MCBÜ Açıkerişim Sistemi :: Browsing by Author "Bayturan O."

Browsing by Author "Bayturan O."

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Effects of Low-Dose Combination Therapy with an Angiotensin-Converting Enzyme Inhibitor and a Diuretic on Flow-Mediated Vasodilation in Hypertensive Patients: A 6-Month, Single-Center Study
(Excerpta Medica Inc., 2003) Sekuri C.; Bayturan O.; Gocer H.; Tavli T.; Tezcan U.K.
Background: Combination therapy with an angiotensin-converting enzyme (ACE) inhibitor and a diuretic has been shown to be highly effective in hypertension. Clinical trials have demonstrated that ACE inhibitors may improve endothelial cell dysfunction in hypertension. However, the effectiveness of the combination treatment in endothelial cell dysfunction is unknown. Objective: This study investigated the effects of a new low-dose combination, perindopril 2 mg plus indapamide 0.625 mg, on brachial artery flow-mediated vasodilation (FMD) and left ventricular diastolic function in hypertension. Methods: Patients aged 18 to 75 with newly diagnosed stage 1 or 11 hypertension were eligible. Endothelium-dependent brachial artery FMD and endothelium-independent vasodilation were assessed at baseline. Patients were treated with oral perindopril 2 mg plus indapamide 0.625-mg tablets once daily for 6 months. FMD measurements were then repeated. Percentage changes in FMD from baseline to 6 months, as well as left ventricular diastolic function parameters (isovolumic relaxation time [IVRT] and mitral diastolic E-wave deceleration time [EDT]), indicated the effectiveness of the intervention. Results: Twenty-nine Turkish patients were enrolled (17 women, 12 men; mean [SD] age, 54.5 [9.5] years [range, 38-75 years]). The mean (SD) baseline FMD was 7.00% (2.39%) (endothelial cell dysfunction) and increased significantly to 8.68% (2.78%) at 6 months (P = 0.02); FMD improved in 15 patients (51.7%). At baseline and 6 months of therapy, mean (SD) IVRT was 101.7 (12.4) ms and 95.5 (7.7) ms, respectively (P < 0.001), and EDT was 234.7 (33.9) ms and 217.9 (25.6) ms, respectively (P < 0.001). Conclusions: In this small sample of hypertensive patients, a low-dose combination ACE inhibitor and diuretic significantly improved brachial artery FMD and left ventricular diastolic function. The improvement in FMD values was independent of the stage of hypertension. These findings suggest a relationship between improvement in endothelial cell function and diastolic function. Copyright © 2003 Excerpta Medica, Inc.
Images in cardiovascular medicine. Giant unruptured noncoronary sinus of Valsalva aneurysm.
(2004) Utuk O.; Bayturan O.; Bilge A.R.; Tikiz H.; Tezcan U.K.
[No abstract available]
Doppler index of myocardial performance and its relationship with mitral E wave deceleration time in acute Q-wave myocardial infarction; [Akut Q-Dalgali Miyokard ̇ Infarktününde Miyokardiyal Performans ̇Indeksi ve Mitral E Dalga Deselerasyon Zamani Arasindaki ̇ Ilişki]
(2004) Şekuri C.; Kurhan Z.; Tavli T.; Bayturan O.; Ütük O.; Bilge A.R.; Tikiz H.; Tezcan U.K.
Objective: The objectives of the study were to assess myocardial systolic and diastolic functions by myocardial performance index (MPI) and its relationship with E - wave deceleration time (DT) in early phase of acute Q-wave myocardial infarction (MI). Methods: We performed nongeometric Doppler-derived echocardiography to assess combined systolic and diastolic functions using myocardial performance index in 50 patients with acute Q-wave MI at early phase of events, (25 pts with anterior MI and 25 pts with inferior MI). The index is defined as the sum of the isovolumic contraction and isovolumic relaxation times divided by ventricular ejection time and was obtained by Doppler measurement from the diastolic mitral inflow and left ventricular outflow velocity-time intervals. Results: As a result, the index was 0.54±0.1 in all patients with MI. We also estimated the higher MPI and DT values in anterior than inferior MI (MPI: 0.61±0.07 vs., 0.46±0.06, p<0.001; DT: 244±64 msec vs. 204±31.2 msec, p=0.005, respectively). Myocardial performance index was positively correlated with DT in inferior MI (r=0.42, p<0.035) and negatively correlated with anterior MI (r=- 0.72, p=0.0001). Conclusion: These data suggest that Doppler-derived MPI reflects severity of global left ventricular dysfunction in early phase of acute MI and may be a useful parameter in these patients.
Evaluation of diastolic function by transmitral color M-mode flow propagation velocity in hypertensive patients; [Hipertansif olgularda transmitral renkli M-mod akim yayilma hizi ile diyastolik fonksiyonlarin deǧerlendirilmesi]
(2004) Şekuri C.; Tavli T.; Danahaliloǧlu S.; Göçer H.; Bayturan O.; Ütük O.; Bilge A.R.; Tikiz H.; Tezcan U.K.
Objective: Diastolic dysfunction is considered as the most important cause of heart failure and morbidity in hypertensives. This study was designed to evaluate the relationship between the transmitral diastolic color M-mode flow propagation velocity (FPV) and left ventricular relaxation by using Doppler echocardiography. Methods: In the present study, thirty-nine patients (21 male, %58.3, age mean 52.7 ± 5.9 years) with hypertension stage-I and over, were included. Transmitral diastolic E and A velocities, E-deceleration time (DT) and isovolumic relaxation time (IVRT) were measured by pulse Doppler method. We performed color M-mode technique for measurement of FPV of transmitral diastolic flow in the apical four-chamber view. We measured slope of aliasing velocity (blue aliasing) determined by color M-mode images. Results: Flow propagation velocity values were not statistically related with age and gender, whereas differentiation of age groups were estimated as poor parabolic relationship, specially in patients over fifty years, FPV is estimated to be decreasing. Color M-mode FPV is correlated with DT, (r = -0.715, p<0.01), IVRT (r = -0.736, p<0.01 and interventricular septum thickness (r = -0.498, p<0.01), but not correlated with E/A ratio. Conclusion: Color M-mode FPV is correlated with DT and IVRT, which are important parameters for evaluation of diastolic function in hypertensive patients. This parameter is related with left ventricular relaxation and should be considered as a routine echocardiographic evaluation, because it is not affected by minimal changes in left ventricular filling pressure.
Selective COX-2 inhibition with different doses of rofecoxib does not impair endothelial function in patients with coronary artery disease
(2005) 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. Copyright©2005 by Okayama University Medical School.
Coarctation of the aorta evaluated with 64-row multislice computed tomography
(2006) Utuk O.; Karaca M.; Bayturan O.; Oncel G.; Tezcan U.K.; Bilge A.R.
[No abstract available]
Huge pulsating cystic cardiac mass
(2006) Utuk O.; Bilge A.R.; Bayturan O.; Sirin H.; Iskesen I.; Tezcan U.K.
[No abstract available]
Pulmonary hypertension in patients with chronic renal failure
(2007) Havlucu Y.; Kursat S.; Ekmekci C.; Celik P.; Serter S.; Bayturan O.; Dinc G.
Background: Many etiologies causing pulmonary hypertension (PH) have been reported, and one of the background disease seen with patients with PH is chronic renal failure (CRF); however, the pathogenesis of PH in this group of patients is not explained satisfactorily. Objectives: The aims of this study were to evaluate the incidence of unexplained PH among patients with CRF and to suggest possible etiologic factors. Methods: Two hundred and eleven patients with CRF were evaluated and the ones who have comorbid conditions that cause PH were excluded. Pulmonary arterial pressure (PAP) and cardiac functions were evaluated by Doppler echocardiography. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. The patients were followed for at least 6 months. Results: Forty-eight CRF patients (20 males, 28 females) were included: 23 were predialysis patients, and 25 patients received hemodialysis via AVF. Patients were followed for 7.5 ± 1.01 months. Systolic PAP >35 mm Hg was found in 56% (14/25) of patients receiving hemodialysis (36.8 ± 10.7 mm Hg) and in 39.1% (9/23) of predialysis patients (29.5 ± 9.5 mm Hg). The parathyroid hormone level, cardiac output values and CRF duration were found to be increased in patients with elevated systolic PAP (p < 0.05). AVF flow and AVF duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). There was a negative correlation between systolic PAP and residual urine volume (p < 0.05). AVF compression in hemodialysis patients decreased systolic PAP from 36.8 ± 10.7 to 32.8 ± 10.5 mm Hg. Systolic PAP values were increased at the end of the study in the predialysis group, whereas they were decreased at the end of the follow-up in the hemodialysis group (36.9 ± 10.5 and 32.04 ± 10.5 mm Hg, respectively). Conclusions: This study demonstrates a high incidence of PH among patients with CRF. CRF duration, AVF flow, parathyroid hormone level and cardiac output may be involved in the pathogenesis of PH. The effective hemodialysis and dry weight reduction decreased systolic PAP values. Copyright © 2007 S. Karger AG.
Effect of CPAP therapy on catathrenia and OSA: A case report and review of the literature
(2008) Songu M.; Yilmaz H.; Yuceturk A.V.; Gunhan K.; Ince A.; Bayturan O.
Introduction: Catathrenia is a rare, idiopathic, sleep-related respiratory condition characterized by irregular groans, which occur during prolonged expiration in sleep. The origins of catathrenia remain inexplicable, the long-term prognosis unexplained. Moreover, empirical treatment with neither pharmacological nor non-pharmacological approaches was satisfactory. Case report: We report a case of catathrenia with concurrent obstructive sleep apnea complicated with pulmonary hypertension and reviewed the literature. Discussion: Treatment with nasal continuous positive airway pressure resulted in marked improvement of catathrenia, obstructive sleep apnea, daytime dyspnea, and pulmonary hypertension for our patient. We think that nasal continuous positive airway pressure can be an option for the treatment of this infrequent but sometimes very disturbing sleep disorder. © Springer-Verlag 2008.
Effect of losartan on excercise tolerance and echocardiographic parameters in patients with mitral regurgitation
(2008) Sekuri C.; Utuk O.; Bayturan O.; Bigle A.; Kurban Z.; Tavli T.
Objectives. The aim of this study was to assess the effects of losartan treatment on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation (MR) secondary to mitral valve prolapse or rheumatic heart disease. Methods. Twenty-seven patients (14 males, 13 females, mean age 51±11, range 21-76) with moderate MR due to mitral valve prolapse or rheumatic heart disease were examined by means of Doppler echocardiography. The subjects were submitted to treadmill exercise tests using the modified Bruce protocol at baseline, after six hours and after the six-week treatment period to be evaluated based on their exercise tolerance. Mitral Regurgitant Volume (MRV), effective regurgitant orifice diameter, left atrial volume, left ventricle (LV) end-diastolic volume index, LV end-systolic volume index, LV ejection fraction (LVEF), left ventricle mass index were calculated at baseline and after six weeks of treatment with single dose of losartan (50 mg/ day). Results. Total treadmill exercise time increased from 477.7±147.9 to 535.7±149.0 seconds after six hours (p<0.01) and to 559.6±142.8 seconds after six weeks of treatment.Also, metabolic equivalent values increased following six hours of first dose and six weeks of losartan treatment (from 10.9±2.9 to 11.8±3.1,p=0.006 and 12.4±3.1, p=0.002; respectively). However, peak exercise systolic blood pressure (BP) was reduced after six hours and six weeks of treatment, and resting diastolic BP did not change after six hours but reduced at the end of the treatment period. MR volume decreased significantly from 29.3±14.1 ml to 25.1±14.8 ml, (p=0.025) without significant change in regurgitant orifice diameter (0.72±0.37 cm vs. 0.66±0.37 cm, p=NS), left atrium diameter and area while LVEF increased from 51.70±13.37 to 54.11-11.75 (p=0.015) with losartan. Conclusion. We conclude that the angiotensin II receptor antagonist losartan improves exercise tolerance and echocardiographic parameters in patients with moderate MR.
Relationship of insulin resistance in chronic haemodialysis patients with inflammatory indicators, malnutrition, echocardiographic parameters and 24 hour ambulatory blood pressure monitoring
(2010) Kurat S.; Colak H.B.; Toraman A.; Tekçe H.; Ulman C.; Bayturan O.
Objective. The relationship between malnutrition, echocardiographic parameters, 24 h ambulatory blood pressure (ABP) parameters and decreased insulin sensitivity index (ISI-S) in chronic haemodialysis patients was investigated. Material and methods. ISI-S and inflammatory indicators were measured. The nutritional state was assessed by malnutrition score. Echocardiography and 24 h ABP were performed 1 day before the second haemodialysis session of the week. Results. ISI-S was inversely correlated with the night-time mean blood pressure (BP)/day-time mean BP ratio (p 0.021) and malnutrition score (p < 0.01). High-sensitivity C-reactive protein, night-time mean BP/day-time mean BP and vena cava collapse index were independent risk factors affecting ISI-S (p < 0.001; β 0.412, p 0.025; β 0.204, p < 0.001; β 0.465). Conclusions. The decrease in ISI-S along with the hypervolaemia suggests that volume overload is a contributory factor in the pathogenesis of insulin resistance in patients with chronic renal failure. This study indicates that, in addition to the traditional cardiovascular risk factors in these patients, insulin resistance can be regarded as a risk factor, but not an independent one, mainly a reflection of the underlying culprit, hypervolaemia. © 2010 Informa Healthcare.
Beyond lowering LDL cholesterol; [LDL kolesterolü düşürmenin ötesi]
(2011) Bayturan O.; Ütük O.; Tuzcu E.M.
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. © 2011 by AVES Yayi{dotless}nci{dotless}li{dotless}k Ltd.
Serum and pleural fluid N-Terminal-Pro-B-Type natriuretic peptide concentrations in the differential diagnosis of pleural effusions; [Plevral efüzyonların ayırıcı tanısında serum ve plevral sıvı n-terminal-pro-B-tip natriüretik peptid konsantrasyonunun yeri]
(Ankara University, 2011) Yorgancioǧlu A.; Özgen Alpaydin A.; Yaman N.; Taneli F.; Bayturan O.; Şakar Coşkun A.; Çelik P.
Currently, new biomarkers like N-Terminal-Pro-B-Type natriuretic peptide (NT-proBNP) have been used in the differential diagnosis of pleural effusions. In our study, we aimed to investigate the diagnostic value of NT-proBNP, especially in cardiac originated pleural effusions. Forty-five patients with pleural effusions were included in the study. NT-proBNP levels and biochemical markers involved in the Light's criteria were analyzed in pleural fluid and serums of the patients. Pleural fluid culture, AFB smear, cytology were performed where they were indicated according to the clinical evaluation. In patients, to whom cardiac pathology was considered to be; cardiological evaluation and echocardiography were also done. Thirtyeight pleural effusions were exudative and, 7 were transudative according to the Light's criteria. Final diagnosis were malignant effusion in 13, infection (tuberculosis/pneumonia) in 10, congestive heart failure in 21, and other conditions related with pleural effusion in 1 of the patients. Median (25th to 75th percentiles) NT-proBNP levels of serum and pleural fluid due to congestive heart failure (CHF) were 4747 pg/mL (931-15754) and 4827 pg/mL (1290-12.430) while median NTproBNP levels of serum and pleural fluid related with non-cardiac reasons were 183 pg/mL (138-444) and 245 pg/mL (187-556) respectively. NT-proBNP levels of serum and pleural fluid were significantly high in CHF (p< 0.001 for both). When four groups were compared serum and pleural fluid NT-proBNP levels were highest in the CHF group which was followed by malignancy, infection and others (p< 0.001 for both). Fourteen of 21 patients who were accepted to have congestive heart failure as the final diagnosis by a cardiological evaluation had an exudative pleural fluid according to the Light's criteria. Serum and pleural fluid NT-proBNP levels were higher in transudates and this reached statistically significance for pleural fluid (p= 0.009). We suggest that measurement of pleural fluid NT-proBNP is a smart approach and pleural fluid NTproBNP can reflect cardiac origin of effusions better than serum NT-proBNP and Light's criteria.
Atrial fibrillation, progression of coronary atherosclerosis and myocardial infarction
(SAGE Publications Inc., 2017) Bayturan O.; Puri R.; Tuzcu E.M.; Shao M.; Wolski K.; Schoenhagen P.; Kapadia S.; Nissen S.E.; Sanders P.; Nicholls S.J.
Background Despite atrial fibrillation representing an established risk factor for stroke, the association between atrial fibrillation and both progression of coronary atherosclerosis and major adverse cardiovascular events is not well characterized. We assessed the serial measures of coronary atheroma burden and cardiovascular outcomes in patients with and without atrial fibrillation. Methods Data were analyzed from nine clinical trials involving 4966 patients with coronary artery disease undergoing serial intravascular ultrasonography at 18-24 month intervals to assess changes in percent atheroma volume (PAV). Using a propensity weighted analysis, and following adjustment for baseline variables, patients with (n = 190) or without (n = 4776) atrial fibrillation were compared with regard to coronary plaque volume and major adverse cardiovascular events (death, myocardial infarction, and stroke). Results Atrial fibrillation patients demonstrated lower baseline PAV (36.0 ± 8.9 vs. 38.1 ± 8.9%, p = 0.002) and less PAV progression (-0.07 ± 0.34 vs. + 0.23 ± 0.34%, p = 0.001) compared with the non-atrial fibrillation group. Multivariable analysis revealed atrial fibrillation to independently predict both myocardial infarction [HR, 2.41 (1.74,3.35), p<0.001] 2.41 (1.74, 3.35), p < 0.00) and major adverse cardiovascular events [HR, 2.2, (1.66, 2.92), p<0.001] 2.20 (1.66, 2.92), p < 0.001]. Kaplan-Meier analysis showed that atrial fibrillation compared with non-atrial fibrillation patients had a significantly higher two-year cumulative incidence of overall major adverse cardiovascular events (4.4 vs. 2.0%, log-rank p = 0.02) and myocardial infarction (3.3 vs. 1.5%, log-rank p = 0.05). Conclusions The presence of atrial fibrillation independently associates with a heightened risk of myocardial infarction despite a lower baseline burden and progression rate of coronary atheroma. Further studies are necessary to define the pathogenesis of myocardial infarction in the setting of atrial fibrillation. © European Society of Cardiology.
Warfarin Use Is Associated With Progressive Coronary Arterial Calcification: Insights From Serial Intravascular Ultrasound
(Elsevier Inc., 2018) Andrews J.; Psaltis P.J.; Bayturan O.; Shao M.; Stegman B.; Elshazly M.; Kapadia S.R.; Tuzcu E.M.; Nissen S.E.; Nicholls S.J.; Puri R.
Objectives: This study compared serial changes in coronary percent atheroma volume (PAV) and calcium index (CaI) in patients with coronary artery disease who were treated with and without warfarin. Background: Warfarin blocks the synthesis and activity of matrix Gla protein, a vitamin K–dependent inhibitor of arterial calcification. The longitudinal impact of warfarin on serial coronary artery calcification in vivo in humans is unknown. Methods: In a post hoc patient-level analysis of 8 prospective randomized trials using serial coronary intravascular ultrasound examinations, this study compared changes in PAV and CaI in matched arterial segments in patients with coronary artery disease who were treated with (n = 171) and without (n = 4,129) warfarin during an 18- to 24-month period. Results: Patients (mean age 57.9 ± 9.2 years; male 73%; prior and concomitant 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statin) use, 73% and 97%, respectively) demonstrated overall increases in PAV of 0.41 ± 0.07% (p = 0.001 compared with baseline) and in CaI (median) of 0.04 (interquartile range [IQR]: 0.00 to 0.11; p < 0.001 compared with baseline). Following propensity-weighted adjustment for clinical trial and a range of clinical, ultrasonic, and laboratory parameters, there was no significant difference in the annualized change in PAV in the presence and absence of warfarin treatment (0.33 ± 0.05% vs. 0.25 ± 0.05%; p = 0.17). A significantly greater annualized increase in CaI was observed in warfarin-treated compared with non–warfarin-treated patients (median 0.03; IQR: 0.0 to 0.08 vs. median 0.02; IQR: 0.0 to 0.06; p < 0.001). In a sensitivity analysis evaluating a 1:1 matched cohort (n = 164 per group), significantly greater annualized changes in CaI were also observed in warfarin-treated compared with non–warfarin-treated patients. In a multivariate model, warfarin was independently associated with an increasing CaI (odds ratio: 1.16; 95% confidence interval: 1.05 to 1.28; p = 0.003). Conclusions: Warfarin therapy is associated with progressive coronary atheroma calcification independent of changes in atheroma volume. The impact of these changes on plaque stability and cardiovascular outcomes requires further investigation. © 2018 American College of Cardiology Foundation
Visfatin: A potential biomarker for the early diagnosis and monitoring of acute coronary syndrome
(Kare Publishing, 2019) Guvenc Y.; Cuhadar S.; Bayturan O.; Ulman C.; Horasan G.D.; Utuk O.; Acar M.
Objectives: Acute coronary syndrome (ACS) is a major cause of mortality and morbidity worldwide; thus, early diagnosis is very important. The most common cause of ACS is the rupture of a vulnerable atherosclerotic plaque in the coronary artery, an occurrence in which inflammation plays a key role. The aim of the present study was to investigate visfatin as a proinflammatory biomarker in the early diagnosis and monitoring of ACS and to compare visfatin’s relationship with troponin T, tumor necrosis factor-alpha (TNF-α), and creatine kinase-MB (CK-MB). Methods: Sixty ACS patients and 30 healthy control subjects were enrolled in this study. One blood sample was drawn from the control participants, and 3 were obtained from the ACS patients at intervals 0-6 hours (T0), 6-12 hours (T1), and 12-24 (T2) hours from the start of chest pain. Serum visfatin, TNF-α, troponin T, and CK-MB levels were assessed. Visfatin and TNF-α levels were assessed using enzyme-linked immunosorbent assay testing, troponin T was evaluated using chemiluminescence, and CK-MB by enzymatic methods. Results: Serum TNF-α, troponin T, and CK-MB levels in the T0 blood samples were statistically significantly higher in the ACS patients compared with the controls (p=0.004, p<0.001, p<0.001, respectively). A significant positive correlation was observed between visfatin and troponin T (r=0.290, p=0.007) in the T0 samples. Visfatin concentrations were lower in the ACS group in the T0, T1 and T2 samples [4.01±6.23ng/mL, 1.80±3.47 ng/mL, and 1.72±2.67ng/mL, respectively; p=0.005; T0 >(T1=T2)]. Conclusion: Visfatin had a significant positive correlation with troponin T. Visfatin did not demonstrate a rise and fall pattern like the standard biomarkers in terms of monitoring the progress of ACS patients, as there was a significant decrease after the first 6 hours. Although visfatin did not demonstrate superiority to troponin, its efficiency in a multimarker panel merits further evaluation. The role of visfatin in the early phase of pathophysiological mechanisms requires additional investigation. © 2018 by International Journal of Medical Biochemistry.
CHA2DS2-VASc score and modified CHA2DS2-VASc score can predict mortality and intensive care unit hospitalization in COVID-19 patients
(Springer, 2021) Gunduz R.; Yildiz B.S.; Ozdemir I.H.; Cetin N.; Ozen M.B.; Bakir E.O.; Ozgur S.; Bayturan O.
In this study, we investigated whether the CHA2DS2-VASc score could be used to estimate the need for hospitalization in the intensive care unit (ICU), the length of stay in the ICU, and mortality in patients with COVID-19. Patients admitted to Merkezefendi State Hospital because of COVID-19 diagnosis confirmed by RNA detection of virus by using polymerase chain reaction between March 24, 2020 and July 6, 2020, were screened retrospectively. The CHA2DS2-VASc and modified CHA2DS2-VASc score of all patients was calculated. Also, we received all patients’ complete biochemical markers including D-dimer, Troponin I, and c-reactive protein on admission. We enrolled 1000 patients; 791 were admitted to the general medical service and 209 to the ICU; 82 of these 209 patients died. The ROC curves of the CHA2DS2-VASc and M-CHA2DS2-VASc scores were analyzed. The cut-off values of these scores for predicting mortality were ≥ 3 (2 or under and 3). The CHA2DS2-VASc and M-CHA2DS2-VASc scores had an area under the curve value of 0.89 on the ROC. The sensitivity and specificity of the CHA2DS2-VASc scores were 81.7% and 83.8%, respectively; the sensitivity and specificity of the M-CHA2DS2-VASc scores were 85.3% and 84.1%, respectively. Multivariate logistic regression analysis showed that CHA2DS2-VASc, Troponin I, D-Dimer, and CRP were independent predictors of mortality in COVID-19 patients. Using a simple and easily available scoring system, CHA2DS2-VASc and M-CHA2DS2-VASc scores can be assessed in patients diagnosed with COVID-19. These scores can predict mortality and the need for ICU hospitalization in these patients. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
HbA1c, Coronary atheroma progression and cardiovascular outcomes
(Elsevier B.V., 2022) Dykun I.; Bayturan O.; Carlo J.; Nissen S.E.; Kapadia S.R.; Tuzcu E.M.; Nicholls S.J.; Puri R.
Background and aims: We tested the hypothesis that on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events (MACE: death, myocardial infarction, cerebrovascular accident, coronary revascularization, or hospitalization for unstable angina) rates. Methods: We performed a post-hoc pooled analysis of data from seven prospective, randomized trials involving serial coronary intravascular ultrasonography (IVUS). The percent atheroma volume (PAV) was calculated as the proportion of the entire vessel wall occupied by atherosclerotic plaque. Using multivariable mixed modeling, we determined the association of on-treatment HbA1c with annualized change in PAV. Cox proportional hazard models were used to assess the association of HbA1c with incidence of MACE. Results: Among 3,312 patients (mean age 58.6±9years, 28.4%women) average on-treatment HbA1c was 6.2±1.1%. Overall, there was no net significant annualized change in PAV (0.12±0.19%, p = 0.52). In a fully adjusted multivariable analysis (following adjustment of age, sex, body mass index, systolic blood pressure, smoking, low- and high-density lipoprotein cholesterol, triglyceride levels, peripheral vascular disease, trial, region, and baseline PAV), higher on-treatment HbA1c levels were independently associated with annualized changes in PAV [beta-estimate (95% confidence interval): 0.13(0.08, 0.19), p < 0.001]. On-treatment HbA1c levels were independently associated with MACE [hazard ratio (95% confidence interval): 1.13(1.04, 1.23), p = 0.005]. Conclusions: Independent of achieved cardiovascular risk factor control, greater HbA1c levels significantly associate with coronary atheroma progression rates and clinical outcomes. These results support the notion of a direct, specific effect of glycemic control upon coronary atheroma and atherosclerotic events, supporting the rationale of therapies designed to directly modulate it. © 2022 The Author(s)

Browsing by Author "Bayturan O."

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