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Öğe Akut Stent Trombozu Gelişimi ile Serum Trigliserid Seviyeleri Arasındaki İlişkinin Değerlendirilmesi(Mebas Medikal Basın Yayın San. ve Tic. Ltd. Şti, 2019) Gül, Murat; Acar, Burak; Şahan, Ekrem; İnci, SinanAkut stent trombozu, işlemin ilk 24 saati içinde gelişen miyokard enfarktüsü ve ani ölümle ilişkili olabilen perkütan koroner girişiminölümcül bir komplikasyonudur. Dislipidemi kardiyovasküler hastalıklar için iyi bilinen bir risk faktörüdür. Etkin statin tedavisiyle hedefdüşük yoğunluklu lipoprotein kolesterol değerlerine ulaşılmasına rağmen rezidü risk yüksek kalmaya devam etmektedir. Bu çalışmada perkütankoroner girişim yapılan stabil koroner arter hastalarında stent trombozu ile başvuru esnasındaki trigliserid değeri arasındaki ilişkiyiaraştırmayı amaçladık.Gereç ve Yöntem: Stabil koroner arter hastalığı sebebiyle Ocak 2013 ile Aralık 2017 aralığında koroner anjiografi yapılan toplamda7.512 hasta retrospektif olarak değerlendirildi. Hastane içi akut stent trombozu gelişen toplamda 122 hasta tanımlandı. Teknik sebeplerebağlı stent trombozu geliştiği düşünülen (sınır diseksiyonu, undersize stent seçimi, yetersiz stent ekspansiyonu vs.) 24 hasta çalışmadışında bırakıldı. Akut stent trombozu gelişen 98 hasta ve kontrol grubu olarak 502 hasta çalışmaya dahil edildi. Akut stent trombozunuöngörmede trigliserid düzeylerinin prediktif değeri araştırıldı.Bulgular: Stent trombozu gelişen grupta kontrol grubuna kıyasla stent uzunluğu, total kolesterol, trigliserid seviyesi,düşük yoğunluklu lipoproteinkolesterol seviyesi, beyaz küre sayısı, fibrinojen ve ürik asit seviyesi kontrol grubuna göre anlamlı olarak daha fazla saptandı.Yapılan çok değişkenli regresyon analizinde stent uzunluğu, fibrinojen, ürik asit, beyaz küre sayısı ve trigliserid seviyeleri akut stent trombozunuöngörmede bağımsız değişkenler olarak bulundu.Sonuç: Artmış trigliserid seviyeleri, elektif perkütan koroner girişim sonrası akut stent trombozunu öngörmede önemli bir değişken olarakbulundu. Stent trombozuyla ilişkili olduğu bilinen klinik ve anjiyografik parametrelere bu laboratuvar bulgusunun da dahil edilmesi,stent trombozu açısından yüksek riskli hastaların belirlenmesine katkı sağlayabilir.Öğe Impact of the radial versus femoral access for primary percutaneous intervention on smoking cessation rates: A paradoxus between the health related quality of life and smoking quitting?(Elsevier, 2018) Deveci, Bülent; Özeke, Özcan; Gül, Murat; Acar, Burak; Çetin, Elif Hande Ozcan; Burak, Cengiz; Çay, Serkan; Topaloğlu, Serkan; Aras, Dursun; İlkay, ErdoğanBackground: Smoking cessation is potentially the most effective secondary prevention measure and improves prognosis after acute ST-segment elevation myocardial infarction (STEMI), but more than half of the patients continue to smoke after STEMI. The awareness of the disease's severity and the short hospital stay at the index STEMI have been found to be associated with persistent smoking after STEMI. Objective: To assess whether the paradoxical relationship between smoking quitting rates and health-related quality of life (QOL) scores in STEMI patients undergoing primary percutaneous intervention (pPCI) by radial (RA) versus femoral approach (FA). Methods: Our population is represented by 138 STEMI patients undergoing pPCI by FA or RA. The smoking cessation rates and QOL scores were evaluated. Results: Patients at RA group (46 patients, 57 +/- 9 years, 87% male) had a higher European Quality of Life-5 Dimensions (EQ-5D) index score at post-PCI first week compared to FA group (92 patients, 57 +/- 8 years, 75% male) [FA: median 0.81 (0.22) vs. RA: 1 (0.22), p = 0.042], although it was similar at baseline [FA: median 1 (0) vs. RA: 1 (0), p = 0.992]. Total hospital length of stay [RA: median 3 (1) day vs. FA: 4 (1), p < 0.001] was significantly reduced in the RA group. Whereas the smoking cessation rates at 1-year post-discharge were 41% in RA group, it was 67% in FA group (p = 0.003). Female sex, pain-to-door time and RA during p-PCI were independent predictors of continued smoking after STEMI. Conclusion: This study shows that the smoking cessation was lower in RA group compared to FA group. The more comfortable conditions of STEMI management related to RA may cause a lower awareness of the disease severity and lower motivation to quit smoking. Therefore, it is important to inquire about smoking status at each clinical encounter, particularly in patients undergoing pPCI by the radial approach. (c) 2018 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.Öğe Monocyte-to-HDL-cholesterol ratio is associated with ascending aorta dilatation in patients with bicuspid aortic valve(Makerere University, Medical School, 2021) Acar, Burak; Yayla, Çağrı; Gül, Murat; Karanfil, Murat; Ünal, Sefa; Uçar, Fatih; Kuyumcu, Serdar Mevlüt; Ertem, Ahmet Göktuğ; Özen, Yasin; Özbay, Mustafa Bilal; Özeke, Özcan; Aydoğdu, SinanBackground: The importance of monocyte count-to-HDL-cholesterol ratio (MHR) in cardio- vascular diseases has been shown in various studies. Ascending aortic dilatation (AAD) is a common complication in the patients with bicuspid aortic valve. In this study, we aimed to investigate the relationship between MHR and the presence of aortic dilatation in the patients with bicuspid aortic valve. Methods: The study population included totally 347 patients with bicuspid aortic valve.169 patients with aortic dilatation (ascending aorta diameter ? 4.0 cm) and 178 patients with no aortic dilatation. Echocardiographic and laboratory measurement was done and compared between groups. Results: The mean age of the participants was 44.7 ± 15.4 years and average ascending aorta diameter was 3.2 ± 0.3 cm in dilatation negative group and 4.4 ± 0.4 cm in positive group. MHR was significantly increased in in patients with aortic dilatation. MHR and uric acid level was independently associated with the presence of aortic dilatation in the patients with bicuspid aortic valve. Conclusion: We found a significant relationship between MHR and aortic dilatation in the patients with bicuspid aortic valve.Öğe Prevalence of post-procedural pain and associated factors experienced after transradial coronary angiography(Czech Society of Cardiology Z.S, 2021) Gül, Murat; Acar, Burak; Karabulut, Özlem; Karanfil, Mustafa; Ünal, Sefa; Yayla, Çağrı; Ertem, Ahmet Göktuğ; Erbay, İlke; Tok, Derya; Demirkan, Burcu; Özdemir, Ayça; Kısacık, Halil LütfiIntroduction: Coronary angiography is a principle diagnostic and therapeutic procedure in modern cardiology practice. The transradial access for cardiac catheterization has overtaken the transfemoral approach because of many advantages. However, some patients suffer radial pain after the procedure. Unfortunately, this complication has been poorly evaluated in previous studies. The present study aimed to determine the prevalence of radial pain after transradial coronary angiography and investigate factors that influence post-procedural pain. Methods: This is a cross-sectional study in which a total of 100 consecutive patients who underwent elective transradial coronary angiography ± percutaneous coronary intervention between January 2015–2016 were evaluated. The patients were asked about presence of disturbing pain in the forearm especially wrist region after the procedure. Verbal rating scale was used to evaluate pain assessment. The patients were divided as early pain group (two hours after the procedure) and prolonged pain group (one month after the procedure) and analysis was performed. Results: A total of 55 patients suffered from pain in the early phase (after two hours), and 26 of patients had prolonged pain at one month after the radial intervention. Independent pain predictors in the early pain group were male operator (p = 0.004, OR = 3.386, 95% CI: 1.484–7.725) and experience of operator (OR = 4.147, 95% CI: 1.637–10.506, p = 0.003). On the other hand, the younger age of patients (OR = 0.955, 95% CI: 0.915–0.966, p = 0.032) and experience of operator (OR = 3.947, 95% CI: 1.547–10.047, p = 0.004) were the independent predictors of prolonged radial pain. Conclusion: Pain after radial coronary angiography is not uncommon. Experience, operator gender, and age of the patients were independent predictors of pain after transradial coronary angiography.
