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Coronary Artery Disease: HELP
Articles by Aylin Yıldırır
Based on 16 articles published since 2008

Between 2008 and 2019, A. Yildirir wrote the following 16 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Guideline 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. 2013

Anonymous3190768 / Montalescot, Gilles / Sechtem, Udo / Achenbach, Stephan / Andreotti, Felicita / Arden, Chris / Budaj, Andrzej / Bugiardini, Raffaele / Crea, Filippo / Cuisset, Thomas / Di Mario, Carlo / Ferreira, J Rafael / Gersh, Bernard J / Gitt, Anselm K / Hulot, Jean-Sebastien / Marx, Nikolaus / Opie, Lionel H / Pfisterer, Matthias / Prescott, Eva / Ruschitzka, Frank / Sabaté, Manel / Senior, Roxy / Taggart, David Paul / van der Wall, Ernst E / Vrints, Christiaan J M / Anonymous3200768 / Zamorano, Jose Luis / Achenbach, Stephan / Baumgartner, Helmut / Bax, Jeroen J / Bueno, Héctor / Dean, Veronica / Deaton, Christi / Erol, Cetin / Fagard, Robert / Ferrari, Roberto / Hasdai, David / Hoes, Arno W / Kirchhof, Paulus / Knuuti, Juhani / Kolh, Philippe / Lancellotti, Patrizio / Linhart, Ales / Nihoyannopoulos, Petros / Piepoli, Massimo F / Ponikowski, Piotr / Sirnes, Per Anton / Tamargo, Juan Luis / Tendera, Michal / Torbicki, Adam / Wijns, William / Windecker, Stephan / Anonymous3210768 / Knuuti, Juhani / Valgimigli, Marco / Bueno, Héctor / Claeys, Marc J / Donner-Banzhoff, Norbert / Erol, Cetin / Frank, Herbert / Funck-Brentano, Christian / Gaemperli, Oliver / Gonzalez-Juanatey, José R / Hamilos, Michalis / Hasdai, David / Husted, Steen / James, Stefan K / Kervinen, Kari / Kolh, Philippe / Kristensen, Steen Dalby / Lancellotti, Patrizio / Maggioni, Aldo Pietro / Piepoli, Massimo F / Pries, Axel R / Romeo, Francesco / Rydén, Lars / Simoons, Maarten L / Sirnes, Per Anton / Steg, Ph Gabriel / Timmis, Adam / Wijns, William / Windecker, Stephan / Yildirir, Aylin / Zamorano, Jose Luis. ·The disclosure forms of the authors and reviewers are available on the ESC website www.escardio.org/guidelines. ·Eur Heart J · Pubmed #23996286.

ABSTRACT: -- No abstract --

2 Review [Valvular heart disease associated with coronary artery disease]. 2009

Yildirir, Aylin. ·Başkent Universitesi Tip Fakültesi, Kardiyoloji Anabilim Dali, Ankara, Türkiye. ayliny@baskent-ank.edu.tr ·Anadolu Kardiyol Derg · Pubmed #19581151.

ABSTRACT: Nowadays, age-related degenerative etiologies have largely replaced the rheumatic ones and as a natural result of this etiologic change, coronary artery disease has become associated with valvular heart disease to a greater extent. Degenerative aortic valve disease has an important pathophysiological similarity to atherosclerosis and is the leader in this association. There is a general consensus that severely stenotic aortic valve should be replaced during bypass surgery for severe coronary artery disease. For moderate degree aortic stenosis, aortic valve replacement is usually performed during coronary bypass surgery. Ischemic mitral regurgitation has recently received great attention from both diagnostic and therapeutic points of view. Ischemic mitral regurgitation significantly alters the prognosis of the patient with coronary artery disease. Severe ischemic mitral regurgitation should be corrected during coronary bypass surgery and mitral valve repair should be preferred to valve replacement. For moderate degree ischemic mitral regurgitation, many authors prefer valve surgery with coronary bypass surgery. In this review, the main characteristics of patients with coronary artery disease accompanying valvular heart disease and the therapeutic options based on individual valve pathology are discussed.

3 Article Platelet Membrane Γ-Glutamyl Transferase-Specific Activity and the Clinical Course of Acute Coronary Syndrome. 2019

Demirtaş, Koray / Yayla, Çağri / Sade, Leyla Elif / Yildirir, Aylin / Özin, Mehmet Bülent / Haberal, Ayşegül / Müderrisoğlu, Ibrahim Haldun. ·1 Department of Cardiology, Türkiye Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey. · 2 Faculty of Medicine, Department of Cardiology, Baskent University, Ankara, Turkey. · 3 Faculty of Medicine, Department of Biochemistry, Baskent University, Ankara, Turkey. ·Angiology · Pubmed #29996664.

ABSTRACT: γ-Glutamyl transferase (GGT) participates in oxidative and inflammatory reactions inside the atheroma plaque and platelets. We evaluated whether platelet membrane γ-glutamyl transferase (Plt-GGT) activity is a predictor of major adverse cardiac events (MACEs) during 3 months follow-up of patients with acute coronary syndrome (ACS; MACE-3M). We included 105 patients who were hospitalized consecutively with the diagnosis of ACS. Patients with an MACE-3M were older, more likely to have hypertension, hyperlipidemia, family history of coronary artery disease(CAD), thrombolysis in myocardial infarction (TIMI) risk score >4, higher Plt-GGT and serum GGT activities, serum C-reactive protein level, and lower left ventricular ejection fraction (LVEF) when compared to those without MACE-3M (all P values ≤.05). By receiver-operator characteristic (ROC) curve analysis, 265 mU/mg for Plt-GGT, 30 U/L for serum GGT, and 45% for LVEF were determined as cutoff values to discriminate MACEs. Platelet GGT activity >265 mU/mg, TIMI risk score >4, and family history of CAD were independent predictors of MACE-3M (all P values <.05). Platelet GGT activity was as an independent predictor for MACEs in patients with ACS during the 3 months follow-up.

4 Article Coronary artery disease detected by coronary computed tomography angiography is associated with red cell distribution width. 2016

Karaçağlar, Emir / Bal, Uğur / Hasırcı, Senem / Yılmaz, Mustafa / Doğanözü, Ersin / Coşkun, Mehmet / Atar, İlyas / Yıldırır, Aylin / Müderrisoğlu, Haldun. ·Department of Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey. dremirkaracaglar@hotmail.com. · Department of Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey. · Department of Cardiology, Başkent University Faculty of Medicine, Adana, Turkey. · Department of Radiology, Başkent University Faculty of Medicine, Ankara, Turkey. ·Turk Kardiyol Dern Ars · Pubmed #27774965.

ABSTRACT: OBJECTIVE: Increased red blood cell distribution width (RDW) is associated with severity of coronary artery disease (CAD). The aim of the present study was to retrospectively evaluate the relationship between CAD detected by coronary computed tomography angiography (CCTA) and RDW. METHODS: Records of 291 patients who underwent 16-slice CCTA due to the presence of angina-like chest pain were retrospectively evaluated. Exclusion criteria were applied. Clinical characteristics, risk factors for CAD, and RDW values on CCTA were noted. RESULTS: RDW levels in patients with CAD were significantly higher than in those with normal coronary arteries (NCAs) (15.50±1.57 compared to 14.80±1.41, p=0.001). Diabetes mellitus, hypertension, and history of smoking were significantly more common in the CAD group (p=0.018, p=0.007, and p=0.013, respectively). On multivariate logistic regression analysis, RDW (p=0.009 [odds ratio (OR): 1.352; 95% confidence interval (CI): 1.081-1.683]), age (p<0.001 [OR: 1.063; 95% CI 1.031-1.090]), and history of smoking (p=0.003 [OR: 2.672; 95% CI: 1.360-5.232]) were shown to be independent predictors for CAD detected by CCTA. CONCLUSION: The present results suggest that higher RDW levels are independently associated with presence of CAD detected by CCTA in patients without known CAD. Further studies are warranted to clarify the exact role of RDW in risk stratification.

5 Article Serum cystatin C and neutrophil gelatinase-associated lipocalin in predicting the severity of coronary artery disease in diabetic patients. 2016

Okyay, Kaan / Yıldırır, Aylin / Çiçek, Mutlu / Aydınalp, Alp / Müderrisoğlu, Haldun. ·Department of Cardiology, Faculty of Medicine, Başkent University Ankara Education and Research Hospital, Ankara-Turkey. drokyay@yahoo.com. · Department of Cardiology, Faculty of Medicine, Başkent University Ankara Education and Research Hospital, Ankara-Turkey. ·Anatol J Cardiol · Pubmed #27182610.

ABSTRACT: OBJECTIVE: Cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) are biomarkers of renal functions. We evaluated their roles in predicting the severity of coronary artery disease (CAD). METHODS: Fifty-two consecutive type 2 diabetic patients (32 males, 65.7±8.6 years) who underwent coronary angiography (CAG) for stable CAD were included in this single-center, prospective, cross-sectional study. Patients with an estimated glomerular filtration rate <60 mL/min/1.73 m2 and with a history of by-pass surgery and/or coronary stent implantation were excluded. The vessel score and Gensini score were calculated to assess the presence and severity of CAD. Mann-Whitney U test, Spearman test, and multiple linear regression analysis were used for the main statistical analyses. RESULTS: Serum cystatin C levels were higher in patients with multivessel disease than in those with single vessel disease [1260 ng/mL (953-1640) vs. 977 ng/mL (599-1114), p=0.017]. According to the median Gensini score, the higher score group also had higher cystatin C levels than the lower score group [1114 ng/mL (948-1567) vs. 929 ng/mL (569-1156), p=0.009]. However, serum NGAL levels were similar between these subgroups. There was a positive correlation between cystatin C and Gensini score (r=0.334, p=0.016). Multiple linear regression analysis revealed serum cystatin C as an independent predictor of the Gensini score (ß=0.360, t=2.311, p=0.026). These results may aid in defining cystatin C as a surrogate marker of the extent of CAD in further clinical trials. CONCLUSION: Serum Cystatin C, but not NGAL levels, could predict the severity of CAD in diabetic patients.

6 Article Hematological parameters can predict the extent of coronary artery disease in patients with end-stage renal disease. 2015

Bal, Zeynep / Bal, Ugur / Okyay, Kaan / Yilmaz, Mustafa / Balcioglu, Serhat / Turgay, Ozge / Hasirci, Senem / Aydinalp, Alp / Yildirir, Aylin / Sezer, Siren / Muderrisoglu, Haldun. ·Department of Nephrology, Baskent University School of Medicine, Fevzi Cakmak Caddesi 10. Sokak No: 45, 06490, Bahcelievler, Ankara, Turkey. zeynepberki@yahoo.com. · Department of Cardiology, Baskent University School of Medicine, Fevzi Cakmak Caddesi 10. Sokak No: 45, 06490, Bahcelievler, Ankara, Turkey. · Department of Nephrology, Baskent University School of Medicine, Fevzi Cakmak Caddesi 10. Sokak No: 45, 06490, Bahcelievler, Ankara, Turkey. ·Int Urol Nephrol · Pubmed #26246038.

ABSTRACT: PURPOSE: Aside from traditional factors (e.g., diabetes, age, and hypertension), some hematological parameters, such as neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), have increasingly been reported as measures of systemic inflammation and atherosclerosis in patients with end-stage renal disease (ESRD). This study aimed to determine whether there is an association between these hematological parameters and the extent of coronary artery disease (CAD) in patients with ESRD. METHODS: A total of 149 consecutive ESRD patients (66 % males) without established CAD were studied. NLR, RDW, and MPV values in all patients were calculated from the complete blood count before coronary angiography. Angiographic views were assessed by an experienced interventional cardiologist, and the extent of CAD was evaluated by the Gensini score. The patients were divided into quartiles of the Gensini score. RESULTS: Age, time on dialysis, calcium-phosphorus product, C-reactive protein levels, NLR, and MPV were significantly different among the groups (all p < 0.05). The Gensini score was correlated with age, time on dialysis (both p < 0.001), NLR (p = 0.004), and C-reactive protein levels (p = 0.034) and inversely correlated with left ventricular ejection fraction (p = 0.023). Multivariate regression analysis showed that age (p = 0.001), time on dialysis (p < 0.001), NLR (p = 0.001), and MPV (p = 0.005) were independent predictors of the extent of CAD. CONCLUSIONS: Aside from the well-known traditional factors, NLR and MPV are independent predictors of the extent of CAD in patients with ESRD.

7 Article Coronary anatomy, anatomic variations and anomalies: a retrospective coronary angiography study. 2015

Altin, Cihan / Kanyilmaz, Suleyman / Koc, Sahbender / Gursoy, Yusuf Cemil / Bal, Uğur / Aydinalp, Alp / Yildirir, Aylin / Muderrisoglu, Haldun. ·Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey. ·Singapore Med J · Pubmed #25502334.

ABSTRACT: INTRODUCTION: The incidence of coronary artery anomalies (CAAs) varies from 0.2% to 8.4%. Knowledge of such anatomical variations is important as coronary procedures are regularly performed these days. We aimed to find the coronary dominance pattern, intermediate artery (IMA) frequency and CAA incidence in our clinic, and compare them to those in the literature. METHODS: The medical reports of 5,548 patients who had undergone coronary angiography (CAG) between 2005 and 2009 were retrospectively investigated. Dominance pattern and presence of IMA and CAA were recorded. CAAs were described using two different classifications: Angelini and Khatami's classification, and a new modified classification that was derived from Angelini and Khatami's classification. Some procedural details and clinical features of the patients with CAA were also investigated. RESULTS: Coronary dominance pattern was: 81.6% right coronary artery, 12.2% circumflex artery and 6.2% co-dominant. IMA was present in 613 (11.0%) patients. The incidences of overall anomaly were 2.7% and 1.4%, according to the different classifications. Absent left main coronary artery, which was the most common anomaly in the present study, was found in 51 (0.9%) patients. Incidences of myocardial bridge, coronary arteriovenous fistulae and aneurysms were 1.1%, 0.2% and 0.3%, respectively. CONCLUSION: CAAs are generally asymptomatic, isolated lesions. Some may lead to anginal symptoms, myocardial infarction or sudden death. We found that CAA was associated with increased radiation and contrast exposure in patients who underwent CAG. This risk could be reduced if appropriate catheters were designed and training programmes on ostial cannulation were developed.

8 Article [Serum gamma-glutamyltransferase activity: a new marker for coronary artery bypass graft disease]. 2011

Ulus, Taner / Yıldırır, Aylin / Sade, Leyla Elif / Balta, Sevket / Ozin, Bülent / Sezgin, Atilla / Müderrisoğlu, Haldun. ·Department of Cardiology, Medicine Faculty of Başkent University, Ankara, Turkey. tanerulus@hotmail.com ·Turk Kardiyol Dern Ars · Pubmed #21532296.

ABSTRACT: OBJECTIVES: Serum gamma-glutamyltransferase (GGT) activity has been shown to be related to the development of atherosclerosis and cardiovascular events. We evaluated the association between GGT and severe graft disease in patients undergoing coronary artery bypass graft (CABG) surgery. STUDY DESIGN: We evaluated 113 patients (mean age 62±9 years; range 21 to 81 years) who underwent control coronary angiography after a mean of 39 months (range 18 to 84 months) following CABG surgery. A graft was considered patent if there was <70% stenosis or severely diseased if there was ≥70% stenosis on coronary angiography. Preoperative serum GGT levels were measured in all the patients and none had severe systemic or hepatobiliary disease. The association between serum GGT level and severe graft disease was investigated. The grafts were also evaluated separately. RESULTS: Coronary angiography showed severe graft disease involving at least one graft in 65 patients (57.5%). Serum GGT level was significantly higher in patients with severe graft disease (p=0.001). ROC curve analysis yielded a cut-off value of 29.5 U/l for serum GGT level to predict severe graft disease (area under the curve: 0.69) with 48% sensitivity and 82% specificity. While GGT levels were similar for internal mammary artery grafts (p>0.05), radial artery grafts and saphenous vein grafts (SVG) with severe graft disease were associated with significantly higher GGT levels (p=0.003 and p<0.001, respectively). In multivariate analysis, family history of coronary artery disease at a young age (OR 2.46, 95% CI 1.08-5.61, p=0.03) and serum GGT (OR 1.03, 95% CI 1.00-1.07, p=0.05) were independent predictors of severe graft disease. Separate analysis based on the graft types showed that GGT was an independent predictor of severe graft disease for only SVG (OR 1.02, 95% CI 1.00-1.04, p=0.03). CONCLUSION: Serum GGT level may be an independent marker for the development of severe SVG disease in patients undergoing CABG surgery.

9 Article Is there any relationship between coronary artery disease and postprandial triglyceride levels? 2011

Atar, Inci Aslı / Atar, Ilyas / Aydınalp, Alp / Ertan, Cağatay / Bozbaş, Hüseyin / Ozin, Bülent / Yıldırır, Aylin / Müderrisoğlu, Haldun. ·Cardiology Clinic, Güven Hospital, Ankara, Turkey. ·Anadolu Kardiyol Derg · Pubmed #21421512.

ABSTRACT: OBJECTIVE: We aimed to evaluate the relationship between postprandial triglyceride (PPTG) levels and coronary artery disease (CAD). METHODS: A total of 80 patients were included in this prospective cohort study. Oral lipid loading was used in order to measure PPTG levels. In the fasting state and after the high fat breakfast, triglyceride levels were measured by enzymatic methods at 2nd, 4th, 6th and 8th hours. We made subgroup analysis to show the effects of lipid loading on triglyceride levels in patients with and without fasting hypertriglyceridemia. We evaluated triglyceride levels and changes of triglyceride levels in percentages after lipid loading using a general linear model for repeated measures. Sample size analysis was performed. RESULTS: Baseline clinical, demographic and laboratory characteristics of both groups were similar. The peak triglyceride levels were seen at the 4th hour in both groups. Triglyceride levels were significantly increased after lipid-rich-breakfast loading compared to baseline levels in both groups (p<0.001) but these changes were not significant (p=0.279). In patients with elevated fasting triglyceride levels, the area under the plasma triglyceride concentration curve was significantly larger in CAD group than control group (334±103 vs. 233±58 mg/dl, p=0.02). CONCLUSION: Our data show that in patients who have a high fasting triglyceride level, high levels of PPTG may be related to CAD, however high PPTG levels are not related to CAD in patients with normal fasting levels of triglyceride.

10 Article Determinants of coronary artery disease in liver transplant candidates. 2010

Aydinalp, Alp / Atar, Ilyas / Bal, Ugur / Aktas, Ayse / Ertan, Cagtay / Atar, Asli / Yildirir, Aylin / Ozin, Bulent / Muderrisoglu, Haldun / Haberal, Mehmet. ·Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey. alpaydinalp@superonline.com ·Exp Clin Transplant · Pubmed #20565371.

ABSTRACT: OBJECTIVES: The potential for perioperative and late cardiovascular complications in liver transplant candidates makes careful preoperative risk assessment imperative. We sought to identify the determinants of coronary artery disease in liver transplant candidates. MATERIALS AND METHODS: Liver transplant candidates with end-stage liver disease who were more than 40 years old and undergoing coronary angiography were retrospectively included in this study. Patients with known coronary heart disease or valvular heart disease were excluded. Symptoms, coronary artery disease risk factors, blood tests, electrocardiogram, echocardiography, treadmill stress test, myocardial perfusion scintigraphy, and coronary angiography results were recorded. A multivariable logistic regression model was used to assess the independent predictors of coronary artery disease. RESULTS: A total of 139 patients (mean age, 52 +/- 8; 110 male [79%]) were included in the analysis. Coronary angiography revealed that 13 patients (9.4%) had coronary artery disease. The frequency of diabetes mellitus, stable angina symptoms, positive smoking status, presence of 2 or more risk factors for coronary artery disease, and mean low-density lipoprotein cholesterol levels were significantly higher in patients with coronary artery disease than in patients without coronary artery disease. The electrocardiogram, echocardiography, and noninvasive stress test results were not valuable tools in liver transplant candidates for the diagnosis of coronary artery disease. In multivariate analysis, typical angina symptoms and low-density lipoproteins cholesterol levels appeared to be independent factors that were predictive of coronary artery disease. CONCLUSIONS: Typical anginal symptoms and low-density lipoprotein cholesterol levels seem to be the best predictors of coronary artery disease in liver transplant candidates.

11 Article Value of stress myocardial perfusion scanning in diagnosis of severe coronary artery disease in liver transplantation candidates. 2009

Aydinalp, A / Bal, U / Atar, I / Ertan, C / Aktaş, A / Yildirir, A / Ozin, B / Mudderisoglu, H / Haberal, M. ·Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey. alpaydinalp@superonline.com ·Transplant Proc · Pubmed #19917381.

ABSTRACT: BACKGROUND: The significant potential for perioperative and late cardiovascular complications makes careful preoperative cardiac risk assessment imperative in liver transplantation candidates. OBJECTIVE: To determine the sensitivity and specificity of myocardial perfusion scanning for detection of coronary artery disease (CAD) in liver transplantation candidates. PATIENTS AND METHODS: We prospectively evaluated 93 liver transplantation candidates. Patients with known CAD were excluded. All patients, regardless of symptoms and risk factors, underwent myocardial perfusion scanning and coronary angiography. RESULTS: Results of myocardial perfusion scanning were abnormal in 64 patients (68.8%) and normal in 29 patients (31.2%). Of patients with abnormal scans, only 6 (9.4%) had severe CAD at coronary angiography. None of the 29 patients with normal perfusion scans and the 24 patients with fixed defects had severe CAD; however, 6 of 40 patients (15.0%) with reversible perfusion defects had severe CAD at coronary angiography (P = .005). Alcoholic liver disease, reversible perfusion defects at myocardial perfusion scanning, left ventricular systolic dysfunction, and higher low-density lipoprotein (LDL) cholesterol and triglyceride levels were significantly associated with CAD. Defining reversible perfusion defects as a sign of ischemia, and fixed defects and normal perfusion as nonischemic, myocardial perfusion scanning had 100% sensitivity but 61% specificity for severe CAD. The test's accuracy was low (38%). CONCLUSIONS: The results of reversible perfusion defects on myocardial perfusion scanning were sensitive but not specific for CAD in liver transplantation candidates. The high number of false-positive results decreased the test's accuracy.

12 Article Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. 2009

Eroglu, S / Sade, L E / Yildirir, A / Bal, U / Ozbicer, S / Ozgul, A S / Bozbas, H / Aydinalp, A / Muderrisoglu, H. ·Department of Cardiology, Baskent University Faculty of Medicine, 10.sok No:45, 06490 Bahcelievler, Ankara, Turkey. serpileroglu@gmail.com ·Nutr Metab Cardiovasc Dis · Pubmed #18718744.

ABSTRACT: BACKGROUND AND AIM: Epicardial adipose tissue (EAT), which is thought to be a component of visceral adiposity, is associated with the metabolic syndrome. We aimed to test the hypothesis that echocardiographic EAT thickness can be a marker for the presence and severity of coronary artery disease (CAD). METHOD AND RESULTS: In all, 150 patients (100 patients with CAD and 50 patients with normal coronary arteries by diagnostic coronary angiography; 65 women, 85 men; mean age 55.7+/-7.4 years) were enrolled. EAT thickness was measured using 2-D echocardiographic parasternal long- and short-axis views. EAT thickness measurements were compared with angiographic findings. EAT thickness was significantly higher in patients with CAD in comparison to those with normal coronary arteries (6.9+/-1.5 mm vs. 4.4+/-0.8 mm; P<0.001). Furthermore, EAT thickness increased with the severity of CAD (multivessel disease 7.4+/-1.2 mm vs. single vessel disease 5.7+/-1.7 mm; P<0.001). Gensini's score significantly correlated with EAT thickness (r=0.600, P<0.001). EAT thickness of > or = 5.2 mm had 85% sensitivity and 81% specificity (ROC area 0.914, P<0.001, 95% CI [0.86-0.96]) for predicting CAD. CONCLUSION: EAT thickness, which is easily and non-invasively evaluated by transthoracic echocardiography, can be an adjunctive marker to classical risk factors for the prediction of CAD.

13 Article Evaluation of coronary microvascular function in patients with end-stage renal disease, and renal allograft recipients. 2009

Bozbas, Huseyin / Pirat, Bahar / Demirtas, Saadet / Simşek, Vahide / Yildirir, Aylin / Sade, Elif / Sayin, Burak / Sezer, Siren / Karakayali, Hamdi / Muderrisoglu, Haldun. ·Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey. hbozbas@gmail.com ·Atherosclerosis · Pubmed #18550064.

ABSTRACT: BACKGROUND: Approximately half of all deaths in patients with end-stage renal disease (ESRD) are due to cardiovascular diseases. Although renal transplant improves survival and quality of life in these patients, cardiovascular events significantly affect survival. We sought to evaluate coronary flow reserve (CFR), an indicator of coronary microvascular function, in patients with ESRD and in patients with a functioning kidney graft. METHODS: Eighty-six patients (30 with ESRD, 30 with a functioning renal allograft, and 26 controls) free of coronary artery disease or diabetes mellitus were included. Transthoracic Doppler echocardiography was used to measure coronary peak flow velocities at baseline and after dipyridamole infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak flow velocities and was compared among the groups. RESULTS: The mean age of the study population was 36.1+/-7.3 years. No between-group differences were found regarding age, sex, or prevalences of traditional coronary risk factors other than hypertension. Compared with the renal transplant and control groups, the ESRD group had significantly lower mean CFR values. On multivariate regression analysis, serum levels of creatinine, age, and diastolic dysfunction were independent predictors of CFR. CONCLUSIONS: CFR is impaired in patients with ESRD suggesting that coronary microvascular dysfunction, an early finding of atherosclerosis, is evident in these patients. Although associated with a decreased CFR compared with controls, renal transplant on the other hand seems to have a favorable effect on coronary microvascular function.

14 Article The effects of prior calcium channel blocker therapy on creatine kinase-MB levels after percutaneous coronary interventions. 2008

Gulmez, Oyku / Atar, Ilyas / Ozin, Bülent / Korkmaz, Mehmet Emin / Atar, Asli / Aydinalp, Alp / Yildirir, Aylin / Muderrisoglu, Haldun. ·Baskent University Faculty of Medicine, Department of Cardiology, Oymaci sokak No: 7, Altunizade, Istanbul, Turkey. gulmezoyku@yahoo.com ·Vasc Health Risk Manag · Pubmed #19337554.

ABSTRACT: BACKGROUND: Use of intracoronary calcium channel blockers (CCBs) during percutaneous coronary intervention (PCI) has been shown to have favorable effects on coronary blood flow. We aimed to investigate the effects of CCBs administrated perorally on creatine kinase-MB (CK-MB) levels in patients undergoing elective PCI. METHODS: A total of 570 patients who underwent PCI were evaluated for CK-MB elevation. Patients who were on CCB therapy when admitted to the hospital constituted the CCB group. No CCBs were given to the rest of the patients during the periprocedural period and these patients served as the control group. Blood samples for CK-MB were obtained before and at 6 h, 24 h, and 36 h after the procedure. RESULTS: 217 patients were in the CCB group (mean age 60.2 +/- 9.3 years, 162 males), and 353 were in the control group (mean age 60.0 +/- 10.1 years, 262 males). CK-MB levels increased above the normal values in 41 patients (18.9%) of the CCBs group and in 97 patients (27.5%) of the control group (p = 0.02). Median CK-MB levels were significantly higher in the control group for all studied hours (for all p < 0.05). CONCLUSIONS: Prior oral CCB therapy may have favorable effects in preventing myocyte necrosis after elective PCI.

15 Article The effect of postural changes (leg lifting) on tissue Doppler parameters in coronary artery disease. 2008

Pirat, Bahar / Yildirir, Aylin / Simşek, Vahide / Ozin, Bülent / Müderrisoğlu, Haldun. ·Department of Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey. baharp@baskent-ank.edu.tr ·Turk Kardiyol Dern Ars · Pubmed #18497554.

ABSTRACT: OBJECTIVES: We investigated the effect of increased preload through postural changes (leg lifting) on tissue Doppler parameters in patients with and without coronary artery disease (CAD). STUDY DESIGN: The study included 42 patients who were scheduled for coronary angiography. All the patients underwent standard two-dimensional, color Doppler and tissue Doppler echocardiography before coronary angiography. Tissue Doppler imaging was performed from septal and lateral mitral annuluses at baseline and during 45 degrees leg lifting followed by two-minute stabilization. Patients were grouped based on coronary angiography findings: those having stenosis greater than 70% were considered to have CAD and those with normal coronary arteries comprised the control group. Echocardiography measurements were compared between the two groups. RESULTS: Angiography showed normal coronary arteries or border irregularities in 22 patients and CAD in 20 patients. The two groups were similar with regard to demographic data and ejection fractions, except for male preponderance in the CAD group. Compared with the control group, patients with CAD exhibited a significantly lower isovolumic acceleration rate (IVA) at the lateral (p=0.007) and septal (p=0.03) mitral annuluses. In the control group, leg lifting resulted in increased systolic velocity (S) compared with baseline at the lateral (p=0.009) and septal (p=0.01) annuluses, whereas S wave augmentation was only significant at the septal annulus (p=0.009) in patients with CAD. No significant change was observed in IVA following leg lifting in both groups. CONCLUSION: Preload alteration induced by leg lifting resulted in similar changes in tissue Doppler parameters in patients with and without CAD, except for blunted augmentation of S wave at the lateral annulus in CAD. Detection of decreased IVA at baseline may be a useful finding for CAD.

16 Article Increased lipoprotein(a) in metabolic syndrome: is it a contributing factor to premature atherosclerosis? 2008

Bozbaş, Hüseyin / Yildirir, Aylin / Pirat, Bahar / Eroğlu, Serpil / Korkmaz, Mehmet E / Atar, Ilyas / Ulus, Taner / Aydinalp, Alp / Ozin, Bülent / Müderrisoğlu, Haldun. ·Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey. hbozbas@gmail.com ·Anadolu Kardiyol Derg · Pubmed #18400630.

ABSTRACT: OBJECTIVE: It is well known that patients with metabolic syndrome (MS) have a greater risk of developing coronary artery disease (CAD). However, the association of novel coronary risk factors with MS has not been well established. In this study, we sought to investigate the association of lipoprotein (a) [Lp(a)], homocysteine (Hcy), uric acid, and C-reactive protein (CRP) levels with MS. METHODS: We enrolled 355 consecutive patients from our outpatient cardiology clinic into this cross-sectional, controlled study-186 with MS and 169 without MS, according to the Adult Treatment Panel III criteria. Serum Hcy, Lp(a), uric acid, and CRP levels were determined and compared between the groups. RESULTS: The groups were homogenous with regard to age, sex, and other demographic variables (all p>0.05). As expected, the prevalence of hypertension (85.4% vs 55.6%, p<0.001) and dyslipidemia (78.3% vs 62.6%, p<0.05) were higher in patients in the MS group. Patients were comparable with respect to smoking (28.4% vs 24.8%, p =0.4) and family history of CAD (46.1% vs 40.8%, p=0.3). Patients with MS had significantly higher Lp(a) levels [29.2 (13.4-45.7) vs 16.2 (9.5-26.2) mg/dL; p<0.0001] compared with controls, whereas Hcy (12.2+/-4.8 vs 12.3+/-4.9 micromol/L; P=0.8), uric acid (5.7+/-1.6 vs 5.3+/-1.3 mg/dL; p=0.08), and CRP levels [6.0 (3.7-9.3) vs 5.1 (3.2-7.6) mg/L; p=0.07] were similar. CONCLUSION: Patients with MS seems to have increased serum levels of Lp(a), which might contribute to the premature atherosclerosis observed in these patients. Further research is needed to better clarify this issue.