Kaan Okyay

Baskent University, Engüri, Ankara, Turkey

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Publications (24)27.68 Total impact

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    ABSTRACT: Currently, there is not enough echocardiographic information regarding aging-associated changes in the octogenarian population. We aimed to characterize echocardiographic measures of structure and function among a group of healthy octogenarians. Approximately 350 octogenarians, residing in nursing homes, were screened in Ankara, Turkey. According to inclusion criteria, 40 octogenarians were enrolled. These subjects underwent conventional and tissue Doppler echocardiography according to the guidelines of the American Society of Echocardiography (ASE). The population was also separated into various groups according to gender, body mass index (BMI, <25 vs. 25-29.9), and blood pressure (<80/120 mmHg vs. 80-89/120-139 mmHg). All measurements were indexed by dividing to body surface area (BSA) for standardization. Left ventricular mass (LVM), posterior wall thickness, right ventricular diameter, tricuspid E/A ratio, and septal e'-wave velocity were significantly higher in men, which lost significance after adjusting for BSA. There was no significant difference between groups formed by BMI and blood pressure. Moreover, mild global left and right ventricular dysfunction including a prominent diastolic counterpart, however, with normal ejection fraction was revealed using conventional and tissue Doppler techniques. Finally, we checked our results with the current reference values of the ASE and observed the following differences: ventricular septum, relative wall thickness, LVM, and mass index values were above ASE reference range, posterior wall measurements were close to upper range. On the contrary, left ventricular diameters and volumes were below ASE reference range. We described echocardiographic measures of structure and function in a group of healthy octogenarians.
    Echocardiography 02/2014; · 1.26 Impact Factor
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    ABSTRACT: Fas/Fas ligand system contributes to the programmed cell death induced by myocardial ischemia. We investigated whether serum soluble Fas ligand (sFasL) level is independently related with the severity and extent of angiographically assessed coronary artery disease (CAD). We included 169 patients in this study. Two groups were formed based on the existence of a lesion on coronary angiography. First group included patients with normal coronary arteries (NCA; = 53). Patients with atherosclerotic lesions were included in the second group ( = 116). We used the coronary vessel score (the number of the coronary arteries with a lesion leading to ≥ 50% luminal obstruction) and the Azar score to determine the extent and the severity of CAD. Standard enzyme-linked immunosorbent assay kits were used to measure serum sFasL levels. The serum sFasL level was higher in patients with CAD than in patients with NCA (0.52 ± 0.23 mU/mL vs. 0.45 ± 0.18 mU/mL, = 0.023). The sFasL level correlated with Azar score ( = 0.231, = 0.003) and with coronary vessel score ( = 0.269, < 0.001). In the multivariate analysis, we found that age (beta: 0.188, = 0.008), gender (beta: 0.317, < 0.001), diabetes mellitus (DM; beta: 0.195, = 0.008), and sFasL level (beta: 0.209, = 0.003) were independently related with Azar score. When we used coronary vessel score as the dependent variable, we found that age ( = 0.020), gender ( < 0.001), DM ( = 0.006), and sFasL level ( = 0.001) were independent predictors. Serum sFasL level is associated with angiographically more severe CAD. Our findings suggest that sFasL level may be a biochemical surrogate of severe coronary atherosclerosis.
    International Journal of Angiology 03/2012; 21(1):29-34.
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    ABSTRACT: We investigated the prognostic importance of plasma myeloperoxidase levels in patients with ST-elevation myocardial infarction (STEMI) at long-term follow-up, and we analyzed the correlations between plasma myeloperoxidase levels and other biochemical values.We evaluated 73 consecutive patients (56 men; mean age, 56 ±11 yr) diagnosed with acute STEMI and 46 age- and sex-matched healthy control participants. Patients were divided into 2 groups according to the median myeloperoxidase level (Group 1: plasma myeloperoxidase ≤68 ng/mL; and Group 2: plasma myeloperoxidase >68 ng/mL). Patients were monitored for the occurrence of major adverse cardiovascular events (MACE), which were defined as cardiac death; reinfarction; new hospital admission for angina; heart failure; and revascularization procedures.The mean follow-up period was 25 ± 16 months. Plasma myeloperoxidase levels were higher in STEMI patients than in control participants (82 ± 34 vs 20 ±12 ng/mL; P=0.001). Composite MACE occurred in 12 patients with high myeloperoxidase levels (33%) and in 4 patients with low myeloperoxidase levels (11%) (P=0.02). The incidences of nonfatal recurrent myocardial infarction and verified cardiac death were higher in the high-mye-loperoxidase group. In multivariate analysis, high plasma myeloperoxidase levels were independent predictors of MACE (odds ratio = 3.843; <95% confidence interval, 1.625-6.563; P=0.003).High plasma myeloperoxidase levels identify patients with a worse prognosis after acute STEMI at 2-year follow-up. Evaluation of plasma myeloperoxidase levels might be useful in determining patients at high risk of death and MACE who can benefit from further aggressive treatment and closer follow-up.
    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 01/2012; 39(4):500-6. · 0.67 Impact Factor
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    ABSTRACT: The impact of dialysis type on the biomarkers that reflect the severity of cardiovascular diseases is not clearly known. We aimed to investigate the effect of dialysis type on biomarkers of cardiovascular diseases in patients with end-stage renal disease (ESRD). The study included 108 patients who had been on dialysis treatment (57 patients receiving hemodialysis, 51 patients receiving peritoneal dialysis) for ESRD for at least three months. Blood samples were collected just after the dialysis. Serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), cardiac troponin I (TnI), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and plasma fibrinogen levels were measured and compared between the two dialysis groups. The two dialysis groups were similar with respect to age and gender. The frequency of hypertension was significantly higher in patients receiving peritoneal dialysis. This group also had higher total cholesterol, HDL cholesterol, LDL cholesterol, and hemoglobin levels. Serum levels of NT-proBNP, hs-CRP, IL-6, and TNF-α, and plasma fibrinogen levels were similar in the two dialysis groups (p>0.05), but TnI was significantly higher in patients receiving peritoneal dialysis (p=0.04). Comparison of the patient subgroups based on the duration of dialysis (<12 months, 12-36 months, and >36 months) showed that longer dialysis duration was associated with significantly lower values of NT-proBNP, TNF-α, and hs-CRP (p<0.05). The dialysis type does not affect serum NT-proBNP, hs-CRP, IL-6, TNF-α, and plasma fibrinogen levels, but TnI level is higher in patients treated with peritoneal dialysis.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 09/2011; 39(6):456-62.
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    ABSTRACT: We sought to explain the clinical importance of the osteopontin (OPN) in the setting of acute ST-elevation myocardial infarction (STEMI). Eighty consecutive patients (55 = 11 years, 12 women and 68 men) and sixty healthy control subjects were included in the study. In all patients, plasma OPN levels were assessed on admission and on the third day (peak value). Creatinine kinase (CK)/CK-myocardial band (MB), troponin I and N-terminal pro-brain natriuretic factor levels and echocardiographic findings were also recorded. Patients were classified into high and low OPN groups according to the median OPN value, and monitored for the occurrence of major adverse cardiovascular events (MACE). Patients with STEMI had higher OPN levels (23.8 [16.7-41.3] ng/ml) on admission than the control subjects (18.0 [11.3-31.5] ng/ml, P = 0.004).The third day value of OPN was significantly higher (39.2 [27.2-56.0] ng/ml) than the OPN level on admission (23.8 [16.7-41.3] ng/ml, P < 0.001). Admission and peak OPN levels were not correlated with CK/CK-MB, white blood cell counts, troponin I and the N-terminal pro-brain natriuretic factor. The plasma OPN levels were not correlated with left ventricular wall motion score index either. In the subgroups of infarct localization and reperfusion strategy, plasma OPN levels were similar. When the patients were compared according to the median OPN values, there were no differences in the occurrence of MACE between the high and low OPN groups. This study suggests, for the first time, that the plasma OPN level increases in the first hours of the acute STEMI; however, it could not be used as a prognostic biomarker of STEMI.
    Acta cardiologica 04/2011; 66(2):197-202. · 0.61 Impact Factor
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    International Journal of Cardiology - INT J CARDIOL. 01/2011; 147.
  • International Journal of Cardiology - INT J CARDIOL. 01/2011; 147.
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    ABSTRACT: We sought to investigate the early and late effects of magnetic resonance imaging (MRI) on stent thrombosis and major adverse coronary events after coronary artery stent (CAS) implantation at a long-term follow-up period. Forty-three patients (28 men, mean age 63+/-10 years) who underwent CAS implantation before MRI examination were included. MRI was performed on a 1.5-T MR-system with a phased array multicoil. An average of 1.3 stents per patient were implanted (1-4 stents). More than one MRI was performed for two patients. Patients who underwent MRI within 8 weeks after the procedure were included in the early-term group (17 patients), and those who underwent MRI after 8 weeks were included in the late-term group (26 patients). Mean follow-up period was 36+/-15 months. There was no acute or subacute stent thrombosis. Late stent thrombosis that resulted in acute myocardial infarction was observed in a patient from the early group after an operation for prostate hyperplasia 5 months after MRI, and the patient underwent percutaneous coronary artery angioplasty. De-nova lesion was observed in four patients in the early group and two patients in the late group (P=0.14). In-stent restenosis was recorded in two patients in the early group and three patients in the late group (P=0.98). Composite major adverse cardiac events (acute coronary syndrome, myocardial infarction, death, and cerebrovascular event) were observed in seven of the early-group patients (41%), and in six of the late-group patients (23%) (P=0.20). MRI can be safely performed in patients with CAS implantation both in the early and late course, and is not associated with an increased risk of major adverse clinical cardiac events at long-term follow-up.
    Coronary artery disease 03/2009; 20(2):138-42. · 1.56 Impact Factor
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    ABSTRACT: Visceral adipose tissue plays a central role in the development of metabolic syndrome (MS). Our study aimed to determine a relationship between MS and subepicardial adipose tissue (SAT), a component of visceral fat surrounding the heart and coronary vessels. A total of 123 patients (54 +/- 10 years of age, 47 male patients) diagnosed with MS and 123 age- and gender-matched control subjects were evaluated echocardiographically. Thickness of the SAT was measured using M-mode echocardiography in parasternal long and short axis views. Maximum values at any site were measured, and the average value was used for statistical analyses. Metabolic syndrome was identified according to the latest criteria of International Diabetes Federation. The patients with MS had significantly higher SAT thickness compared to the subjects in the control group (5.1 +/- 1.7 vs. 3.4 +/- 1.6 mm, P < 0.001). A stepwise increase was noted in the SAT thickness depending on the number of the MS components (P < 0.001). The multivariate stepwise linear regression analysis revealed that the diagnosis of MS (t = 3.019, P = 0.001), serum triglyceride level (t = 3.423, P = 0.001), gender (t = -5.507, P < 0.001), age (t = 2.394, P = 0.02) and waist circumference (t = 9.656, P < 0.001) were the independent determinants of SAT thickness. For each 10 and 20-cm increase in waist circumference, 0.094 and 0.19-mm increases in SAT thickness were expected. As an optimal cut off point, 4.35 mm SAT thickness have determined metabolic syndrome with a 61.7% sensitivity and 79.2% specificity. A close relationship between SAT thickness and MS was demonstrated. Assessment of SAT thickness in routine echocardiographic examinations might be used in predicting the existence of MS and its associated cardiovascular risks.
    The International Journal of Cardiovascular Imaging 09/2008; 24(6):577-83. · 2.65 Impact Factor
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    ABSTRACT: Hyperuricemia (HU) is a well-recognized risk factor for cardiovascular diseases. The independence of this association from other confounding factors has remained controversial. The possible contributory effect of HU to myocardial impairment produced by hypertension (HT), however, has not been clarified yet. The study was designed to assess the left ventricular (LV) systolic and diastolic function in patients with HT with or without HU. Tissue Doppler imaging (TDI) was used for detailed analysis as this method was superior to other conventional echocardiographic techniques. The study participants consisted of 27 patients (men 56%, mean age+/-SD; 55+/-10 years) with HT without HU, and 27 patients with HT with HU (men 62%, mean age+/-SD; 56+/-9 years), and 27 age-matched healthy control participants (men 57%, mean age+/-SD; 53+/-11 years). Cardiac functions were determined using echocardiography, comprising standard two-dimensional and conventional Doppler and TDI. Peak systolic myocardial velocity at mitral annulus (Sm), mitral inflow velocities and early diastolic mitral annular velocity (Em), late diastolic mitral annular velocity (Am), peak systolic mitral annular velocity, Em/Am, and myocardial performance index were calculated by TDI. Mitral inflow velocities and tissue Doppler-derived mitral annular diastolic velocities were significantly different in the patient groups (HT without HU and HT with HU) compared with the control cases. Tissue Doppler-derived myocardial performance index (LV-MPI) was significantly impaired in the patient groups compared with those of the control's (0.48+/-0.09, 0.53+/-0.07, and 0.39+/-0.07, respectively, P<0.001). Significant differences were also observed between the patients who had HT without HU and the patients who had HT with HU regarding LV-MPI. Significant correlations were observed between the serum uric acid levels and LV function parameters.
    Blood Pressure Monitoring 04/2008; 13(2):79-84. · 1.80 Impact Factor
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    ABSTRACT: Carotid intima-media thickness (C-IMT) measured noninvasively by ultrasonography is now widely used as a surrogate marker for atherosclerotic disease and directly associated with increased risk of cardiovascular disease. Hyperuricemia (HU) is a well recognized risk factor for cardiovascular diseases. The independence of this association from other confounding factors has remained controversial. But the possible contributory effect of HU to carotid intima-media thickness (C-IMT) produced by hypertension (HT) has not been clarified yet. The study was designed to assess the C-IMT in patients with hypertension (HT) with or without HU. The study participants consisted of 30 patients (men 60%, mean age+/-S.D.: 49+/-11 years) with HT without HU, and 25 patients with HT and HU (men 52%, mean age+/-S.D.: 52+/-12 years), and 25 age-matched healthy control subjects (men 56%, mean age+/-S.D.: 50+/-13 years). All study groups were examined by B-mode ultrasound to measure the C-IMT at the far wall of the common carotid artery. C-IMT were significantly higher in the patient groups (HT without HU and HT with HU) compared to the control cases (0.70+/-0.14, 0.83+/-0.16 versus 0.57+/-0.16, mm, respectively, p<0.001). In the patients groups, patients with HU had significantly higher carotid IMT compared to the patients without HU. In stepwise linear regression analysis, we found that serum uric acid (SUA) levels independently but modestly associated with C-IMT (beta=0.42, p=0.002). We have shown that higher SUA levels are associated with atherogenesis independent from hypertension. Prospective studies will be necessary to confirm and extend these findings including early screening for hyperuricemia and lowering of SUA level looking at potential benefits in slowing progression of C-IMT in hypertensive patients.
    Atherosclerosis 03/2008; 197(1):159-63. · 3.71 Impact Factor
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    ABSTRACT: The most important cause of increased mortality in end-stage renal disease (ESRD) is cardiovascular diseases. We investigated the prognostic value of cardiac troponin T (cTnT) and homocysteine in the long-term follow-up of ESRD patients. The study included 78 patients (54 males, 24 females; mean age 53.2+/-16.6 years) with ESRD, who had been on hemodialysis treatment for at least three months. Baseline troponin T and homocysteine levels were measured and the patients were followed-up from March 2002 to May 2007 for major adverse cardiovascular events (MACE). Major adverse cardiovascular events occurred in 26 patients (33.3%), including cerebrovascular events (n=3, 3.9%), congestive heart failure (CHF) (n=18, 23.1%), coronary artery disease (CAD) (n=19, 24.4%), and death (n=19, 24.4%). Two-thirds of diabetic patients developed MACE and the mean age in the MACE group was significantly greater (p<0.001). Troponin T levels were significantly higher in patients who developed MACE (0.21+/-0.43 ng/ml vs 0.06+/-0.28 ng/ml, p=0.002), whereas homocysteine levels did not differ significantly between the two groups (p=0.82). For a cutoff value of 0.10 ng/ml, cTnT was > or =0.1 ng/ml in 17 patients (21.8%), and <0.10 ng/ml in 61 patients (78.8%). Patients having a cTnT level of > or =0.10 ng/ml showed significantly higher rates of MACE (64.7% vs 24.6%; p=0.003), CHF (47.1% vs 16.4%; p=0.02), and death (52.9% vs 16.4%; p=0.004). There was also a greater tendency to CAD in this group (41.2% vs 19.7%, p=0.10). In multivariate logistic regression analysis, age and diabetes mellitus were the independent predictors of MACE development. Homocysteine levels cannot predict MACE in ESRD patients in the long-term follow-up. Despite a significantly higher incidence of MACE in patients with high cTnT levels, cTnT was not an independent predictor of cardiovascular outcome.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2008; 36(6):382-7.
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    Kaan Okyay, Atiye Cengel, Yusuf Tavil
    The Canadian journal of cardiology 12/2007; 23(13):1088. · 3.12 Impact Factor
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    ABSTRACT: Endothelial dysfunction and subsequently impaired microvascular circulation are the leading mechanisms in the development of cardiac syndrome X (CSX). The study evaluated the plasma asymmetric dimethylarginine (ADMA) and L-arginine levels of the patients with CSX and the control group and aimed to determine any relationship between these parameters and epicardial coronary blood flow and myocardial tissue perfusion. The study group consisted of 32 patients (mean age: 52.6+/-9.4 years, 14 men) with typical exertional angina, positive exercise test, and normal coronary arteries diagnosed as CSX. Plasma ADMA, L-arginine levels, and L-arginine/ADMA ratio were compared with the values of the control group, which consisted of 17 age-matched and sex-matched individuals. Concentrations of L-arginine and ADMA were measured by high-performance liquid chromatography. In all the coronary territories, epicardial coronary flow was assessed by thrombolysis in myocardial infarction (TIMI) frame count (TFC) method, and tissue level perfusion, by myocardial blush grade (MBG) method. A MBG score less than 3 was considered an impaired myocardial perfusion, and a MBG score of '3' in all the coronary territories, a normal myocardial perfusion. The plasma ADMA levels of the study group were higher than those of the control group (0.83+/-0.38 vs. 0.55+/-0.44 micromol/l, P=0.03), whereas plasma L-arginine levels were similar in both groups (70.25+/-21.89 vs. 76.09+/-18.22 micromol/l, P=0.36), resulting in a diminished L-arginine/ADMA ratio in the patients with CSX [82.3 (60.2-128.8) vs. 242.2 (76.7-386.4), P=0.003]. In CSX group, the patients with abnormal myocardial tissue perfusion had increased plasma ADMA levels compared with those with normal tissue perfusion (0.99+/-0.37 vs. 0.69+/-0.34 micromol/l, P=0.02), whereas plasma L-arginine levels were similar in both groups. No correlations were observed between TFC values and plasma ADMA, L-arginine levels, and L-arginine/ADMA ratio. Plasma ADMA levels, however, were negatively correlated with MBG scores (r=-0.349, P=0.014). We have shown for the first time that in the patients with CSX, increased plasma ADMA levels might be associated with impaired myocardial tissue perfusion when assessed by MBG.
    Coronary Artery Disease 12/2007; 18(7):539-44. · 1.11 Impact Factor
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    ABSTRACT: This study evaluated the effects of scaling and root planing (SRP) +/- sub-antimicrobial dose doxycycline (SDD) on gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP) -1, -8, -13 and on serum levels of high-sensitivity C-reactive protein (HsCRP) and lipid fractions in patients with both chronic periodontitis (CP) and coronary artery disease (CAD). Thirty-six patients were randomly distributed into two groups (Placebo or SDD; 6 weeks) and both received two regimens of SRP. At baseline and 6 weeks, GCF and blood were collected and clinical indices were recorded. MMPs, HsCRP and lipid fractions were assayed. There were statistically significant improvements for all clinical parameters, GCF volumes, GCF MMPs and serum levels of HsCRP, apolipoprotein-A (APO-A), high-density lipoprotein (HDL) and lipoprotein-a between pre- and post-treatment in both groups. Between groups, there were statistically significant greater improvements in pocket depth (PD), gingival index (GI), APO-A and HDL, favouring the group receiving SDD adjunctive to SRP (p < 0.05). Greater improvement was detected for PD and GI, and for serum levels of APO-A and HDL cholesterol when using SRP+SDD compared with SRP+placebo in this study. An investigation with larger numbers of patients and a longer duration of drug treatment is needed to confirm these preliminary findings.
    Journal Of Clinical Periodontology 08/2007; 34(8):673-81. · 3.69 Impact Factor
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    ABSTRACT: Gemcitabine, a pyrimidine analogue, is a cell cycle-specific antineoplastic agent that is structurally related to cytarabine. Major side effects of the treatment with gemcitabine are hepatic dysfunction, myelosuppression, renal impairment and pulmonary toxicity. Development of atrial fibrillation (AF) during gemcitabine treatment is very rare and was reported in only 2 case reports in the literature. We report the case of a 65-year-old man who developed AF under gemcitabine therapy for non-small cell lung cancer (stage IIIB). In this patient, AF was intrinsically associated with chemotherapy administration which triggered arrhythmia. Although AF caused by gemcitabine appears to be rare, patients at risk of developing atrial fibrillation should be closely monitored for this complication.
    Onkologie 06/2007; 30(5):253-5. · 1.00 Impact Factor
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    ABSTRACT: In patients with chronic renal failure, the main cause of mortality is cardiovascular disease. Cardiac troponin T (cTnT) and brain natriuretic peptide (BNP) are found to be related with decreased survival in both the normal population and in patients with chronic renal failure in different studies. Our aim is to investigate the relationship between cTnT and BNP in patients with chronic renal failure. 58 chronic haemodialysis patients were enrolled prospectively for the study. Blood samples for measurement of cTnT and BNP were collected after the haemodialysis. The patients are divided into 3 groups according to cTnT measurements. Group I included the patients with cTnT < 0.05 ng/ml, Group II included the patients with cTnT between 0.05 and 0.1 ng/ml and group III included the patients with cTnT > 0. 1 ng/ml. We performed echocardiography in all patients to measure the left ventricular ejection fraction and thickness of septum and posterior wall. When BNP levels were compared among the 3 groups, we found that the BNP level was lowest in group I and highest in group III (165.13 +/- 125.44 pg/dl; 236.0 +/- 107.83 pg/dl; 280.71 +/- 153.25 pg/dl, respectively) (P = 0.01).The difference in BNP levels among groups was statistically significant and independent from left ventricular hypertrophy, left ventricular ejection fraction and volume overload in multiple regression analysis. We also searched the relationship between plasma cTnT and BNP levels and found a positive correlation (r = 0.3; P = 0.023). cTnT and BNP levels were related to each other in patients with chronic renal failure.These parameters can help to identify the patients with a high risk for cardiovascular diseases.
    Acta cardiologica 04/2007; 62(2):171-6. · 0.61 Impact Factor
  • Journal of Electrocardiology - J ELECTROCARDIOL. 01/2007; 40(4).
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    ABSTRACT: Gemcitabine, a pyrimidine analogue, is a cell cycle-specific antineoplastic agent that is structurally related to cytarabine. Major side effects of the treatment with gemcitabine are hepatic dysfunction, myelosuppression, renal impairment and pulmonary toxicity. Development of atrial fibrillation (AF) during gemcitabine treatment is very rare and was reported in only 2 case reports in the literature. Case Report: We report the case of a 65-year-old man who developed AF under gemcitabine therapy for non-small cell lung cancer (stage IIIB). In this patient, AF was intrinsically associated with chemotherapy administration which triggered arrhythmia. Conclusion: Although AF caused by gemcitabine appears to be rare, patients at risk of developing atrial fibrillation should be closely monitored for this complication.
    Onkologie 01/2007; 30(5):253-255. · 1.00 Impact Factor
  • Journal of Electrocardiology - J ELECTROCARDIOL. 01/2007; 40(4).

Publication Stats

136 Citations
27.68 Total Impact Points

Institutions

  • 2014
    • Baskent University
      Engüri, Ankara, Turkey
  • 2005–2012
    • Gazi University
      • • Department of Cardiology
      • • Faculty of Medicine
      Ankara, Ankara, Turkey
  • 2009
    • Erciyes Üniversitesi
      • Department of Cardiology
      Caesarea, Kayseri, Turkey