Nihat Kalay

Publications (64)183.87 Total impact

• Article: Elevated plasma hyaluronan levels in pulmonary hypertension.

  Nihat Kalay, Deniz Elcik, Halit Canatan, Mehmet Gungor Kaya, Mikail Yarlioglues, Abdurrahman Oguzhan, Raed A Dweik, Metin Aytekin
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  ABSTRACT: Pulmonary arterial hypertension (PAH) is a progressive disease, with a poor prognosis. The pathophysiologic mechanism of PAH is unknown, but may involve both tissue remodeling and inflammatory processes. Hyaluronan (HA) is a large glycosaminoglycan polymer and a major component of the extracellular matrix. In the present study, we measured plasma HA levels in PAH associated with systolic congestive heart failure (CHF, n = 16) or chronic obstructive pulmonary disease (COPD, n = 18). The control group was consisted of 14 healthy individuals without pulmonary or cardiovascular disease. Plasma HA levels (ng/mL) were determined in all patients by an enzyme linked HA binding assay. Pulmonary arterial pressure (PAP) was calculated in echocardiography (mmHg). Pulmonary arterial pressures were significantly higher in CHF and COPD (CHF: 55.0 ± 11 mmHg and COPD: 62.5 ± 21 mmHg, p < 0.001 for each), compared to the control group (25.4 ± 5.9 mmHg). Plasma HA levels were significantly higher in CHF (73.0 ± 37.5 ng/ml, p = 0.007) and COPD (87.3 ± 53.2 ng/ml, p = 0.001) compared to control patients (26.2 ± 8.4 ng/ml). There was no significant difference in plasma HA levels between the CFH and COPD groups (p = 0.690). In COPD, plasma HA levels were significantly correlated with PAP, left atrium diameter. There was no significant correlation between plasma HA levels and age or with echocardiography parameters in CHF. Both CHF and COPD are associated with increased plasma HA levels. Elevated plasma HA may contribute to the development of PAH.
  The Tohoku Journal of Experimental Medicine 01/2013; 230(1):7-11. · 1.24 Impact Factor
• Article: Acute Effects of Intracoronary Nitroglycerin and Diltiazem in Coronary Slow Flow Phenomenon.

  Ibrahim Ozdogru, Cemil Zencir, Ali Dogan, Ozcan Orscelik, Mehmet Tugrul Inanc, Ahmet Celik, Mustafa Gur, Zafer Elbasan, Nihat Kalay, Abdurrahman Oguzhan
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  ABSTRACT: BACKGROUND: The coronary slow flow phenomenon (CSFP) is a coronary microvascular disorder angiographically defined by delayed opacification of the distal vasculature in the absence of obstructive coronary artery disease. We aimed to investigate and compare the effects of intracoronary nitrate and diltiazem on thrombolysis in myocardial infarction frame count (TFC) in patients with CSFP during coronary angiography. METHODS: Sixty patients with CSFP were randomly divided into 2 groups. The first group is nitroglycerin group with 30 patients (22 men; mean [SD] age, 50 [12] years), and the second is diltiazem group with 30 patients (27 men; mean age, 54 ± 11 years); intracoronary 5-mg diltiazem or 250-μg nitroglycerin was administered. Heart rate, systolic and diastolic blood pressures, and TFCs in all 3 coronaries were recorded before and after administering these medications. RESULTS: After nitroglycerin administration, systolic and diastolic blood pressures decreased, heart rates significantly increased, and TFCs decreased in all coronaries (P < 0.001 for 3 coronaries). After the application of intracoronary 5-mg diltiazem, heart rate, systolic and diastolic blood pressures, and TFCs were found significantly lower than predrug values (P < 0.001 for all values). When the percent TFC reductions, after the application of intracoronary diltiazem or nitroglycerin, in left anterior descending coronary artery, circumflex coronary artery, and right coronary artery were evaluated, diltiazem significantly reduced the TFCs of the left anterior descending coronary artery and circumflex coronary artery compared with nitroglycerin (P < 0.01 for both coronaries). CONCLUSION: Both intracoronary diltiazem and nitroglycerin improve the TFCs in CSFP, and intracoronary diltiazem is superior to nitroglycerin in reducing TFCs in CSFP.
  Journal of Investigative Medicine 12/2012; · 1.96 Impact Factor
• Article: Relationship between hematologic parameters and left ventricular systolic dysfunction in stable patients with multi-vessel coronary artery disease.

  Orhan Doğdu, Mahmut Akpek, Mikail Yarlıoğlueş, Nihat Kalay, Idris Ardıç, Deniz Elçik, Omer Senarslan, Mehmet Güngör Kaya
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  ABSTRACT: Objectives: Multi-vessel coronary artery disease (MVCAD) has long been recognized as an important predictor of adverse outcomes in patients with chronic stable angina. The aim of this study is to investigate the relationship between hematologic parameters and impairment of left ventricular systolic functions in patients with stable MVCAD. Study design: Patients (n=202) with stable angina and MVCAD were included in this study. According to the left ventricle ejection fraction (LVEF) determined by echocardiography, patients were divided into two groups as the preserved group (LVEF >50%) and the impaired group (LVEF <50%). The preserved group consisted of 106 patients and the impaired group consisted of 96 patients. Results: The frequency of diabetes mellitus was significantly higher in the impaired group compared to the preserved group (respectively, 50% vs. 33%, p=0.01). High sensitivity C-reactive protein (hs-CRP) levels and, neutrophil/lymphocyte ratio (N/L ratio) were significantly higher in the impaired group than in the preserved group (3.9±2.4 vs. 7.9±3.8, p<0.001; 2.7±0.7 vs. 3.9±1.2, p<0.001, respectively). There was a significant correlation between LVEF, N/L ratio and hs-CRP; hs-CRP and N/L ratio were positively correlated (r=0.584; p<0.001), and LVEF was negatively correlated with both hs-CRP and N/L ratio (r=-0.48, p<0.001 and r=-0.43, p<0.001, respectively). A N/L ratio >3.0 had 77% sensitivity and 68% specificity in predicting left ventricular dysfunction in patients with stable MVCAD. In multivariate analysis, N/L ratio (OR: 2.456, <95% Cl 2.056-4.166; p<0.001) was an independent predictor of left ventricular dysfunction in stable patients with MVCAD. Conclusion: N/L ratio and hs-CRP, which is inexpensive and easily measurable in the laboratory, is independently associated with impaired LV systolic functions in patients with stable MVCAD.
  Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 11/2012; 40(8):706-13.
• Article: Protective effects of nebivolol against anthracycline-induced cardiomyopathy: A randomized control study.

  Mehmet G Kaya, Metin Ozkan, Ozgur Gunebakmaz, Hasan Akkaya, Esma G Kaya, Mahmut Akpek, Nihat Kalay, Mustafa Dikilitas, Mikail Yarlioglues, Halit Karaca, Veli Berk, Idris Ardic, Ali Ergin, Yat Yin Lam
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  ABSTRACT: BACKGROUND: We aimed to evaluate the effect of prophylactic nebivolol use on prevention of antracycline-induced cardiotoxicity in breast cancer patients. METHODS: In this small, prospective, double-blind study, we randomly assigned 45 consecutive patients with breast cancer and planned chemotheraphy to receive nebivolol 5mg daily (n=27) or placebo (n=18). Echocardiographic measurements and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels were obtained at baseline and at 6-month of chemotherapy. RESULTS: Both studied groups had comparable echocardiographic variables and NT-pro-BNP levels at baseline. At 6-month, the left ventricular (LV) end-systolic and end-diastolic diameters increased in the placebo group (LVESD: 29.7±3.4 to 33.4±4.5mm; LVEDD: 47.2±3.8 to 52.0±4.6mm, p=0.01 for both) but remained unchanged in the nebivolol group (LVESD: 30.4±3.5 to 31.0±3.6mm, p=0.20; LVEDD: 47.0±4.4 to 47.1±4.0mm, p=0.93). The placebo group also had lower LVEF than the nebivolol group (57.5±5.6% vs. 63.8±3.9%, p=0.01) at 6-month. NT-pro-BNP level remained static in the nebivolol group (147±57 to 152±69 pmol/l, p=0.77) while it increased in the placebo group (144±66 to 204±73 pmol/l, p=0.01). CONCLUSIONS: Prophylactic use of nebivolol treatment may protect the myocardium against antracycline-induced cardiotoxicity in breast cancer patients.
  International journal of cardiology 06/2012; · 7.08 Impact Factor
• Article: Changes in carotid intima-media thickness over two years in patients on haemodialysis.

  Mustafa Duran, Aydin Unal, Mehmet Tugrul Inanc, Mehmet Gungor Kaya, Nihat Kalay, Ayse Ocak, Onur Kadir Uysal, Abdurrahman Oguzhan
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  ABSTRACT: To evaluate the progression of carotid intima-media thickness (CIMT) and to search for possible associations between these changes and other risk factors of atherosclerosis for 2 years in stable patients with chronic renal failure (CRF) on haemodialysis (HD). Study population consisted of 22 patients with newly diagnosed CRF. All patients underwent B-mode ultrasonography of common carotid artery for estimating CIMT and the presence of plaques before and after the first HD session (mean 24.22 +/- 2.14 months). The differences in CIMT before and after long-term HD treatment were compared. Acute phase proteins, calcium-phosphate balance and lipid profile were assessed and anthropometric parameters were measured. Mean age was 55 +/- 13 years and 10 (45%) of the patients were female. After long-term HD treatment, (mean 24.22 +/- 2.14 months) the mean value for CIMT (0.57 +/- 0.08 mm) was significantly lower than that at baseline (0.68 +/- 0.12 mm) (p = 0.02). Only male gender and smoking were correlated with baseline CIMT. After long-term HD treatment, age, total cholesterol, LDL cholesterol, and triglyceride were related with CIMT. Diabetes and smoking were correlated with CIMT. Presence of plaque before HD only correlated with creatinine level and after long-term HD treatment only correlated with total cholesterol level. We found that CIMT was significantly decreased 2 years after starting HD. An association between CIMT and other atherosclerotic risk factors (such as age, cholesterol, triglyceride etc.) could not be determined due to a small sample size.
  Journal of the Pakistan Medical Association 06/2012; 62(6):575-9.
• Article: The effects of significant coronary stenosis and percutaneous coronary intervention on aortic stiffness.

  Nihat Kalay, Deniz Elcik, Ali Doğan, Tolga Saka, Orhan Doğdu, Fatih Koç, Mikail Yarlioğlueş, Mahmut Akpek, Abdurrahman Oğuzhan, Mehmet G Kaya, Idris Ardiç, Ali Ergin
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  ABSTRACT: Although aortic stiffness (AS) is a strong predictor of cardiovascular events, its value is unknown in patients who have coronary stenosis and undergo percutaneous coronary intervention (PCI). Our hypothesis was that AS might provide additional information about coronary hemodynamic status. In this context, we investigated the effects of coronary stenosis and PCI on AS. The study included 107 patients undergoing coronary angiography. The patients were divided into three groups based on the angiographic results: 39 patients with significant lesions (≥50%) formed the 'critical group' and 38 patients with nonsignificant lesions (<50%) formed the 'noncritical group'. The control group (30 patients) had normal angiograms. Aortic stiffness was determined using the carotid-femoral aortic pulse wave velocity (PWV) method. All patients in the critical group underwent successful PCI and repeat PWV measurements. All baseline characteristics were similar in the three groups except for the mean PWV, which was significantly higher (9.4±2.2 m/sec) in the critical group compared to the control group (5.7±1.1 m/sec) and the noncritical group (5.8±1.1 m/sec) (p<0.0001). The latter two groups had similar PWV values (p=0.6). After PCI, the mean PWV decreased significantly by 24.4% to 7.1±2.0 m/sec (p=0.002); however, it was still significantly higher than that of the control group (p<0.0001). In correlation analysis, PWV showed significant correlations with age (r=0.412, p=0.01), systolic blood pressure (r=0.342, p<0.01), and hemoglobin (r=-0.370, p=0.02). Multiple logistic regression analysis showed that PWV was a predictor for significant stenosis [Exp(B) 3.960, 95% CI 2.014-7.786]. Our findings suggest that significant coronary stenosis is associated with significantly increased AS and successful PCI improves AS to some extent.
  Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 03/2012; 40(2):143-7.
• Article: Relation Between Mean Platelet Volume and Severity of Atherosclerosis in Patients With Acute Coronary Syndromes.

  Sani Namik Murat, Mustafa Duran, Nihat Kalay, Ozgur Gunebakmaz, Mahmut Akpek, Cihan Doger, Deniz Elcik, Ayse Ocak, Mehmet Akif Vatankulu, Murat Turfan, Haci Ahmet Kasapkara, Fatih Akin, Musa Sahin, Mehmet Gungor Kaya
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  ABSTRACT: Platelets play a central role in the pathophysiology of coronary artery disease (CAD). Increased mean platelet volume (MPV) is an indicator of platelet function and associated with poor clinical outcome in patients with acute coronary syndrome (ACS). We evaluated the relationship between MPV and severity of CAD in patients with ACS. A total of 395 patients with ACS were included. Severity of CAD was assessed with the Gensini and Syntax scores. High levels of MPV were associated with the Gensini and Syntax scores, number of diseased vessels (>50%), number of critical lesions (>50% and >70%), and noncritical lesions. After multivariate analysis, high levels of MPV were independent predictors of multivessel CAD together with age. In patients with ACS, high MPV levels were associated with severity of CAD. It is possible that MPV can be a helpful marker in patients with CAD for the severity of coronary atherosclerosis.
  Angiology 02/2012; · 1.51 Impact Factor
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  Available from: Mustafa Duran

  Article: The importance of cardiac biomarkers on remodelling after myocardial infarction.

  Ahmet Celik, Nihat Kalay, Omer Sahin, Mustafa Duran, Hasan Korkmaz, Mehmet Ali Kobat, Ertugrul Kurtoglu, Ali Dogan, Sabahattin Muhtaroglu, Oguzhan Baran, Mehmet Tugrul Inanc, Ibrahim Ozdogru, Abdurrahman Oguzhan, Ramazan Topsakal
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  ABSTRACT: The purpose of this study is to evaluate the importance of tenascin-C ( TNC), N-terminal pro brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) on LV remodelling after myocardial infarction (MI). Fifty-seven stable patients with subacute anterior MI who had total or subtotal occlusion in the infarct-related left anterior desending artery in coronary angiography were enrolled the study. 18 of patients who had total occlusion received only medical theraphy, 19 of patients who had total occlusion received successful PCI+ medical theraphy and 20 of patients who had subtotal occlusion received successful PCI+ medical theraphy. Left ventricular volumes and ejection fractions (EF) were measured with echocardiography. Serum TNC, NT-proBNP and CRP levels were measured at admission and a month after treatment. There was significant increase in LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) baseline to follow-up in total-PCI group. Baseline to follow-up; a borderline significant increase was observed in LVEDV in the total-medical group. No significant difference was seen in LV volumes and EF in the subtotal-PCI group. NT-proBNP, TNC and CRP levels were decreased in all groups. The decrease in NT-proBNP and CRP values were significant in the total-medical and subtotal-PCI group but in the total-PCI group they were not significant. The decrease of TNC was significant in all groups but the lowest decrease was seen in the total-PCI group. TNC, NT-proBNP and CRP reflect LV remodelling in accordance with echocardiography after MI. Tenascin-C; NT-pro BNP; CRP; Remodelling; Myocardial infarction.
  Journal of Clinical Medicine Research 02/2012; 4(1):20-5.
• Article: Relationship between psychosocial status, diabetes mellitus, and left ventricular systolic function in patients with stable multivessel coronary artery disease.

  Orhan Dogdu, Mikail Yarlioglues, Mehmet Gungor Kaya, Idris Ardic, Mahmut Akpek, Omer Senarslan, Deniz Elcik, Omer Sahin, Erol Tulumen, Bekir Calapkorur, Nihat Kalay
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  ABSTRACT: Negative emotional conditions contribute to the development of coronary artery disease (CAD). Depression and anxiety are prognostic factors in patients with CAD. The aim of our study was to investigate the association between emotional conditions and left ventricular (LV) systolic functions in CAD. 168 patients (102 men, 66 women, mean age 66.3 ± 9.9 years) with stable angina and multivessel disease (MVD) were included in the study. According to the LV ejection fraction (LVEF) in echocardiography, patients were divided into two groups, the preserved group (LVEF > 50%), and the impaired group (LVEF < 50%). The preserved group consisted of 94 patients and the impaired group consisted of 74 patients. Emotional status was evaluated using the Hamilton Depression (HAM-D), Hamilton Anxiety (HAM-A), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores. The prevalence of diabetes mellitus (DM) was significantly higher in the impaired group than in the preserved group (29.8% vs 56.8%, p < 0.01). The HAM-D, HAM-A, BAI and BDI scores were higher in the impaired group compared to the preserved group (HAM-D: 12.1 ± 3.3 vs 14.5 ± 2.3, p = 0.03; HAM-A: 12.7 ± 3.4 vs 14.3 ± 2.2, p = 0.01; BAI: 18.6 ± ± 6.4 vs 22.1 ± 6.6, p = 0.01 and BDI: 13.9 ± 2.5 vs 17.2 ± 2.0, p = 0.002, respectively). In multivariate analysis, BDI scores (odds ratio [OR]: 2.197, < 95% confidence interval [CI] 1.101-4.387; p = 0.026), HAM-A scores (OR: 1.912, < 95% Cl 1.092-2.974; p = 0.041) and DM (OR: 2.610, < 95% Cl 1.313-5.183; p = 0.006) were important risk factors for LV dysfunction in stable patients with MVD. This study demonstrated that emotional status and DM are factors associated with impaired LV systolic function in patients with stable CAD.
  Cardiology journal 01/2012; 19(3):249-55. · 1.31 Impact Factor
• Article: The effect of adenotonsillectomy on right ventricle function and pulmonary artery pressure in children with adenotonsillar hypertrophy.

  Sema Koc, Metin Aytekin, Nihat Kalay, Mustafa Ozcetin, Turgay Burucu, Kerem Ozbek, Atac Celik, Hasan Kadi, Sefa Gulturk, Fatih Koc
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  ABSTRACT: Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Severe upper airway obstruction may have an effect on chronic alveolar hypoventilation, which consequently may lead to right ventricle (RV) dysfunction induced by hypoxemic pulmonary vasoconstriction. The investigators aimed to study RV function and mean pulmonary artery pressure (mPAP) in patients with ATH who were undergoing adenotonsillectomy by using tissue Doppler echocardiography (TDE). The study examined 27 children with ATH who had a mean age of 8 ± 2 years. The subjects were comprised 17 (63%) males and 10 (37%) females. Hypertrophy of the tonsils was graded according to the Brodsky scale. Children having either grade 3 or 4 hypertrophied adenotonsils were recruited for the study. Adenotonsillectomy was performed on all subjects in the study group and echocardiographic examination was repeated 3 months postoperatively. Tricuspid Em significantly increased after adenotonsillectomy (17.7 ± 3.6 vs. 19.1 ± 5.5, p=0.04). The RV myocardial performance index (MPI) and mPAP significantly decreased after adenotonsillectomy (RV MPI: 0.57 ± 0.13 vs. 0.40 ± 0.12, p<0.001 and mPAP (mmHg): 31 ± 9 vs. 25 ± 7, p=0.001). The results of this study, evaluated with the results of previous studies, demonstrated that adenotonsillectomy improved RV performance and reduced mPAP in children with ATH.
  International journal of pediatric otorhinolaryngology 01/2012; 76(1):45-8. · 0.85 Impact Factor
• Article: The Prognostic Value of Serum Gamma Glutamyl Transferase Activity on Admission in Patients With STEMI Undergoing Primary PCI.

  Mahmut Akpek, Deniz Elcik, Nihat Kalay, Mikail Yarlioglues, Orhan Dogdu, Omer Sahin, Idris Ardic, Abdurrahman Oguzhan, Ali Ergin, Mehmet G Kaya
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  ABSTRACT: We assessed the association between serum gamma glutamyl transferase (GGT) activity with postprimary percutaneous coronary intervention (PCI) coronary flow and in-hospital major advanced cardiac events (MACEs) in patients with ST elevation myocardial infarction (STEMI). Patients with STEMI (n = 425; males 78%; mean age 60 ± 13 years) were enrolled. Patients were divided into 3 GGT tertiles and 2 groups according to thrombolysis in myocardial infarction (TIMI) flow grade. The TIMI flow percentages were similar in the 3 GGT tertiles (32%, 45%, and 42%, respectively, P = .336). Total MACE increased with GGT tertiles (among tertiles, respectively; P < .001). The total MACE was significantly higher in impaired flow group than in normal flow group (23% vs 7%; P < .001). At multivariate analyses, serum GGT activity was an independent predictor of in-hospital MACE (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.01-1.33; P < .001). In conclusion, serum GGT activity is associated with in-hospital MACE in patients with STEMI undergoing primary PCI.
  Angiology 12/2011; · 1.51 Impact Factor
• Article: Relation of left atrial spontaneous echocardiographic contrast in patients with mitral stenosis to inflammatory markers.

  Mehmet G Kaya, Mahmut Akpek, Deniz Elcik, Nihat Kalay, Mikail Yarlioglues, Fatih Koc, Orhan Dogdu, Omer Sahin, Idris Ardic, Abdurrahman Oguzhan, Ali Ergin
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  ABSTRACT: Spontaneous echocardiographic contrast (SEC) is the presence of smoke-like echoes with a characteristic swirling motion of blood in echocardiography. Previous clinical studies have demonstrated that SEC is a risk factor for left atrial thrombus formation and an important indicator of potential systemic embolism originated from heart. An established relation exists between the inflammatory status and the prothrombotic state. Therefore, we investigated the role of inflammatory status on SEC in patients with mitral stenosis (MS). A total of 62 consecutive patients with MS who undergoing mitral balloon valvuloplasty were enrolled in the present study. The patients were divided into 2 groups according to the formation of SEC in the left atrium. Of the 62 patients, 32 (mean age 45 ± 12 years; 75% women) were in the SEC-negative group and 30 patients (mean age 45 ± 11 years; 63% women) were in the SEC-positive group. The high-sensitive C-reactive protein levels were significantly greater in the SEC-positive group than in the SEC-negative group (3.9 ± 2.2 vs 10.6 ± 6.3, p = 0.024). The neutrophil levels (64.6 ± 9.4 vs 72.6 ± 8.6) were significantly greater in the SEC-positive group, and the lymphocyte levels (24.4 ± 6.9 vs 18.3 ± 6.0) were significantly greater in the SEC-negative group (p = 0.001 for each). The neutrophil/lymphocyte (N/L) ratio was also significantly greater in the SEC-positive group (3.0 ± 1.8 vs 4.5 ± 1.8, p = 0.003). In the receiver operating characteristics curve analysis, a N/L ratio > 3.1 mg/dl had a 80% sensitivity and 72% specificity in predicting SEC in patients with MS. On multivariate analysis, high-sensitive C-reactive protein (odds ratio [OR] 1.235, 95% confidence interval [CI] 1.040 to 1.466; p = 0.016), N/L ratio (OR 1.461, 95% CI 0.977 to 2.184; p = 0.02), left atrial volume (OR 3.012, 95% CI 1.501 to 5.611; p = 0.001), and mitral valve area (OR 0.135, 95% CI 0.020 to 0.503; p = 0.017) were independent risk factors of SEC in patients with MS. In conclusion, the high-sensitive C-reactive protein and N/L ratio were independently associated with SEC in patients with MS.
  The American journal of cardiology 12/2011; 109(6):851-5. · 3.58 Impact Factor
• Article: High levels of serum uric acid predict severity of coronary artery disease in patients with acute coronary syndrome.

  Mustafa Duran, Nihat Kalay, Mahmut Akpek, Ozcan Orscelik, Deniz Elcik, Ayse Ocak, Mehmet Tugrul Inanc, H Ahmet Kasapkara, Abdurrahman Oguzhan, Namik K Eryol, Ali Ergin, Mehmet Gungor Kaya
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  ABSTRACT: We aimed to elucidate the relation between serum uric acid (SUA) level and severity of coronary artery disease (CAD) in nondiabetic, nonhypertensive patients (n = 246) with acute coronary syndrome (ACS). Severity of CAD was assessed by the Gensini score. One, 2, and 3 or more diseased vessels were identified in 87 (35.4%), 55 (22.4%), and 104 (42.2%) patients, respectively. Patients with hyperuricemia had higher Gensini score, high number of diseased vessels, critical lesions, and total occlusion. Serum uric acid level was significantly associated with number of diseased vessels. Serum uric acid was an independent risk factor for multivessel disease by univariate analysis. High levels of SUA associated with the severity of CAD in nondiabetic, nonhypertensive patients with ACS.
  Angiology 11/2011; 63(6):448-52. · 1.51 Impact Factor
• Article: Prognostic value of uric acid in patients with ST-elevated myocardial infarction undergoing primary coronary intervention.

  Mehmet G Kaya, Huseyin Uyarel, Mahmut Akpek, Nihat Kalay, Mehmet Ergelen, Erkan Ayhan, Turgay Isik, Gokhan Cicek, Deniz Elcik, Omer Sahin, Said M Cosgun, Abdurrahman Oguzhan, Mehmet Eren, C Michael Gibson
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  ABSTRACT: Elevated uric acid (UA) levels have been associated with cardiovascular disease in epidemiologic studies. The relation between UA levels and long-term outcomes in patients with ST-segment elevation myocardial infarction who undergo primary percutaneous coronary intervention is not known. Data from 2,249 consecutive patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were evaluated. Patients were divided into 2 groups with high or low UA using upper limits of normal of 6 mg/dl for women and 7 mg/dl for men. There were 1,643 patients in the low-UA group (mean age 55.9 ± 11.6 years, 85% men) and 606 patients in the high-UA group (mean age 60.5 ± 12.6 years, 76% men). Serum UA levels were 8.0 ± 1.5 mg/dl in the high-UA group and 5.2 ± 1.0 mg/dl in the low-UA group (p <0.001). The in-hospital mortality rate was significantly higher in patients with high UA levels (9% vs 2%, p <0.001), as was the rate of adverse outcomes in patients with high UA. The mean follow-up time was 24.3 months. Cardiovascular mortality, reinfarction, target vessel revascularization, heart failure, and major adverse cardiac events were all significantly higher in the high-UA group. In a multivariate analyses, high plasma UA levels were an independent predictor of major adverse cardiac events in the hospital (odds ratio 2.03, 95% confidence interval 1.25 to 3.75, p = 0.006) and during long-term follow-up (odds ratio 1.64, 95% confidence interval 1.05 to 2.56, p = 0.03). In conclusion, high UA levels on admission are independently associated with in-hospital and long-term adverse outcomes in patients with ST-segment elevation myocardial infarction who undergo primary percutaneous coronary intervention.
  The American journal of cardiology 11/2011; 109(4):486-91. · 3.58 Impact Factor
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  Available from: anakarder.com

  Article: Clinical outcome of B2/C type isolated proximal LAD disease treated with drug-eluting stents.

  Davran Ciçek, Hasan Pekdemir, Nihat Kalay, Haldun Müderrisoğlu
  Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2011; 11(7):648-9. · 0.44 Impact Factor
• Article: Relationship between platelet indices and spontaneous echo contrast in patients with mitral stenosis.

  Mahmut Akpek, Mehmet G Kaya, Mikail Yarlioglues, Orhan Dogdu, Idris Ardic, Omer Sahin, Deniz Elcik, Ibrahim Ozdogru, Ramazan Topsakal, Abdurrahman Oguzhan, Ali Ergin, Nihat Kalay
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  ABSTRACT: To determine the association of platelet indices with spontaneous echo contrast (SEC) in patients with mitral stenosis. A total of 232 consecutive patients with mitral stenosis who undergoing mitral balloon valvuloplasty were enrolled to the study. Patients were divided into two groups according to the formation of SEC in the left atrium. Group 1: mitral stenosis complicated with SEC; Group 2: mitral stenosis without SEC. Transthoracic echocardiography and transoesophageal echocardiography were performed for each patient. Complete blood counting parameters were measured and all routine biochemical tests were performed. There were 133 patients (mean age 42 ± 11 and 74% female) in the SEC(-) group and 99 patients (mean age 45 ± 10 and 64% female) in the SEC(+) group. Plateletcrit (0.25 ± 0.06 vs. 0.27 ± 0.07, P = 0.043) and mean platelet volume (MPV) levels (9.4 ± 1.1 vs. 10.4 ± 1.2, P < 0.001) were significantly higher in the SEC(+) group. When we divided the SEC(+) patients into four subgroups according to previously reported criteria, MPV levels increased to correlate with the degree of SEC (P < 0.001). At multivariate analysis, MPV levels [odds ratio (OR) 2.365, 95% confidence interval (CI) 1.720-3.251; P < 0.001] and PCT levels (OR 2.699, 95% CI 1.584-4.598; P= 0.033) are independent risk factors of SEC in patients with mitral stenosis. In patients with mitral stenosis, cheaply and easily measurable platelet indices including MPV and PCT levels are associated with the presence of SEC and are independent risk factors of SEC.
  European Heart Journal – Cardiovascular Imaging 09/2011; 12(11):865-70. · 2.32 Impact Factor
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  Available from: Fatih Altunkas

  Article: The relationship between inflammation and slow coronary flow: increased red cell distribution width and serum uric acid levels.

  Nihat Kalay, Metin Aytekin, Mehmet G Kaya, Kerem Ozbek, Metin Karayakalı, Erkan Söğüt, Fatih Altunkas, Ahmet Oztürk, Fatih Koç
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  ABSTRACT: The underlying mechanism of slow coronary flow (SCF) has yet to be elucidated. Increased red cell distribution width (RDW) and uric acid level may be indicative of an underlying inflammatory state. We aimed to investigate RDW and serum uric acid levels in patients with normal coronary arteries and SCF without stenosis. The study included 46 consecutive patients (25 males, 21 females; mean age 54 ± 11 years) with angiographically normal coronary arteries but having SCF in all three coronary arteries. The control group consisted of 40 patients (18 males, 22 females; mean age 54 ± 9 years) with angiographically normal coronary arteries without SCF. In both groups, RDW and serum uric acid levels were measured and compared. In the SCF group, TIMI frame counts measured in the left anterior descending coronary artery, left circumflex coronary artery, and right coronary artery were significantly higher compared to the control group (p<0.05). Patients with SCF exhibited significantly higher RDW (13.4 ± 1.6% vs. 12.6 ± 1.2%, p=0.01) and serum uric acid levels (5.3 ± 1.6 mg/dl vs. 4.7 ± 1.3 mg/dl, p=0.01) compared to controls. In logistic regression analysis, uric acid [Exp(B)=1.612, 95% CI 0.206-5.35, p=0.021] and RDW [Exp(B)=1.496, 95% CI 0.403-4.72, p=0.030] were found as independent predictors of SCF. Our findings show that patients with SCF have significantly increased RDW and serum uric acid levels. This may help throw more light on the pathophysiological basis of SCF.
  Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 09/2011; 39(6):463-8.
• Article: Assessment of red cell distribution width (RDW) in patients with coronary artery ectasia.

  Orhan Dogdu, Fatih Koc, Nihat Kalay, Mikail Yarlioglues, Deniz Elcik, Metin Karayakali, Kerem Ozbek, Mehmet Gungor Kaya
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  ABSTRACT: Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. Red cell distribution width (RDW) is a measure of heterogeneity in the size of red blood cell. In this study, we aimed to investigate RDW levels in patients with CAE. The study population included 54 patients with CAE (28 males; mean age, 59 ± 12) and 40 individuals comprising the control group who had normal coronary arteries (17 males; mean age, 56 ± 10). Admission RDW was measured as part of the automated complete blood count. The RDW was significantly higher in the CAE group than the control (P < .001). Also, high-sensitive C-reactive protein (hs-CRP) levels in patients with CAE were significantly higher as compared with controls (P < .001). This study demonstrates that RDW and hs-CRP were higher in the CAE group compared with the control group. These results show that RDW is a reliable, simple, and inexpensive marker for patients with CAE.
  Clinical and Applied Thrombosis/Hemostasis 08/2011; 18(2):211-4. · 1.33 Impact Factor
• Article: Impaired aortic elastic properties in patients with chronic graft-versus-host disease.

  Orhan Dogdu, Mehmet Gungor Kaya, Mikail Yarlioglues, Ali Dogan, Idris Ardic, Deniz Elcik, Nihat Kalay, Leylagul Kaynar, Fatih Kurnaz, Namik Kemal Eryol
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  ABSTRACT: Graft-versus-host disease (GVHD), which develops as a result of the immunologic response that donor T-lymphocytes generate against host tissue following hematopoietic stem cell transplantation (HSCT), is the leading cause of morbidity and mortality in these patients. The aim of this study is the investigate relation between aortic wall stiffness and duration of the disease in patients with chronic GVHD. The study population included 32 patients (18 men; mean age, 36.9±12.5 years, and mean disease duration=14.7±2.9 months) who received HSCT and was diagnosed with GVHD and 44 patients (23 men; mean age, 35.2±9.6 years, and mean disease duration=13.5±2.4 months) who did not develop GVHD following HSCT. All patients underwent baseline echocardiography before HSCT and were followed. After approximately 10-14 months following HSCT, these patients were divided into two groups based on whether they had developed chronic GVHD, and were compared to aortic stiffness parameters and cardiac functions. There was no change in basal characteristics, laboratory and echocardiographic findings, and aortic stiffness parameters in both groups before HSCT (P>0.05). After HSCT, the mean aortic strain and distensibility values of the chronic GVHD patients were significantly lower, compared with the non-GVHD patients (9.8±3.2% vs. 12.9±5.0%, P=0.002 and 4.1±1.5×10(-6) cm2/dyn vs. 5.3±2.1×10(-6) cm2/dyn; P=0.005, respectively). In addition, aortic stiffness index was increased in the chronic GVHD group compared with non-GVHD group (2.7±1.7 vs. 2.0±0.8, P=0.03). Aortic stiffness measurements were significantly different in chronic GVHD group compared to non-GVHD group and these findings suggested useful explanation for the potential mechanism about the development of disease.
  Echocardiography 08/2011; 28(9):1011-8. · 1.24 Impact Factor
• Article: The association of serum uric acid levels on coronary flow in patients with STEMI undergoing primary PCI.

  Mahmut Akpek, Mehmet G Kaya, Huseyin Uyarel, Mikail Yarlioglues, Nihat Kalay, Ozgur Gunebakmaz, Orhan Dogdu, Idris Ardic, Deniz Elcik, Omer Sahin, Abdurrahman Oguzhan, Ali Ergin, Charles M Gibson
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  ABSTRACT: Uric acid has been shown as a predictor and an independent risk factor for coronary heart disease, but little is known regarding the association of uric acid levels with coronary blood flow in STEMI. We hypothesized that elevated uric acid levels would be associated with impaired flow and perfusion in the setting of STEMI treated with primary PCI. Two hundred and eighty nine patients with STEMI who treated primary PCI were enrolled to study. Patients were divided into two groups based upon the TIMI flow grade. No-reflow was defined as TIMI Grade 0, 1 and 2 flows (group 1). Angiographic success was defined as TIMI 3 flow (group 2). Uric acid, MPV and high sensitive CRP were measured. Major adverse cardiac events (MACE) were defined as in stent thrombosis, non-fatal myocardial infarction and in-hospital mortality. There were 126 patients (mean age 63±11 and 71% male) in group 1 and 163 patients (mean age 58±12 and 80% male) in group 2. Uric acid, MPV, and hs-CRP levels on admission were higher in group 1 (p=0.0001 for each). A uric acid level ≥5.4 mg/dl measured on admission had a 77% sensitivity and 70% specificity in predicting no-reflow at ROC curve analysis. In-hospital MACE was significantly higher in group 1 (29% vs. 7%, p=0.0001). At multivariate analyses, high plasma uric acid (odds ratio (OR) 2.05, <95% confidence interval(CI) 1.49-2.81; p<0.0001), hs-CRP (OR 1.02, <95% CI 1.01-1.03; p=0.0007) and MPV (OR 3.09, <95% CI 1.95-4.89; p<0.0001) levels were independent predictors of no-reflow post primary PCI and uric acid (OR 2.75, <95% CI 1.93-3.94; p<0.0001), hs-CRP (OR 1.01, <95% CI 1-1.02; p=0.006) levels, but not MPV, were independent predictors of in-hospital MACE. Plasma uric acid level on admission is a strong and independent predictor of poor coronary blood flow following primary PCI and in hospital MACE among patients with STEMI. Except for predictive value, uric acid levels may be a useful biomarker for stratification of risk in patients with STEMI and may also lead to carry further therapeutic implications.
  Atherosclerosis 07/2011; 219(1):334-41. · 3.79 Impact Factor