Mehmet Baran Karataş

Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Istanbul, Turkey

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Publications (9)13.12 Total impact

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    ABSTRACT: Pulmonary embolism (PE) is a major cause of cardiovascular death. Thrombolytic therapy was shown to reduce mortality, especially in high risk patients. In elderly patients (>65 years old) with PE, thrombolytic therapy may be underused due to risk of hemorrhagic complications. In this study, we aimed to assess the effectiveness and safety of thrombolytic therapy among elderly patients with PE. 363 patients (205 subjects in study group, 158 subjects in control group) who were admitted to our hospital with PE were enrolled to the study. The patients were divided into subgroups according to their age and treatment strategy. Mortality rates and bleeding complications according to TIMI bleeding criteria in 30 days and 1-year were analyzed. In elderly patients, total mortality (7.8 vs. 20.1 %, p = 0.05) and mortality at 1-year follow-up (1.9 vs. 12.9 %, p = 0.03) was significantly lower in patients who received thrombolytic treatment. Difference in total bleeding (9.8 vs. 4.5 %, p = 0.18) and major bleeding (3.9 vs. 0.6 %, p = 0.10) in thrombolytic and non-thrombolytic groups was non-significant. Thrombolytic therapy is associated with lower mortality and acceptable bleeding complication rates in PE patients older than 65 years old.
    Journal of Thrombosis and Thrombolysis 04/2015; DOI:10.1007/s11239-015-1214-6 · 2.04 Impact Factor
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    ABSTRACT: Digoxin remains widely used today despite its narrow therapeutic index and toxicity. The objective of this study was to investigate the percentage of inappropriate use of digoxin and long-term outcomes of elderly patients hospitalized for digoxin toxicity. The study included 99 consecutive patients hospitalized for digoxin toxicity. The other study criteria for the inappropriate use of digoxin was regarded if participants having depressed left ventricular systolic function (ejection fraction < 45%) who were not on optimal medical therapy including beta-blocker and angiotensin-converting-enzyme inhibitor therapy or if participants having permanent AF who were not on optimal beta-blocker therapy. Appropriate digoxin usage was confirmed in 33 of patients in spite of its narrow therapeutic index. A total of 16 of 99 patients died, with a mean follow-up time of 22.1 ± 10.3 months. Contrary to popular belief, the rate of inappropriate digoxin usage remains high. On account of its narrow therapeutic index and toxicity, digoxin should be used more carefully according to the current evidence and guidelines.
    Journal of Geriatric Cardiology 03/2015; 12(2):143-6. DOI:10.11909/j.issn.1671-5411.2015.02.007 · 1.06 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2014; 14(5). DOI:10.5152/akd.2014.5282 · 0.76 Impact Factor
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    ABSTRACT: The concept that coronary artery ectasia (CAE) is an inflammatory-related disease has been increasingly recognized. Periodontitis induced low-grade chronic systemic inflammation has been shown to be associated with cardiovascular diseases. The aim of the present study was to evaluate the association between periodontitis and CAE.Thirty-two patients with isolated CAE, and 28 age, sex and smoking status-matched subjects with normal coronary arteries (NCA) underwent full dental examinations. Periodontal disease was evaluated using the following clinical parameters; number of remaining teeth, plaque index (PI), gingival index (GI), bleeding on probing (BOP), and pocket depth (PD).Cases and controls did not differ according to their baseline characteristics and prevalence of traditional cardiovascular risk factors. Patients with isolated CAE had higher periodontal indices when compared to subjects with NCA (PD: 3.6 ± 1.26 mm versus 2.3 ± 0.79 mm; GI: 2.29 ± 0.86 versus 1.43 ± 1.19; BOP (%): 52.18 ± 20.1 versus 27.8 ± 10.9, P < 0.001, P < 0.05 and P < 0.05, respectively). Moreover, in multivariate analysis higher values for PD were found to be significant predictors for the likelihood of having coronary ectasia.The results of the present study demonstrate for the first time that there is an association between periodontitis and isolated CAE.
    International Heart Journal 06/2014; DOI:10.1536/ihj.13-361 · 1.13 Impact Factor
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    ABSTRACT: Demographic and clinical characteristics and angiographic findings of Turkish patients with coronary artery fistula have been investigated in this study and diagnostic tests and treatment methods used in these patients have also been evaluated in detail. We have examined the cardiac catheterization laboratory database retrospectively between March 2006 and July 2010. Among 49,567 patients, we have noted 60 patients diagnosed as coronary artery fistula. After coronary angiographic images were evaluated by two invasive cardiologists, 54 patients who had clear evidence of vessel of origin and drainage were included in the study. A total of 54 (0.1%) patients with coronary artery fistula were noted. Mean age was 56.7 ± 10.7 years; 42 out of 54 patients had accompanying cardiac disorders. Patients complaints were directly associated with the presence of the fistula. Chest pain was the admission symptom in all of the patients with isolated coronary artery fistula. Six patients had coexistent congenital anomalies. Myocardial infarction with ST segment elevation occurred in 11 of the patients. In contrast to the previous reports, the most common artery of origin of the fistula was left anterior descending artery (50.8%) and pulmonary artery was found to be the most frequent region of the fistula drainage by 53.7%. Our findings suggest that large fistulas originating from the proximal segments of coronary arteries may increase the likelihood of atherosclerosis and myocardial infarction even in asymptomatic patients with no evidence of ischemia in noninvasive tests and no dilatation of cardiac chambers, and should therefore be closed.
    Cardiology journal 05/2012; 19(3):278-86. DOI:10.5603/CJ.2012.0050 · 1.22 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 05/2011; 11(3):272-4. DOI:10.5152/akd.2011.066 · 0.76 Impact Factor
  • International Journal of Cardiology 03/2011; 147. DOI:10.1016/S0167-5273(11)70209-1 · 6.18 Impact Factor
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    ABSTRACT: Atherosclerotic plaques tend to involve arterial localizations in which blood flow is not laminar due to arterial bends and bifurcations. A 49-year-old man was admitted to hospital with breathlessness and was subsequently diagnosed with left ventricular failure. Coronary angiography revealed three-vessel coronary artery disease and an anomalous extra left anterior descending artery taking off from the right sinus of Valsalva and spared from atherosclerosis. The absence of side branches and the relative lack of bends in arterial geometry were considered to be the cause of resistance to atherosclerosis. The present case identifies local flow conditions as an important factor determining the genesis of atherosclerosis in arterial segments.
    International Journal of Angiology 01/2010; 19(2):e91-3. DOI:10.1055/s-0031-1278370
  • Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 10/2009; 37(7):514.