6 mg kg-1 and 1.2 mg kg-1) on QTc following anaesthetic induction. The second objective is to determine the incidence and kinds of arrhythmias. Methods: In this prospective and randomized trial, patients undergoing elective coronary artery revascularization surgery were included in one of two groups. Both groups took the same anaesthetic induction agents: midazolam and fentanyl. Rocuronium was administered in Group 1 (n=20) with dose of 0.6 mg kg-1 and in Group 2 (n=20) with a dose of 1.2 mg kg-1 for muscle relaxation. Heart rate, average arterial pressure and QTc were recorded before induction (T0), after induction (T1), after muscle relaxant (T2), and 2 minutes (T3) and 5 minutes after intubation (T4). Results: QTc was significantly longer 2 minutes after intubation (in Group 1 and Group 2, respectively, 447.9 +/- 28.3 and 466.1 +/- 37.8 ms) than at the beginning (respectively, 426.9 +/- 25.7, 432.0 +/- 35.5 ms) (p<0.01). In the intergroup comparison, average QTc values were similar in all trial periods (p>0.05). The prevalence of arrhythmias in between Group 1 (35%, n=7) and Group 2 (15%, n=3) was similar (p=0.06). Arrhythmias were recorded 2 minutes after intubation in both groups (n=10, 25%). Conclusion: In patients undergoing coronary artery revascularization surgery, rocuronium doses of 0.6 mg kg-1 and 1.2 mg kg-1 prolong the QTc interval after intubation. Cardiac arrhythmias related to long QTc arising after intubation should be taken into consideration.
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    Beyond lowering LDL cholesterol
    Bayturan, Ö; Ütük, O; Tuzcu, EM
    Compelling evidence from randomized controlled studies demonstrated the crucial role of lowering low-density lipoprotein cholesterol (LDL-C) in the prevention of vascular events. However, not all patients with low LDL-C levels show similar reduction in event rates. The residual risk factors associated with ongoing vascular events despite achieving low LDL-C levels remain to be elucidated. New data suggest that beyond statin therapy, inflammatory mediators, high non-HDL (high-density lipoprotein) cholesterol or apolipoprotein B, small dense LDL-C, type 2 diabetes mellitus, and lifestyle features may have impact on residual vascular risk. In this review, we discussed the significance of identifying these residual risk factors and developing new treatment strategies to further decrease vascular events. The importance of imaging arterial wall to evaluate the effect of various medical therapies has also stated. (Anadolu Kardiyol Derg 2011; 11: 163-7)
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    Selective COX-2 inhibition with different doses of rofecoxib does not impair endothelial function in patients with coronary artery disease
    Tikiz, C; Ütük, O; Bayturan, O; Bayindir, P; Ekmekçi, C; Tikiz, H
    In this study, we investigated the effects of both 25 and 50 mg daily doses of rofecoxib on the endothelial functions of patients with coronary artery disease (CAD). For this purpose, 34 patients with documented severe CAD and who were under aspirin treatment (300 mg/day) were randomized to receive 4 weeks of treatment with a placebo (n = 10, group I), rofecoxib 25 mg/day (n = 12, group II), and rofecoxib 50 mg/day (n = 12, group III). Brachial artery vasodilator responses were measured in order to evaluate endothelial function. The percentage of change in endothelial-dependent vasodilation in groups I, II, and III were similar at the baseline level and showed no significant change after treatment (6.2 +/- 3.9% vs. 5.9 +/- 3.1% and 5.8 +/- 3.3% vs. 5.6 +/- 3.8% and 6.1 +/- 4.5% vs. 5.8 +/- 4.1%, respectively; P > 0.05). Compared with the baseline, endothelium-independent vasodilatation, as assessed by nitroglycerine (NTG), remained unchanged after the treatment period (11.2 +/- 6.9% vs. 10.3 +/- 7.1% and 11.2 +/- 6.3% vs. 9.9 +/- 5.1% and 9.5 +/- 4.9% and 8.8 +/- 4.6 %, respectively; P > 0.05). Treatment with both doses also showed no significant effects on high-sensitivity C-reactive protein (hs-CRP) levels and resting arterial diameters (P > 0.05). In conclusion, 4 weeks of treatment with standard and high doses of rofecoxib showed no significant effects on either endothelial-dependent or independent vasodilator response or plasma hs-CRP levels in patients with severe CAD taking concomitant aspirin.
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    Impact of hemostatic gene single point mutations in patients with non-diabetic coronary artery disease
    Var, A; Ütük, O; Akçali, S; Sanlidag, T; Uyanik, BS; Dinç, G
    Single point mutations in the genes coding for hemostatic factors were shown to be major inherited predisposing factors for venous thromboembolism. However, their contribution in the development of non-diabetic coronary artery disease [nDCAD] remains controversial. Angiographically demonstrated nDCAD patients (n = 86) and healthy controls (n = 90) were included in the study. Genotype analysis of hemostatic gene polymorphisms were assessed by using CVD strip assay, based on allele specific oligonucleotide probes. The carrier frequency of factor V (FV) H1299R, prothrombin G20210A, glycoprotein (Gp) IIIa L33P, plasminogen activator inhibitor-I (PAI-1) 4G/5G, 4G/4G, 5G/5G, methylenetetrahydrofolate reductase (MTHFR) A1298C and beta-fibrinogen -455 G > A were similar between patients and controls. In contrast, frequency of FV Leiden was significantly higher among patients (12.5%) than controls (5%, OR: 7.94; 95%CI: 1.9-49.6) and FXIII V34L was significantly lower among patients (23.7%) than controls (40%, OR: 0.24; 95%CI: 0.1-0.89). In addition, the frequency of the MTHFR C677T polymorphism was 32.5% among patients compared with 42.5% in controls, of which the T/T genotype was significantly lower among patients (5%) than controls (17.5%, OR: 0.06; 95%CI: 0.01-0.58). No difference was observed in prevalence of prothrombin G20210A, FV H1299R, Gp IIIa L33P, PAI-1 4G5G, MTHFR A1298C, beta fibrinogen 455 G > A mutations between patients and controls. However, lower frequency of FXIII Val34Leu and MTHFR C677T polymorphisms may decrease, while FV Leiden polymorphism may increase development of nDCAD.
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    QT dispersion in rheumatoid arthritis patients with and without Sjogren's syndrome
    Pirildar, T; Sekuri, C; Ütük, O; Tezcan, UK
    The aim of this study was to assess the effect of secondary Sjogren's syndrome (SjS) on QT dispersion and corrected QT dispersion in patients with rheumatoid arthritis (RA). We performed electrocardiography and Doppler echocardiography on 58 patients with RA whom we divided into two groups according to the presence of secondary SjS, and on 29 healthy controls. All patients revealed significantly longer QT dispersion and corrected QT dispersion values (P < 0.05). Diastolic function variables were significantly different in all patients compared to controls. QT dispersion and corrected QT dispersion values were significantly longer in RA patients with secondary SjS than in those without. We concluded that secondary SjS could be a cardiovascular risk factor contributing to the well documented cardivascular disease in RA patients.
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    The effect of tirofiban on ST segment resolution in patients with non-ST elevated myocardial infarction
    Bayturan, Ö; Bilge, AR; Seküri, C; Ütük, O; Tikiz, H; Eser, E; Tezcan, UK
    ST segment resolution in ST elevated myocardial infarction has independent predictive value for congestive heart failure and death at 30 days.(1-2)) ST segment depression in unstable angina pectoris (UAP) and non-ST elevated myocardial infarction (NSTEMI) predicts high risk of MI and death and may discriminate patients likely to have greater benefit from aggressive antithrombotic and interventional therapy.(5-6)) This study assessed the effect of tirofiban added to conventional treatment on ST segment resolution in NSTEMI patients. Sixty-four patients were randomized to one of the two groups: 32 patients received conventional treatment while tirofiban was added in the second group of 32 patients. In the first group, 6 patients refused to participate further after giving initial informed consent while 1 patient in the tirofiban group dropped out. We had 26 patients (mean age, 59 years) in the conventional treatment group and 31 patients (mean age, 59 years) received also tirofiban. Tirofiban was administered by intravenous infusion over a 72 hour period. More than 50% regression of depression was considered to be ST segment resolution. The characteristics of the two groups were comparable (Table I). The ST segment resolution evolution did not differ at the 4(th) and 24(th) hours between the two groups. Significant differences occurred in the 72(nd) hour ECG (Table III). ST resolution was present in 67.9% of the tirofiban patients and in 32.1% of the conventional treatment group (P < 0.05). Tirofiban treatment was not associated with an increase in major bleeding even though there was a trend toward an increase in minor bleeding cases and did not influence the occurrence of refractory angina pectoris.