Mehmet Ergelen

Bezmiâlem Vakif Üniversitesi, İstanbul, Istanbul, Turkey

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Publications (91)261.37 Total impact

  • Mehmet Ergelen, Huseyin Uyarel
    International Journal of Cardiology 11/2014; 177(1):161. DOI:10.1016/j.ijcard.2014.09.054 · 6.18 Impact Factor
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    ABSTRACT: Purpose: Platelets play a key role in the genesis of thrombosis. Plateletcrit (PCT) provides complete information on total platelet mass. The relationship between PCT values and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary angioplasty is not known. We sought to determine the effect of PCT values on the outcomes of primary angioplasty for STEMI. Methods: Overall, 2572 consecutive STEMI patients (mean age, 56.6 +/- 11.8 years) undergoing primary percutaneous coronary intervention were enrolled retrospectively into the present study. Plateletcrit at admission was measured as part of the automated complete blood count. Patients were classified into 2 groups: high PCT (>0.237, n = 852) and nonhigh PCT (<0.237, n = 1720). Clinical characteristics and in-hospital and long-term (median, 21 months) outcomes of primary angioplasty were analyzed. Results: A higher in-hospital shock rate was observed among patients with high PCT values compared with those with nonhigh PCT values (6.5 vs 3.8%, respectively; P = .003). The long-term cardiovascular prognosis was worse for patients with high PCT values (Kaplan-Meier, log-rank test; P = .007). We used Cox proportional hazard models to examine the association between PCT and adverse clinical outcomes. High PCT values were also an independent predictor of cardiovascular mortality (hazard ratio, 1.85; 95% confidence interval, 1.061-3.22; P = .03). Conclusion: High PCT values on admission are independently associated with long-term adverse outcomes in patients with STEMI who undergo primary angioplasty.
    Journal of Critical Care 07/2014; 29(6). DOI:10.1016/j.jcrc.2014.07.001 · 2.19 Impact Factor
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    ABSTRACT: Acute heart failure (AHF) is a major cause of hospitalization, morbidity and mortality in the world. Gamma-glutamyl transferase (GGT) is an enzyme responsible for the extracellular catabolism of antioxidant glutathione and a potential risk indicator of cardiac mortality. Limited data exists on the prognostic value of circulating levels of GGT in patients hospitalized due to AHF. We studied the association between baseline GGT activity and in hospital mortality in AHF patients. The study cohort consisted of 183 AHF patients with ejection fraction <50%. The primary end point was in-hospital mortality. Patients were divided into two groups according to in hospital mortality. The relationship between GGT activity and in hospital mortality was tested using logistic regression models, adjusting for clinical characteristics and echocardiographic findings. After adjustment for possible confounders, GGT level was at significantly related (OR 1.056, 95% CI 1.018 - 1.096, p = 0.04) with in-hospital mortality CONCLUSIONS: In conclusion, an elevated GGT activity is a independent predictor of short-term mortality in patients with AHF and reduced left ventricular ejection fraction.
    Kardiologia polska 02/2014; 72(8). DOI:10.5603/KP.a2014.0048 · 0.52 Impact Factor
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    ABSTRACT: This report describes the first use of a new paravalvular leak (PVL) device designed specifically to close paravalvular mitral and paravalvular aortic leaks. The first patient had severe paravalvular mitral leak that was closed using the transapical route with a rectangular designed PVL device which has an oval waist for self-centering and the second patient had moderate paravalvular aortic leak that was closed with a square designed device which has a round waist for self-centering. Both patients had complete closure. © 2013 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 02/2014; 83(2). DOI:10.1002/ccd.25006 · 2.40 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the effect of a levosimendan infusion on hematological variables in patients with acute decompensated heart failure (ADHF). The predictive value of these variables for in-hospital mortality was also evaluated. A total of 553 patients (368 males; mean age, 63.4±14.9 years) with acute exacerbations of advanced heart failure (ejection fraction ≤35%) and treated with either dobutamine or levosimendan were included in this retrospective analysis. The patients that received levosimendan therapy were divided into two groups according to in-hospital mortality: group 1 (21%) included patients who died during hospitalization (n=45), while group 2 (79%) included patients with a favorable outcome (n=174) after levosimendan infusion. Changes in several hematological variables between admission and the third day after levosimendan infusion were evaluated. The demographic characteristics and risk factors of the two groups were similar. A comparison of changes in laboratory variables after the infusion of levosimendan revealed significant improvement only in those patients who had not died (group 2) during hospitalization. The neutrophil to lymphocyte (N/L) ratio after levosimendan infusion was an independent predictor of in-hospital mortality (odds ratio: 1.310, 95% CI: 1.158-1.483, p<0.001). In a receiver-operating characteristic curve analysis, a value of 5.542 for the N/L ratio after levosimendan administration was identified as an effective cut-off point for predicting in-hospital mortality (area under the curve=0.737; 95% confidence interval=1100-1301; p<0.001). Levosimendan treatment was associated with significant changes in hematological variables in patients with ADHF. A sustained higher N/L ratio after levosimendan infusion is associated with an increased risk of in-hospital mortality in patients with ADHF.
    Journal of Cardiology 11/2013; 63(6). DOI:10.1016/j.jjcc.2013.10.009 · 2.57 Impact Factor
  • European geriatric medicine 11/2013; 4(5):350–351. DOI:10.1016/j.eurger.2013.05.007 · 0.55 Impact Factor
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    Journal of the American College of Cardiology 10/2013; 62(18). DOI:10.1016/j.jacc.2013.08.191 · 15.34 Impact Factor
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    Journal of the American College of Cardiology 10/2013; 62(18). DOI:10.1016/j.jacc.2013.08.233 · 15.34 Impact Factor
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    Journal of the American College of Cardiology 10/2013; 62(18). DOI:10.1016/j.jacc.2013.08.511 · 15.34 Impact Factor
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    Journal of the American College of Cardiology 10/2013; 62(18). DOI:10.1016/j.jacc.2013.08.678 · 15.34 Impact Factor
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    Journal of the American College of Cardiology 10/2013; 62(18). DOI:10.1016/j.jacc.2013.08.561 · 15.34 Impact Factor
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    Journal of the American College of Cardiology 10/2013; 62(18). DOI:10.1016/j.jacc.2013.08.498 · 15.34 Impact Factor
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    ABSTRACT: The Zwolle score (Zs) is a validated risk score that has been used to identify low-risk patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The Syntax score (Ss) is an angiographic score that evaluates the complexity of coronary artery disease (CAD). We aimed to create a simple risk score by combining these two scores for risk stratification in patients with STEMI undergoing primary PCI. 299 consecutive STEMI patients (mean age 57.4±11.7, 240 men) who underwent primary PCI were prospectively enrolled in to the present study. The study population was divided into tertiles based on admission Zs and Ss. A high Zs (>3) and high Ss (>24) were defined as values in the third tertiles. A low Zs and low Ss were defined as values in the lower two tertiles. Patients were then classified into four groups: High Zs and high Ss (HZsHSs, n=26); high Zs and low Ss (HZsLSs, n=29);low Zs and high Ss (LZsHSs, n=48);low Zs and low Ss (LZsLSs, n=196). In-hospital cardiac outcomes were then recorded. In-hospital cardiovascular mortality was higher in HZsHSs (50%) compared to HZsLSs (27.5%), LZsHSs (0%), and LZsLSs(0.5%) groups. After adjustment for potentially confounding factors, HZsHSs (odds ratio [OR] 77.6, 95% confidence interval [CI], 6.69-113.1; p=0.001), and HZsLSs (OR 28.9, 95% CI, 2.77-56.2; p=0.005) status, but not LZsHSs and LZsLSs status, remained independent predictors of in-hospital cardiovascular mortality. STEMI patients with HZsHSs represent the highest risk population for in-hospital cardiovascular mortality.
    Kardiologia polska 08/2013; 72(2). DOI:10.5603/KP.a2013.0183 · 0.52 Impact Factor
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    ABSTRACT: Cardiac involvement has been increasingly recognized in patients with polycystic ovary syndrome (PCOS). Identification of the earliest asymptomatic impairment of left ventricular (LV) performance may be important in preventing progression to overt heart failure. Our aim was to investigate LV function with different echocardiographic techniques in patients with PCOS. Thirty patients with PCOS and 30 age and body mass index matched healthy subjects were enrolled to this cross-sectional observational study. All subjects underwent echocardiography for assessment of resting LV function as well as two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (3D-Echo). Global longitudinal strain (GLS) was calculated from 3 standard apical views using 2D-STE. Student t-test, Chi-square test, Pearson's, and Spearman's correlation analysis were used for statistical analysis. The early mitral inflow deceleration time (DT), isovolumetric relaxation time (IVRT) and E/Em ratio were increased in the PCOS group (p<0.05 for all). Waist-to-hip ratio, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and low-density lipoprotein (LDL) levels were higher in PCOS group (p<0.05 for all). Significant correlation was observed between DT, IVRT and insulin value, HOMA-IR (p<0.05 for all). On 3D-Echo evaluation, none of the patients in both groups had LV systolic dysfunction with comparable LV ejection fraction and LV volumes. 2D-STE showed that GLS was significantly reduced in the PCOS group compared to control group (-16.78±0.56% vs. -18.36±1.04%, p<0.001). The GLS was found to be negatively correlated with waist-to-hip ratio and LDL values (p<0.05 for all). These results indicate that PCOS may be related to impaired LV systolic function detected by 2D-STE. In addition, PCOS may lead to diastolic dysfunction. Reduced GLS might be an early indicator of cardiac involvement in this patient population.
    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 08/2013; 13(8). DOI:10.5152/akd.2013.196 · 0.76 Impact Factor
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    ABSTRACT: OBJECTIVES: The prognostic value of cystatin C (CysC) has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of CysC in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). METHODS: We prospectively enrolled 475 consecutive STEMI patients (mean age 55.6 ± 12.4 years, 380 male, 95 female) undergoing primary PCI. The study population was divided into tertiles based on admission CysC values. The high CysC group (n = 159) was defined as a value in the third tertile (>1.12 mg/L), and the low CysC group (n = 316) included those patients with a value in the lower two tertiles (≤1.12 mg/L). Clinical characteristics and in-hospital and one-month outcomes of primary PCI were analyzed. RESULTS: The patients of the high CysC group were older (mean age 62.8 ±13.1 vs. 52.3±10.5, P < .001). Higher in-hospital and 1-month cardiovascular mortality rates were observed in the high CysC group (9.4% vs. 1.6%, P < .001 and 14.5% vs. 2.2%, P < .001, respectively). In Cox multivariate analysis; a high admission CysC value (>1.12 mg/L) was found to be a powerful independent predictor of one-month cardiovascular mortality (odds ratio, 5.3; 95% confidence interval, 1.25-22.38; P = .02). CONCLUSIONS: These results suggest that a high admission CysC level was associated with increased in-hospital and one-month cardiovascular mortality in patients with STEMI undergoing primary PCI.
    Journal of critical care 05/2013; 62(18). DOI:10.1016/j.jcrc.2013.03.004 · 2.19 Impact Factor
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    ABSTRACT: OBJECTIVES: Serum γ-glutamyl transferase (GGT) activity has been shown to be related to the development of atherosclerosis and cardiovascular events. The aim of this study was to evaluate the prognostic value of GGT in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS: A total of 683 consecutive patients with STEMI who underwent primary PCI were evaluated. The study population was divided into tertiles on the basis of admission GGT values. A high GGT (n=221) was defined as a value in the upper third tertile (GGT>37) and a low GGT (n=462) was defined as any value in the lower two tertiles (GGT≤37). The mean follow-up time was 29 months. RESULTS: The in-hospital mortality rate was significantly higher in patients in the high GGT group (7.2 vs. 1.7%, P<0.001), as was the rate of adverse outcomes in patients with high GGT levels. In multivariate analyses, a significant association was found between high GGT levels and adjusted risk of in-hospital cardiovascular mortality (odds ratio=8.6, 95% confidence interval: 2.3-32.4, P=0.001). In a receiver operating characteristic curve analysis, a GGT value greater than 37 was identified as an effective cutoff point in STEMI for in-hospital cardiovascular mortality (area under curve=0.71, 95% confidence interval: 0.59-0.82, P<0.001). There were no differences in the long-term adverse outcome rates between the two groups. CONCLUSION: GGT is a readily available clinical laboratory value associated with in-hospital adverse outcomes in patients with STEMI who undergo primary PCI. However, there was no association with long-term mortality.
    Coronary artery disease 03/2013; 24(4). DOI:10.1097/MCA.0b013e328360d131 · 1.30 Impact Factor
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    ABSTRACT: Objectives: Coronary artery ectasia (CAE) has been defined as a dilated artery luminal diameter that is at least 50% greater than the diameter of the normal portion of the artery. Isolated CAE is defined as CAE without significant coronary artery stenosis and isolated CAE has more pronounced inflammatory symptoms. Neutrophil to lymphocyte ratio (NLR) is widely used as a marker of inflammation and an indicator of cardiovascular outcomes in patients with coronary artery disease. We examined a possible association between NLR and the presence of isolated CAE. Study design: In this study, 2345 patients who underwent coronary angiography for suspected or known ischemic heart disease were evaluated retrospectively. Following the application of exclusion criteria, our study population consisted of 81 CAE patients and 85 age- and gender-matched subjects who proved to have normal coronary angiograms. Baseline neutrophil, lymphocyte and other hematologic indices were measured routinely prior to the coronary angiography. Results: Patients with angiographic isolated CAE had significantly elevated NLR when compared to the patients with normal coronary artery pathology (3.39±1.36 vs. 2.25±0.58, p<0.001). A NLR level >= 2.37 measured on admission had a 77% sensitivity and 63% specificity in predicting isolated CAE at ROC curve analysis. In the multivariate analysis, hypercholesterolemia (OR=2.63, 95% CI 1.22-5.65, p=0.01), obesity (OR=3.76, 95% CI 1.43-9.87, p=0.007) and increased NLR (OR=6.03, 95% CI 2.61-13.94, p<0.001) were independent predictors for the presence of isolated CAE. Conclusion: Neutrophil to lymphocyte ratio is a readily available clinical laboratory value that is associated with the presence of isolated CAE.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 03/2013; 41(2):123-30.
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    ABSTRACT: Objectives: The neutrophil to lymphocyte ratio (NLR) has been investigated as a new predictor for cardiovascular risk. Admission NLR would be predictive of adverse outcomes after primary angioplasty for ST-segment elevation myocardial infarction (STEMI). Methods: A total of 2410 patients with STEMI undergoing primary angioplasty were retrospectively enrolled. The study population was divided into tertiles based on the NLR values. A high NLR (n = 803) was defined as a value in the third tertile (>6.97), and a low NLR (n = 1607) was defined as a value in the lower 2 tertiles (≤6.97). Results: High NLR group had higher incidence of inhospital and long-term cardiovascular mortality (5% vs 1.4%, P < .001; 7% vs 4.8%, P = .02, respectively). High NLR (>6.97) was found as an independent predictor of inhospital cardiovascular mortality (odds ratio: 2.8, 95% confidence interval: 1.37-5.74, P = .005). Conclusions: High NLR level is associated with increased inhospital and long-term cardiovascular mortality in patients with STEMI undergoing primary angioplasty.
    Clinical and Applied Thrombosis/Hemostasis 01/2013; 20(4). DOI:10.1177/1076029612473516 · 1.58 Impact Factor
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    ABSTRACT: Objectives: The iso-osmolar contrast agent iodixanol may be associated with fewer contrast-induced acute kidney injuries when compared with low-osmolar contrast agents. The aim of this study is to compare iodixanol and iopamidol in patients with acute coronary syndrome (ACS) who are currently undergoing coronary angiography. Study design: Two hundred and seventy five consecutive patients who presented to a tertiary cardiovascular center with acute non-ST elevation myocardial infarction and underwent coronary angiography as a part of an early invasive strategy were included in the study (mean age 58±11 years, 79% male). Study participants were administered either iodixanol (n=45) or iopamidol (n=230) and the groups were compared for the highest creatinine levels, the absolute and percent change in creatinine levels, and for the development of contrast induced nephropathy within 72 hours of the procedure. Results: Baseline demographic and clinical characteristics of the patients were similar between the two groups. There were no differences in the preprocedural serum creatinine (iopamidol 1.10±0.54 mg/dl, iodixanol 1.09±0.24 mg/dl, p=0.680), glomerular filtration rate (iopamidol 89±35 ml/dk/1.73 m2, iodixanol 89±26 ml/dk/1.73 m2, p=0.934), or contrast volume used during the procedure (iopamidol 180±80 ml vs. iodixanol 166±73 ml, p=0.226) between the groups. The absolute change in serum creatinine after the procedure (iopamidol 0.136±0.346 mg/dl, iodixanol 0.072±0.070 mg/dl, p=0.118) and the percent change in serum creatinine after the procedure (iopamidol 12.1±29.6%, iodixanol 6.8±6.9%, p=0.075) were not statistically significant between the two groups. Contrast induced nephropathy developed 10% (95% confidence interval [CI] 6-14%) in iopamidol group whereas it was 2.2% (95% CI -2-7%) in iodixanol group (p=0.144). Conclusion: Iodixanol was not superior to iopamidol regarding contrast induced acute kidney injury after coronary angiography in an unselected general patient population with ACS.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2013; 41(1):21-7.
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    ABSTRACT: Background: T-wave positivity in aVR lead patients with heart failure and anterior wall old ST-segment elevation myocardial infarction (STEMI) are shown to have a higher frequency of cardiovascular mortality, although the effects on patients with STEMI treated with primary percutaneous coronary intervention (PCI) has not been investigated. In this study, we sought to determine the prognostic value of T wave in lead aVR on admission electrocardiography (ECG) for in-hospital mortality in patients with anterior wall STEMI treated with primary PCI. Methods: After exclusion, 169 consecutive patients with anterior wall STEMI (mean age: 55 ± 12.9 years; 145 men) undergoing primary PCI were prospectively enrolled in this study. Patients were classified as a T-wave positive (n = 53, group 1) or T-wave negative (n = 116, group 2) in aVR based upon the admission ECG. All patients were evaluated with respect to clinical features, primary PCI findings, and in-hospital clinical results. Results: T-wave positive patients who received primary PCI were older, multivessel disease was significantly more frequent and the duration of the patient's hospital stay was longer than T-wave negative patients. In-hospital mortality tended to be higher in the group 1 when compared with group 2 (7.5% vs 1.7% respectively, P = 0.05). After adjusting the baseline characteristics, positive T wave remained an independent predictor of in hospital mortality (odds ratio: 4.41; 95% confidence interval 1.2-22.1, P = 0.05). Conclusions: T-wave positivity in lead aVR among patients with an anterior wall STEMI treated with primary PCI is associated with an increase in hospital cardiovascular mortality.
    Annals of Noninvasive Electrocardiology 01/2013; 18(1):51-7. DOI:10.1111/j.1542-474X.2012.00530.x · 1.08 Impact Factor

Publication Stats

426 Citations
261.37 Total Impact Points

Institutions

  • 2012–2014
    • Bezmiâlem Vakif Üniversitesi
      İstanbul, Istanbul, Turkey
  • 2011–2014
    • Istanbul University
      • Department of Anesthesiology and Reanimation
      İstanbul, Istanbul, Turkey
  • 2011–2012
    • Balikesir University
      Hadrianutherae, Balıkesir, Turkey
  • 2006–2011
    • Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center
      İstanbul, Istanbul, Turkey
  • 2010
    • Mardin State Hospital
      Marde, Mardin, Turkey
    • Acibadem Üniversitesi
      • Department of Cardiology
      İstanbul, Istanbul, Turkey
    • Ahi Evren Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi
      Atrabazandah, Trabzon, Turkey
  • 2009–2010
    • Istanbul Training and Research Hospital
      İstanbul, Istanbul, Turkey
  • 2007
    • Acibadem Hospitals Group
      İstanbul, Istanbul, Turkey
  • 2005
    • Koşuyolu Kalp ve Araştırma Hastanesi
      İstanbul, Istanbul, Turkey