Publications (58)103.01 Total impact
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Article: The relationship between γ-glutamyl transferase levels and the clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
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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; · 1.56 Impact Factor -
Article: Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasia.
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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. -
Article: Predictive Value of Elevated Neutrophil to Lymphocyte Ratio in Patients Undergoing Primary Angioplasty for ST-Segment Elevation Myocardial Infarction.
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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; · 1.33 Impact Factor -
Article: Prognostic Significance of T-Wave Amplitude in Lead aVR on the Admission Electrocardiography in Patients with Anterior Wall ST-Elevation Myocardial Infarction Treated by Primary Percutaneous Intervention.
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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. · 1.10 Impact Factor -
Article: [Nephrotoxicity of iodixanol versus iopamidol in patients with acute coronary syndrome].
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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. -
Article: The impact of NT-proBNP on admission for early risk stratification of patients undergoing primary percutaneous coronary intervention.
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ABSTRACT: Incompleted ST segment resolution (STR) after primary percutaneous coronary intervention (PCI) is associated with worse clinical outcomes. To investigate the association between plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) levels on admission and STR after reperfusion, in a patient with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. After exclusion, 81 consecutive patients with STEMI (mean age: 61.3 ± 13.4 years) undergoing primary PCI were prospectively enrolled in this study. Patients were divided into two groups according to ST-segment resolution: ΣSTR < 50%, the no-reflow phenomenon positive (+) group (n = 20), and ΣSTR ≥ 50%, the no-reflow phenomenon negative (-) group (n = 61). Patients were followed up for six months. The no-reflow phenomenon (+) group had similar baseline cardiovascular risk factors (e.g. age, sex, hypertension, diabetes mellitus) but higher mid-term mortality (25% vs. 6.5%, p = 0.02) than the no-reflow phenomenon (-) group. The frequency of anterior MI in the no-reflow phenomenon (+) group was higher (75%, p = 0.02). NT-proBNP levels on admission were higher in the no-reflow phenomenon (+) group (p = 0.001). A NT-proBNP level ≥ 563.4 pg/mL measured on admission had a 72.7% sensitivity and 72.9% specificity in predicting no-reflow phenomenon at ROC curve analysis. At multivariate analysis, anterior MI, high NT-proBNP levels, prolonged chest pain-to-reperfusion time (> 6 h) and post-TIMI-3 flow were independent predictors of no-reflow phenomenon after primary PCI. Plasma NT-proBNP level on admission is a strong and independent predictor of no-reflow phenomenon following primary PCI and mid-term cardiovascular mortality in patients with STEMI.Kardiologia polska 01/2013; 71(2):165-75. · 0.51 Impact Factor -
Article: Predictive Value of Neutrophil to Lymphocyte Ratio in Clinical Outcomes of Non-ST Elevation Myocardial Infarction and Unstable Angina Pectoris: A 3-Year Follow-Up.
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ABSTRACT: We sought to determine the prognostic value of neutrophil to lymphocyte ratio (NLR) in non-ST elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP). A total of 308 (mean age 59.22 ± 11.93) patients with NSTEMI and UAP were prospectively evaluated. The study population was divided into tertiles based on admission NLR values. The patients were followed for clinical outcomes for up to 3 years after discharge. In the Kaplan-Meier survival analysis, 3-year mortality was 21.6% in patients with high NLR versus 3% in the low-NLR group (P < .001). In a receiver-operating characteristic curve analysis, an NLR value of 3.04 was identified as an effective cut point in NSTEMI and UAP of a 3-year cardiovascular mortality (area under curve [AUC] = 0.86, 95% confidence interval [CI] 0.8-0.92). An NLR value >3.04 yielded a sensitivity of 79% and specificity of 71%. Admission NLR is the strong and independent predictor of a 3-year cardiovascular mortality in patients with NSTEMI and UAP.Clinical and Applied Thrombosis/Hemostasis 11/2012; · 1.33 Impact Factor -
Article: Prognostic Value of Total Bilirubin in Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Coronary Intervention.
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ABSTRACT: Previous studies have shown that the serum total bilirubin (TB) concentration was inversely related with stable coronary artery disease, diabetes mellitus, hypertension, and metabolic syndromes. The relation between TB levels and in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI) is not known. Data from 1,624 consecutive patients with STEMI who underwent primary PCI were evaluated. TB was measured after primary PCI, and the study population was divided into tertiles. The high TB group (n = 450) was defined as a value in the upper third tertile (>0.9 mg/dl) and the low TB group (n = 1,174) as any value in the lower 2 tertiles (≤0.9 mg/dl). The in-hospital mortality rate was significantly greater in the high TB group than in the low TB group (4% vs 1.5%, p = 0.003). In the multivariate analyses, a significant association was noted between high TB levels and the adjusted risk of in-hospital cardiovascular mortality (odds ratio 3.24, 95% confidence interval 1.27 to 8.27, p = 0.014). In the receiver operating characteristic curve analysis, TB >0.90 mg/dl was identified as an effective cutpoint in patients with STEMI for in-hospital cardiovascular mortality (area under the curve 0.66, 95% confidence interval 0.55 to 0.76, p = 0.001). The mean follow-up period was 26.2 months. No differences were seen in the long-term mortality rates between the 2 groups. In conclusion, high TB is independently associated with in-hospital adverse outcomes in patients with STEMI who undergo primary PCI. However, no association was found with long-term mortality.The American journal of cardiology 10/2012; · 3.58 Impact Factor -
Article: Patients with Tombstoning Pattern on the Admission Electrocardiography Who Have Undergone Primary Percutaneous Coronary Intervention for Anterior Wall ST-Elevation Myocardial Infarction: In-Hospital and Midterm Clinical Outcomes.
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ABSTRACT: Background: A tombstoning pattern (T-pattern) is associated with in-hospital poor outcomes patients with ST-segment elevation myocardial infarction (STEMI), but no data are available for midterm follow-up. We sought to determine the prognostic value of a T-pattern on admission electrocardiography (ECG) for in-hospital and midterm mortality in patients with anterior wall STEMI treated with primary percutaneous coronary intervention (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-pattern (n = 32) or non-T-pattern (n = 137) based upon the admission ECG. Follow-up to 6 months was performed. Results: In-hospital mortality tended to be higher in the T-pattern group compared with non-T-pattern group (9.3% vs 2.1% respectively, P = 0.05). All-cause mortality was higher in the T-pattern group than non-T-pattern group for 6 month (P = 0.004). After adjusting the baseline characteristics, the T-pattern remained an independent predictor of 6-month all-cause mortality (odds ratio: 5.18; 95% confidence interval: 1.25-21.47, P = 0.02). Conclusion: A T-pattern is a strong independent predictor of 6-month all-cause mortality in anterior STEMI treated with primary PCI. Therefore, it may be an indicator of high risk among patients with anterior wall STEMI.Annals of Noninvasive Electrocardiology 10/2012; 17(4):315-22. · 1.10 Impact Factor -
Article: Prognostic impact of red blood cell transfusion in patients undergoing primary angioplasty for ST elevation myocardial infarction.
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ABSTRACT: OBJECTIVES: We aimed to examine in-hospital and long-term outcomes of red blood cell (RBC) transfusions in patients undergoing a primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). METHODS: Overall, 2537 consecutive STEMI patients (mean age 56.2±11.7 years, 2111 men, 426 women) undergoing primary angioplasty were enrolled retrospectively into the present study. Patients were categorized according to whether they received RBC transfusions during hospitalization. Clinical characteristics, and in-hospital and long-term outcomes of the primary PCI were analyzed. RESULTS: Of the consecutive 2537 patients, 88 (3.4%) received RBC transfusions during the index hospitalization. The transfused patients were older than nontransfused patients (mean age 63.6±12.1 vs. 56.2±11.8, P<0.001). Compared with nontransfused patients, female sex and hypertension were more prevalent in transfused patients (45.4 vs. 15.8%, P<0.001; 52.3 vs. 40.7%, P=0.04, respectively). Baseline values of hematocrit and hemoglobin were lower in patients receiving transfusion (33±6.2 vs. 40.2±4.7%, P<0.001; 11.1±2.3 vs. 13.7±1.6 mg/dl, P<0.001, respectively). The transfused patients had significantly higher in-hospital and long-term mortality (for in-hospital mortality: 10.2 vs. 2.7%, P<0.001; for long-term mortality: 14.1 vs. 5.1%, P=0.001). By multivariate Cox regression analysis, in all 2537 patients, RBC transfusion was found to be a powerful independent predictor of in-hospital cardiovascular mortality (odds ratio 8.31, P<0.001). CONCLUSION: These results show that RBC transfusion is associated with increased in-hospital and long-term mortality in patients with STEMI undergoing a primary PCI.Coronary artery disease 09/2012; · 1.56 Impact Factor -
Article: High SYNTAX score predicts worse in-hospital clinical outcomes in patients undergoing primary angioplasty for acute myocardial infarction.
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ABSTRACT: OBJECTIVE: A high SYNTAX score (SXscore) is a predictor of adverse outcomes for stable and unstable coronary syndromes. We aimed to examine whether a high SXscore will determine in-hospital clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. METHODS: A total of 646 (mean age 56.1±12.5; 516 males, 130 females) patients with STEMI undergoing a primary percutaneous coronary intervention were evaluated prospectively. The study population was divided into tertiles based on the SXscore values. A high SXscore (n=196) was defined as a value in the third tertile (>21.75), and a low SXscore (n=450) was defined as a value in the lower two tertiles (≤21.75). Patients were followed up for in-hospital clinical outcomes. RESULTS: In-hospital cardiovascular mortality occurred more in the high SXscore group than in the low SXscore group (10.7 and 2.4%, respectively, P<0.001). In a receiver-operating characteristic curve analysis, an SXscore value of 21.75 was identified as an effective cut point in STEMI for in-hospital cardiovascular mortality (area under curve=0.75, 95% confidence interval: 0.66-0.83, P<0.001). An SXscore value of more than 21.75 yielded a sensitivity of 66% and a specificity of 71.5%. A significant association was noted between a high SXscore level and the adjusted risk of in-hospital cardiovascular mortality (odds ratio: 3.92, 95% confidence interval: 1.1-13.9, P=0.03). CONCLUSION: Our findings showed that patients with a high SXscore undergoing primary angioplasty for STEMI have a poor in-hospital survival, and that a high SXscore represents an independent risk factor for in-hospital cardiovascular mortality.Coronary artery disease 09/2012; · 1.56 Impact Factor -
Article: The indicators of high risk on admission electrocardiography in patients with anterior wall ST-elevation myocardial infarction.
International journal of cardiology 09/2012; · 7.08 Impact Factor -
Article: The relationship between red blood cell distribution width and the clinical outcomes in non-ST elevation myocardial infarction and unstable angina pectoris: a 3-year follow-up.
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ABSTRACT: Red blood cell distribution width (RDW), a marker of variation in the size of the circulating red blood cells, was evaluated in patients with non-ST elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP). Higher RDW is associated with mortality in the general population, particularly in those with symptomatic cardiovascular disease, and heart failure. We hypothesized that admission RDW might be predictive of adverse clinical outcomes for patients with NSTEMI and UAP. We prospectively enrolled 310 patients with NSTEMI and UAP (mean age 59.3±11.9 years; 236 men, 74 women) in this study. Admission RDW was measured and the study population was classified on the basis of RDW tertiles. A high RDW (n=95) was defined as a value in the upper third tertile (>14%) and a low RDW (n=215) was defined as any value in the lower two tertiles (≤14%). The patients were followed up for clinical outcomes for up to 3 years after discharge. In the Kaplan-Meier survival analysis, the 3-year mortality rate was 19% in the high RDW group versus 5.6% in the low RDW group (P<0.001). In the receiver operating characteristic curve analysis, an RDW value of more than 14% yielded a sensitivity of 60% and a specificity of 72.5%. A significant association was found between a high admission RDW level and the adjusted risk of cardiovascular mortality (hazard ratio: 3.2, 95% confidence interval: 1.3-7.78, P=0.01). RDW is a readily available clinical laboratory value associated with long-term cardiovascular mortality in NSTEMI and UAP.Coronary artery disease 06/2012; 23(5):330-6. · 1.56 Impact Factor -
Article: The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention.
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ABSTRACT: The purpose of this study was to evaluate the predictive value of red cell distribution width (RDW) on the electrocardiographic no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PCI). One-hundred consecutive patients (mean age 61.3 ± 12.8 years and male 77%) with ST-elevation myocardial infarction, who were treated with primary PCI, were analyzed prospectively. RDW and high sensitive C reactive protein (hs-CRP) were measured. The sum of ST-segment elevation was obtained immediately before and 60 min after the restoration of coronary flow. The difference between two measurements was accepted as the amount of ST-segment resolution and was expressed as ∑STR. ∑STR < 50% was accepted as electrocardiographic sign of no-reflow phenomenon. There were 30 patients in the no-reflow group (Group 1) and 70 patients in the normal re-flow group (Group 2). RDW and hs-CRP levels on admission were higher in Group 1. An RDW level ≥14% measured on admission had 70% sensitivity and 64% specificity in predicting no-reflow on ROC curve analysis. Mid-term cardiovascular events were significantly higher in Group 1. In multivariate analyses, RDW (OR 2.93, <95% CI 1.42-6.04; p = 0.004), and tirofiban (OR 0.16, <95% CI 0.05-0.48; p = 0.001) were independent predictors of no-reflow, and RDW (OR 5.89, <95% CI 1.63-21.24; p = 0.007), and creatine kinase-MB (CK-MB) on admission (OR 1.01, <95% CI 1.00-1.02; p = 0.006) were independent predictors of mid-term mortality. A greater baseline RDW value was independently associated with the presence of electrocardiographic no-reflow.Atherosclerosis 06/2012; 224(1):143-9. · 3.79 Impact Factor -
Article: A comparison of direct versus conventional stenting in patients undergoing primary angioplasty for ST-elevation myocardial infarction.
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ABSTRACT: The aim of our study was to determine the impact of direct stenting (DS) on procedural success and the in-hospital outcome among patients with ST-elevation myocardial infarction (STEMI) treated with a primary percutaneous coronary intervention (PCI). With improvements in stent designs, DS has become more widespread. The theoretical advantages of DS include a shorter procedural time, a lower contrast dose, and reduced spiral dissections, along with reduced radiation exposure and procedural costs. A total of 1992 consecutive STEMI patients were reviewed; 621 patients (31.2%) were included in the DS group and 1371 (68.8%) in the conventional stenting (CS) group. The clinical and angiographic characteristics, in-hospital outcomes, and predictors of unsuccessful primary angioplasty were analyzed. The incidence of in-hospital major adverse cardiac events (MACE) was 6.1% in the CS group and 4.3% in the DS group. The difference between the two patient groups was not statistically significant for myocardial reinfarction (re-MI), target-vessel revascularization, and MACE. Nonetheless, the rates of in-hospital mortality and advanced heart failure were significantly lower in the DS group. CS [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.65-7.37, P=0.001], Killip class 2/3 (OR 2.5, 95% CI 1.2-5.23, P=0.01), glomerular filtration rateless than 60 ml/min/1.73 m (OR 2.2, 95% CI 1.22-3.94, P=0.008), and anterior MI (OR 1.61, 95% CI 1.01-2.56, P=0.04) were found to be independent predictors of unsuccessful procedures. DS improves the in-hospital outcomes of STEMI patients treated with primary PCI, particularly by reducing the rates of in-hospital mortality and advanced heart failure. CS was an independent predictor of unsuccessful PCI.Coronary artery disease 05/2012; 23(5):348-53. · 1.56 Impact Factor -
Article: Circadian, Weekly, and Seasonal Variation in Early Stent Thrombosis Patients Who Previously Underwent Primary Percutaneous Intervention With ST Elevation Myocardial Infarction.
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ABSTRACT: One of the major concerns remaining in the treatment with stenting is the occurrence of stent thrombosis (ST). We reviewed 1960 consecutive patients (mean age 56 ± 11.6 years, 84.6% males) treated with primary coronary stenting for ST elevation myocardial infarction between 2003 and 2008. All clinical, angiographic, and follow-up data were retrospectively collected. The data when the patient had angina pectoris was obtained from medical record. Early ST was observed in 89 (4.5%) patients. We identified 86 patients with early ST and known date and time of symptom onset. In these patients (mean age 59.2 ± 13.9, 83.7% males), symptoms occurred mostly at night time (00.00-6.00 am ) and during winter months but the day of the week effect was not presence. In conclusion, occurrences of early ST throughout the week were equally distributed, but early ST was more likely to occur in the winter months and night hours.Clinical and Applied Thrombosis/Hemostasis 05/2012; · 1.33 Impact Factor -
Article: Slow coronary flow in patients undergoing urgent coronary angiography for ST elevation myocardial infarction.
International journal of cardiology 04/2012; 156(1):106-8. · 7.08 Impact Factor -
Article: Clinical outcomes of primary angioplasty in ST elevation myocardial infarction patients with antecedent hypertension during hospital stay and follow-up.
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ABSTRACT: Hypertension is a known risk factor for coronary artery disease. However, the number of studies focusing on the events following ST elevation myocardial infarction (STEMI) in patients with an antecedent hypertension is limited. Our aim is to evaluate the clinical outcomes of primary angioplasty in STEMI patients with antecedent hypertension during hospital stay and follow-up. A total of 373 patients (177 of whom had antecedent hypertension) who were treated by primary angioplasty because of STEMI were included in this study. All parameters were compared between the groups with and without hypertension. Hypertensive patients who received primary angioplasty were older (59.9 ± 12.6 vs. 52 ± 12.3, P < .001) and had higher rates of in-hospital mortality and major adverse cardiac events than patients without hypertension. Among STEMI patients, only history of hypertension for more than 10 years was a predictor of in-hospital mortality (odds ratio: 4.374, 95% CI 1.017-18.822, P = .04). Patients with an antecedent hypertension have higher initial risk profiles and show more negative outcomes during a 6-month follow-up period.Clinical and Experimental Hypertension 04/2012; 34(5):357-62. · 1.07 Impact Factor -
Article: Impact of Altitude on Predicting Midterm Outcome in Patients With ST Elevation Myocardial Infarction.
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ABSTRACT: This study investigated the effects of altitude on occurrence of mid-term negative events among patients presenting with ST elevation myocardial infarction (STEMI). This study enrolled 492 patients with STEMI. 119 of those patients were living at an intermediate altitude (1960 m, Group I) and 373 were living at sea level (0 m, Group II). There was no significant difference between the different altitude groups in terms of the incidence of cardiac death, urgent target vessel revascularization (TVR), stroke/transient ischemic attack (TIA) and composite endpoints. However, Group I had a significantly higher reinfarction incidence when compared with the Group II. Independent predictors of 6-month composite endpoints were history of statin use, presentation with acute stent thrombosis, peak CK-MB level, success of procedure, Killip classification, and left ventricular ejection fraction. In conclusion, altitude status and altitude-related hematologic changes had no influence over the mid-term outcomes in STEMI patients treated with percutaneous intervention.Clinical and Applied Thrombosis/Hemostasis 04/2012; · 1.33 Impact Factor -
Article: Relation of the metabolic syndrome with proarrhythmogenic electrocardiographic parameters in patients without overt diabetes.
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ABSTRACT: We aimed to observe the relationship of the metabolic syndrome and proarrythmogenic ECG parameters and to evaluate a possible correlation of these parameters to the metabolic syndrome score in patients without overt diabetes mellitus. The study population consisted of 142 patients with the metabolic syndrome and 170 age- and gender-matched control subjects. In the ECG recordings, resting heart rate, QRS duration, corrected QT duration and corrected QT dispersion were measured. Patients were classified into three groups based on number of fulfilled metabolic syndrome criteria: group 1 (three metabolic syndrome criteria), group 2 (four metabolic syndrome criteria) and group 3 (five metabolic syndrome criteria). Patients with the metabolic syndrome had a higher increased resting heart rate, QTcd, prolonged QRS and QTc duration. Resting heart rate increases significantly parallel to the increase in the metabolic syndrome score across the groups, whilst QRS duration remained unchanged. QTc duration and QTc dispersion were significantly higher in groups 2 and 3 when compared to group 1. However, no significant differences were observed between groups 2 and 3. We demonstrated that the metabolic syndrome and its score related with increased resting heart rate and prolonged repolarization durations in patiens without overt diabetes mellitus. These pro arrhythmogenic parameters could be used in the development of risk stratification schemes for sudden cardiac death in patients with the metabolic syndrome.Acta cardiologica 04/2012; 67(2):195-201. · 0.61 Impact Factor
Top co-authors
Top Journals
Institutions
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2009–2013
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Balikesir University
Balıkesir, Balikesir, Turkey
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2007–2012
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Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center
İstanbul, Istanbul, Turkey
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2011
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Bezmiâlem Vakif Üniversitesi
İstanbul, Istanbul, Turkey
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2010
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Acibadem Üniversitesi
İstanbul, Istanbul, Turkey
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