Mehmet Baran Karataş

Istanbul Training and Research Hospital, İstanbul, Istanbul, Turkey

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Publications (24)37.91 Total impact


  • No preview · Article · Feb 2016 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
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    ABSTRACT: Background: CHA2DS2-VASc score has been validated in risk prediction for stroke and thromboembolism in patients with atrial fibrillation (AF). Association of CHA2DS2-VASc score with higher risk of venous thromboembolism and pulmonary embolism (PE) has also been shown. In this study, we investigated the long-term prognostic value of CHA2DS2-VASc score in patients with acute pulmonary embolism (APE).
    No preview · Article · Jan 2016 · Clinical and Applied Thrombosis/Hemostasis
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    ABSTRACT: Thrombosis and distal embolization play crucial role in the etiology of no-reflow. CHA2DS2-VASc score is used to estimate the risk of thromboembolism in patients with atrial fibrillation. We tested the hypothesis that CHA2DS2-VASc can predict no-reflow among patients who underwent primary percutaneous coronary intervention (PCI). A total number of 2375 consecutive patients with ST-segment elevation myocardial infarction were assessed for the study. Patients were divided into 2 groups as no-reflow (n = 111) and control (n = 1670) groups according to post-PCI no-reflow status. CHA2DS2-VASc scores were calculated for all patients. CHA2DS2-VASc scores were significantly higher in the no-reflow group compared to the control group. After a multivariate regression analysis, CHA2DS2-VASc score remained as an independent predictor (odds ratio: 1.58, 95% confidence interval: 1.33-1,88, P < .001) of no-reflow. Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥2 as a predictor of no-reflow with a sensitivity of 66% and a specificity of 59%. Moreover, in-hospital mortality was also associated with significantly higher CHA2DS2-VASc scores. In conclusion, CHA2DS2-VASc score is associated with higher risk of no-reflow and in-hospital mortality rates in patients who underwent primary PCI.
    No preview · Article · Dec 2015 · Angiology
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    ABSTRACT: Objectives: New-onset atrial fibrillation (NOAF) during hospitalization is considered a frequent complication associated with worse outcomes in the setting of ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of admission serum laboratory parameters, neutrophil to lymphocyte ratio (NLR), and monocyte to high-density lipoprotein ratio (MHR) with NOAF in STEMI patients treated with a primary percutaneous coronary intervention (PCI). Patients and methods: A total of 621 patients who were hospitalized with a diagnosis of STEMI and treated with primary PCI were retrospectively enrolled in the study. NOAF during index hospitalization and overall mortality were reported as the clinical outcomes. Results: In our study population, 40 (6.4%) patients developed NOAF during index hospitalization. Monocyte counts, mean platelet volume (MPV), red cell distribution width (RDW), NLR, MHR, C-reactive protein (CRP), creatinine, glucose, and uric acid levels were higher in the NOAF+ group compared with the NOAF- group. In multivariate regression analysis, age, left-ventricular ejection fraction, left atrial volumes, admission heart rate, multivessel disease, increased levels of CRP, MPV, RDW, uric acid, NLR, and MHR independently predicted NOAF. In addition, NOAF was found to be an independent predictor of overall mortality in the study population. Conclusion: For the first time in the literature, admission serum levels of MPV, RDW, uric acid, NLR, and MHR were found to be correlated independently with NOAF after primary PCI.
    No preview · Article · Dec 2015 · Coronary Artery Disease
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    ABSTRACT: Background: Serum cholesterols play an important role in pathophysiology and prognosis of acute thrombotic diseases. The aim of the present study was to investigate the prognostic value of serum lipid parameters in acute pulmonary embolism (APE). Methods: From January 2008 to January 2014 a total of 275 patients who were hospitalised with a diagnosis of APE were retrospectively screened. Clinical data, laboratory parameters, serum cholesterol levels were recorded and pulmonary embolism severity index (PESI) scores were calculated. Mortality rate at 30 days was investigated as the clinical outcome. Results: In our study population, 24 patients (8.7%) died within 30 days. Serum total cholesterol, LDL-C, HDL-C and triglyceride levels were significantly lower in deceased patients when compared to the survived patients (3.1 ± 0.6 vs. 4.7 ± 1.2 mmol/L, p < 0.01; 1.8 ± 0.9 vs. 2.9 ± 0.9 mmol/L, p < 0.01; 0.9 ± 0.3 vs. 1.2 ± 0.3 mmol/L, p < 0.01; 1.4 ± 0.7 vs. 1.7 ± 0.6 mmol/L, p = 0.04, respectively). In multivariate regression analysis; PESI scores (OR: 1.06 95% CI: 1.01-1.11, p < 0.01), right ventricular diameter (OR: 11.31 95% CI: 3.25-52.64, p < 0.01), total cholesterol (OR: 1.09 95% CI: 1.02-1.17, p < 0.01), LDL-C (OR: 1.06 95% CI: 1.01-1.12, p = 0.02), HDL-C (OR: 1.21 95% CI: 1.04-1.41, p < 0.01) and triglyceride (OR: 1.03 95% CI: 1.01-1.05, p < 0.01) levels were independently correlated with mortality. Conclusions: Serum total cholesterol, LDL-C, HDL-C and triglyceride levels, obtained within the first 24hours of hospital admission, may have prognostic value in patients with APE.
    No preview · Article · Nov 2015 · Heart, Lung and Circulation
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    ABSTRACT: Background: Blood pressure variability (BPV) is a novel parameter related to adverse cardiovascular findings and events, especially in hypertensive patients. The aim of the present study was to investigate the relationship between short-term BPV and ascending aortic dilatation (AAD). Hypothesis: Hypertensive patients with AAD may exhibit higher short-term BPV compared to hypertensive patients with normal diameter ascending aorta and BPV may be correlated with aortic sizes. Methods: Seventy-six hypertensive patients with AAD and 181 hypertensive patients with a normal-diameter ascending aorta were retrospectively enrolled in the study. Clinical data, echocardiographic characteristics, and 24-hour ambulatory blood pressure monitoring characteristics were compared between the 2 groups. Standard deviation (SD) and Δ of BP were used as parameters of BPV. Results: Although 24-hour mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similar between the 2 groups, the SD of SBP and SD of DBP values were significantly higher in AAD patients (17.2 ± 6.8 vs 13.8 ± 3.5, P < 0.01; and 12.1 ± 5.1 vs 10.7 ± 3.1, P = 0.02, respectively). Daytime SD of SBP values were higher in AAD patients, whereas nighttime SD of SBP values did not differ between groups. In multivariate linear regression analysis, 24-hour SD of SBP, 24-hour Δ SBP, daytime SD of SBP, daytime Δ SBP, and left ventricular mass index were independently correlated with aortic size index. Conclusions: Our study revealed higher levels of short-term BPV in hypertensive patients with AAD. This conclusion warrants further study.
    Full-text · Article · Nov 2015 · Clinical Cardiology
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    ABSTRACT: Background: Monocyte count to high-density lipoprotein ratio (MHR) has recently emerged as an indicator of inflammation and oxidative stress in the literature. We aimed to investigate the prognostic value of MHR in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI). Methods: A total of 513 patients who were hospitalized with diagnosis of acute ST-segment elevation myocardial infarction and treated with primary PCI were retrospectively enrolled in the study. Demographic and clinical data, admission laboratory parameters, and MHR values were recorded. Inhospital major adverse cardiac events (MACE) and mortality were reported as the clinical outcomes. Results: Twenty-six patients (5%) died, and MACE was observed in 86 patients (17%) during hospital follow-up. Patients were categorized in 3 groups according to tertiles of admission MHR. The rates of inhospital mortality and MACE were significantly higher in tertile 3 group compared to tertile 1 group (10% vs 1%, 27% vs 11%; P < .01 and P < .01). In multivariate regression analysis, age, sex, presence of Killip 3 or 4, left ventricular ejection fraction, troponin I, C-reactive protein, and increased MHR levels (odds ratio, 1.03; 95% confidence interval, 1.01-1.05; P < .01) independently predicted inhospital mortality; age, presence of Killip 3 or 4, troponin I, and increased MHR levels (odds ratio, 1.02; 95% confidence interval, 1.01-1.04; P < .01) independently predicted MACE. Conclusion: Admission MHR values were found to be independently correlated with inhospital MACE and mortality after primary PCI.
    No preview · Article · Oct 2015 · The American journal of emergency medicine
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    ABSTRACT: The relationship between psychiatric illness and heart disease has been frequently discussed in the literature. The aim of the present study was to investigate the relationship between anxiety, depression and overall psychological distress, and coronary slow flow (CSF). In total, 44 patients with CSF and a control group of 50 patients with normal coronary arteries (NCA) were prospectively recruited. Clinical data, admission laboratory parameters, and echocardiographic and angiographic characteristics were recorded. Symptom Checklist 90 Revised (SCL-90-R), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scales were administered to each patient. The groups were comparable with respect to age, sex, and atherosclerotic risk factors. In the CSF group, BAI score, BDI score, and general symptom index were significantly higher than controls (13 [18.7] vs. 7.5 [7], p = 0.01; 11 [14.7] vs. 6.5 [7], p = 0.01; 1.76 [0.81] vs. 1.1[0.24], p = 0.01; respectively). Patients with CSF in more than one vessel had the highest test scores. In univariate correlation analysis, mean thrombolysis in myocardial infarction (TIMI) frame counts were positively correlated with BAI (r = 0.56, p = 0.01), BDI (r = 0.47, p = 0.01), and general symptom index (r = 0.65, p = 0.01). The psychiatric tests were not correlated with risk factors for atherosclerosis. Our study revealed higher rates of depression, anxiety, and overall psychological distress in patients with CSF. This conclusion warrants further studies.
    No preview · Article · Aug 2015 · Arquivos brasileiros de cardiologia
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    ABSTRACT: This study aimed to evaluate the relationship between the neutrophil-to-lymphocyte (N/L) ratio and left ventricular free wall rupture (LVFWR) in patients with ST elevation myocardial infarction (STEMI). Previous studies showed a correlation between increased levels of inflammatory markers and adverse cardiovascular events. The role of inflammation markers, particularly the N/L ratio, in mechanical complications after myocardial infarction has not been studied. Retrospectively, we compared the N/L ratio values of 23 patients with STEMI complicated by LVFWR with 214 STEMI patients without this complication. The diagnosis of rupture was confirmed by echocardiography in each case. Neutrophil counts [median 8.5 × 10(3)/µl, interquartile range (IQR) 6.4, vs. 7.8 × 10(3)/µl, IQR 4.7, p = 0.02] and the N/L ratio (5.66, IQR 4.17, vs. 4.1, IQR 3.93, p = 0.01) were significantly higher in the LVFWR group. In receiver operating characteristic analysis, an N/L ratio above 3.7 predicted LVFWR with a sensitivity of 82.6% and a specificity of 46.9% (area under the curve = 0.654, p = 0.016). In multivariate regression analysis, age, hypertension, increased creatinine levels and increased N/L ratio (odds ratio = 1.61, 95% confidence interval = 1.15-2.23, p = 0.01) were found to be independent predictors of LVFWR. In our study, the N/L ratio was found to be independently correlated with the risk of LVFWR. © 2015 S. Karger AG, Basel.
    No preview · Article · Jun 2015 · Cardiology
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    ABSTRACT: Electrocution injury (EI) is a major problem in developing countries. The aim of this study is to investigate the effect of EI on electrocardiographic (ECG) parameters. A total of 43 patients hospitalized with diagnosis of EI were prospectively enrolled. Admission ECGs were compared with follow-up ECGs obtained one month after the event. Maximum P wave duration (Pmax), minimum P wave duration (Pmin), P wave dispersion (PWD), PR interval, QRS complex duration, corrected QT duration (QTc), QT dispersion (QTD), T peak to T end (Tp-e) interval were longer and Tp-e interval/QT and Tp-e interval/QTc ratios were higher on admission ECGs compared to follow-up ECGs. Frontal QRS-T angle and frequency of patients with fragmented QRS were also higher on admission ECGs. Our study revealed that EI causes significant deterioration of admission ECG parameters. The clinical use of these parameters in prediction of arrhythmias after EI warrants further studies. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Jun 2015 · Journal of electrocardiology
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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.
    No preview · Article · Apr 2015 · Journal of Thrombosis and Thrombolysis

  • No preview · Article · Mar 2015 · The American Journal of Cardiology

  • No preview · Article · Mar 2015 · The American Journal of Cardiology
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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.
    Full-text · Article · Mar 2015 · Journal of Geriatric Cardiology

  • No preview · Article · Jan 2015 · Cardiology
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    Full-text · Article · Jun 2014 · Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
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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.
    No preview · Article · Jun 2014 · International Heart Journal
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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.
    Full-text · Article · May 2012 · Cardiology journal
  • Y. Çanga · M.B. Karataş · V. Kirbaş · S. Özcan · G. Durmuş

    No preview · Article · Mar 2012 · Turkiye Klinikleri Cardiovascular Sciences
  • Y. Çanga · K.S. Özcan · M.B. Karataş · G. Durmuş · I.C. Erdinler
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    ABSTRACT: Rheumatoid arthritis (RA) is a chronic multisystem disease of unknown cause which affects approximately 1% of the population. The typical characteristic of RA is persistent inflammatory synovitis which usually involves peripheral joints in a symmetric distribution. Systemic involvements of RA include pericarditis, pleuritis, vasculitis, entrapment neuropathy, interstitial lung disease and Sjogren and Felty syndromes. Echocardiographic and postmortem studies have shown that RA affects pericardium in nearly 50% of the patients. However, cardiac tamponade is a rare complication of RA. In this report, we present a surgically-treated 61-year-old female patient with cardiac tamponade secondary to loculated pericardial effusion.
    No preview · Article · Jan 2012 · Turkish journal of rheumatology