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Coronary Artery Disease: HELP
Articles from Miscellaneous institutions in Denizli
Based on 18 articles published since 2010

These are the 18 published articles about Coronary Artery Disease that originated from Miscellaneous institutions in Denizli during 2010-2020.
+ Citations + Abstracts
1 Review Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment. 2017

Abou Sherif, Sara / Ozden Tok, Ozge / Taşköylü, Özgür / Goktekin, Omer / Kilic, Ismail Dogu. ·Cardiovascular Research Division, Kings College London, London, UK. · Department of Cardiology, Memorial Hospital, Istanbul, Turkey. · Ozel Saglik Hospital, Denizli, Turkey. · Department of Cardiology, Pamukkale University, Denizli, Turkey. ·Front Cardiovasc Med · Pubmed #28529940.

ABSTRACT: Coronary artery aneurysms (CAAs) are uncommon and describe a localized dilatation of a coronary artery segment more than 1.5-fold compared with adjacent normal segments. The incidence of CAAs varies from 0.3 to 5.3%. Ever since the dawn of the interventional era, CAAs have been increasingly diagnosed on coronary angiography. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease (KD), and percutaneous coronary intervention. The natural history of CAAs remains unclear; however, several recent studies have postulated the underlying molecular mechanisms of CAAs, and genome-wide association studies have revealed several genetic predispositions to CAA. Controversies persist regarding the management of CAAs, and emerging findings support the importance of an early diagnosis in patients predisposed to CAAs, such as in children with KD. This review aims to summarize the present knowledge of CAAs and collate the recent advances regarding the epidemiology, etiology, pathophysiology, diagnosis, and treatment of this disease.

2 Article Association of Heart Rate Recovery With Microalbuminuria in Non-Obstructive Coronary Artery Disease. 2017

Yurtdas, Mustafa / Ozdemir, Mahmut / Aladag, Nesim / Yaylali, Yalin Tolga. ·Department of Cardiology, Balikesir Sevgi Hospital, Balikesir, Turkey. · Department of Cardiology, Van Education and Research Hospital, Van, Turkey. · Department of Cardiology, School of Medicine, Pamukkale University, Denizli, Turkey. ·Cardiol Res · Pubmed #29118882.

ABSTRACT: Background: Non-obstructive coronary artery disease (CAD) is associated with significantly increased risk for myocardial infarction. Heart rate recovery (HRR), a measure of autonomic function, is a strong predictor of all-cause mortality. Microalbuminuria, a marker of early arterial disease, is an independent risk factor for cardiovascular disease and mortality. We aimed to investigate HRR and determine its relationship with microalbuminuria in patients with non-obstructive CAD. Methods: We prospectively studied 565 patients who underwent elective coronary angiography. All participants underwent urinary analysis and then an exercise test. Microalbuminuria was defined as an urinary albumin-to-creatinine ratio (UACR) of 30 - 299 mg/g. The HRR was abnormal if ≤ 12 beats/min during the first minute after exercise. First, all patients were divided into two groups, patients with microalbuminuria (n = 152) and patients without microalbuminuria (n = 413). Then, all patients were re-divided into two groups, those with lower HRR (≤ 12 beats/min, n = 126) and those with higher HRR (> 12 beats/min, n = 439). Results: Patients with microalbuminuria had lower HRR and patients with lower HRR had higher UACR. While UACR was negatively correlated with HRR in patients with microalbuminuria (r = -0.424; P < 0.001) and in patients with lower HRR (r = -0.192; P= 0.042), there was no correlation of UACR with HRR in neither patients with normoalbuminuria nor patients with higher HRR, respectively. In the all study population, there was a significant inverse association between UACR and HRR (r = -0.445, P < 0.001), and UACR independently predicted the presence of lower HRR (P < 0.001). Conclusions: Our findings showed that there was a significant inverse association between UACR and HRR in patients especially with microalbuminuria, and that albuminuria might predict cardiac autonomic imbalance evaluated by HRR in patients with non-obstructive CAD.

3 Article A coronary proatherosclerotic marker: Pregnancy-associated plasma protein A and its association with coronary calcium score and carotid intima-media thickness. 2017

Guven, Abdullah / Demircelik, Bora / Gurel, Ozgul Malcok / Er, Okan / Aydin, Halil Ibrahim / Bozkurt, Alper. ·Department of Cardiology, Aydin State Hospital, Aydin, Turkey. · Department of Cardiology, Hopa State Hospital, Artvin, Turkey. · Department of Cardiology, Susehri State Hospital, Sivas, Turkey. · Department of Cardiology, Denizli State Hospital, Denizli, Turkey. · Department of Cardiology, Erzurum State Hospital, Erzurum, Turkey. · Department of Radiology, Yeni Yuzuncu Yıl Hospital, Ankara, Turkey. ·Adv Clin Exp Med · Pubmed #28791822.

ABSTRACT: BACKGROUND: Atherosclerosis, a chronic inflammatory disorder of the arteries, is responsible for the greatest number of deaths in westernized societies, with numbers increasing at a marked rate in developing countries. Coronary calcium score (CCS), carotid intima-media thickness (CIMT) and pregnancy-associated plasma protein A (PAPP-A) are predictors for the development of atherosclerosis. OBJECTIVES: This study was aimed to investigate the relationship between CCS, CIMT and PAPP-A for earlier diagnosis of atherosclerosis. MATERIAL AND METHODS: A total of 99 patients were included in the study. Coronary computerized tomography (CT) angiography was performed on all patients. The calcium scoring technique was performed using a sequential scanning mode. CIMT measurement was done through the area 1 cm distal of the bulbus arteriosus with carotid Doppler ultrasound. PAPP-A values were analyzed by double immunoenzymatic technique. RESULTS: Out of 99 patients, 63 were found with coronary atherosclerosis using multislice computed tomography (MSCT) coronary angiography. When the cut-off point for CCS was taken to be 0.40, the sensitivity of this parameter was 97% and its specificity was 68.3%. When the cut-off point for CIMT was taken to be 0.60, the sensitivity and the specificity of these parameters were 75.0% and 87.3%, respectively, for the right measurements and 75.0% and 79.4%, respectively, for the left measurements. CONCLUSIONS: This data support the conclusion that PAPP-A, like CCS and CIMT, is a parameter that can be used to detect subclinical atherosclerosis.

4 Article Turkey: coronary and structural heart interventions from 2010 to 2015. 2017

Kilic, Ismail Dogu / Karacop, Erdem / Akdemir, Ramazan / Goktekin, Omer. ·Department of Cardiology, Pamukkale University Hospitals, Denizli, Turkey. ·EuroIntervention · Pubmed #28504237.

ABSTRACT: Growing populations and ageing demographics lead to an increased burden of ischaemic heart disease and related cardiovascular interventions, resulting in pressure on healthcare systems. Although the healthcare system in Turkey has undergone comprehensive remodelling over the last decade, there are many challenges to overcome, including better reimbursement for cardiovascular interventions, standardisation of interventional cardiology services and research-related activities. In this manuscript, we present an overview of coronary and structural heart interventions in Turkey, as well as providing information on current reimbursement policies and the healthcare system.

5 Article Severity of coronary atherosclerosis in patients with COPD. 2017

Dursunoglu, Neşe / Dursunoglu, Dursun / Yıldız, Ali İhsan / Uludag, Burcu / Alaçam, Zahide Namlı / Sarıçopur, Ahmet. ·Departments of Chest, Pamukkale University Medical Faculty, Denizli, Turkey. · Departments of Cardiology, Pamukkale University Medical Faculty, Denizli, Turkey. ·Clin Respir J · Pubmed #26605517.

ABSTRACT: BACKGROUND AND AIMS: Chronic obstructive pulmonary disease (COPD) has many comorbidities such as coronary artery disease (CAD) and stroke. Chronic low-grade systemic inflammation and oxidative stress play a significant role in CAD and COPD. We analysed that impact of COPD on intensity and severity of coronary artery lesions on the angiogram in the groups of patients with COPD according to the Global Initiative for Obstructive Lung Disease (GOLD) grades updated in 2015. METHODS: The study included 102 COPD patients and 80 randomly selected subjects without any pulmonary disease who underwent coronary angiography. According to the GOLD grade for COPD, patients were divided into four groups: A, B, C and D. The severity and extent of CAD were determined using the Gensini score. RESULTS: There were no significant between-group differences in age, body mass index, smoking history, plasma lipids levels, frequency of hypertension, diabetes and CAD. The mean Gensini score in patients with COPD was significantly higher than those without (respectively, 25.7 ± 32.9 vs 17.5 ± 24.8, P = 0.01). While Gensini score was the highest level in the patient group D (64.9 ± 34.9), it was the lowest level in the patient group A (10.2 ± 19.4, P = 0.0001). The Gensini scores increased in accordance with increases in the GOLD grades. We observed that COPD was independently predictive for Gensini score after a multi-variate logistic regression analysis (odds ratio 1.374; 95% confidence interval 1.672-9.232; P = 0.001). CONCLUSION: Severity and intensity of coronary atherosclerosis increases in accordance with increases in the GOLD grades for COPD.

6 Article Optical coherence tomography guidance for percutaneous coronary intervention with bioresorbable scaffolds. 2016

Caiazzo, Gianluca / Longo, Giovanni / Giavarini, Alessandra / Kilic, Ismail Dogu / Fabris, Enrico / Serdoz, Roberta / Mattesini, Alessio / Foin, Nicolas / Secco, Gioel Gabrio / De Rosa, Salvatore / Indolfi, Ciro / Di Mario, Carlo. ·Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Græcia" University, Catanzaro, Italy; National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. · National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. · Pamukkale University School of Medicine, Cardiology, Denizli, Turkey. · National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom; Cardiovascular Department, "Ospedali Riuniti" & University of Trieste, Trieste, Italy. · National Heart Centre Singapore, Singapore. · Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Græcia" University, Catanzaro, Italy. · National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. Electronic address: c.dimario@rbht.nhs.uk. ·Int J Cardiol · Pubmed #27404705.

ABSTRACT: BACKGROUND: The effect of optical coherence tomography (OCT) guidance on the implantation strategy during all phases of percutaneous coronary intervention (PCI) with bioresorbable vascular scaffolds (BVSs) in a real-world scenario has been poorly investigated. METHODS: Consecutive patients undergoing BVS implantation at our institution were included in this registry. Frequency-domain OCT pullbacks were performed at the operator's discretion during all phases of BVS implantation procedures to optimize preparation of lesions, confirm BVS size, and optimize expansion and apposition of scaffolds. RESULTS: Between September 2012 and July 2015, 203 BVSs were implanted in 101 consecutive patients at our institution (2.01 BVSs/patient). In 66 patients, the procedure was performed under OCT guidance. In the OCT subgroup, 66 (77.6%) of the 85 treated lesions were complex (B2/C AHA/ACC type). Overall, 147 OCT pullbacks were performed and 72/147 (49.0%) pullbacks indicated the need for changing strategy. After angiography-only-guided optimisation of BVS in 27 (31.8%) lesions, an OCT examination prompted performance of a second post-expansion. This resulted in an increase in the minimal scaffold area (5.5 to 6.3mm(2), p=0.004) and a decrease in the incomplete scaffold apposition area (1.1 to 0.6mm(2), p=0.082), with no new stent fractures. When the population was divided according to the time of BVS implantation, an initial learning adaptation became evident, with the number of OCT-guided changes in strategy significantly decreasing between the initial and final time periods (p=0.017). CONCLUSIONS: OCT guidance for BVS implantation significantly affects the procedural strategy, with favourable effects on acute results and the learning curve.

7 Article Evaluation of heart rate variability in patients with coronary artery ectasia and coronary artery disease. 2016

Yıldız, Bekir Serhat / Özkan, Emel / Esin, Fatma / Özkan, Hayrettin / Alihanoğlu, Yusuf İzzettin / Kılıç, İsmail Doğu / Evrengül, Harun / Kaftan, Havane Asuman. ·Department of Cardiology, Pamukkale University Faculty of Medicine, Denizli, Turkey. bserhatyildiz@yahoo.com. · Department of Cardiology, İzmir Atatürk Training and Research Hospital, İzmir, Turkey. · Department of Cardiovascular Surgery, İzmir Bozyaka Training and Research Hospital İzmir, Turkey. · Department of Cardiology, Pamukkale University Faculty of Medicine, Denizli, Turkey. ·Turk Kardiyol Dern Ars · Pubmed #27372615.

ABSTRACT: OBJECTIVE: The present study compared heart rate variability (HRV) parameters in patients with coronary artery ectasia (CAE) and coronary artery disease (CAD). METHODS: The study population consisted of 60 consecutive patients with CAE (14 women; mean age 51.63±7.44 years), 60 consecutive patients with CA (15 women; mean age 53.67±9.31 years), and 59 healthy individuals (13 women; mean age 52.85±8.19 years). Electrocardiograms, 24-hour Holter analyses, and routine biochemical tests were performed, and clinical characteristics were evaluated. Coronary angiography images were analyzed. Time-domain HRV parameters, including the standard deviation (SD) of normal-to-normal intervals (SDNN) and the root mean square of difference in successive normal-to-normal intervals (RMSSD) were evaluated, as were frequency-domain HRV parameters including low-frequency (LF), very low-frequency (VLF), high-frequency (HF), the proportion derived by dividing low- and high-frequency (LF/HF), and total power (TP). RESULTS: SDNN was lower in both the CAE and CAD groups, compared to the healthy group (140.85±44.21, 96.51±31.28, and 181.05±48.67, respectively). A significant difference in RMSSD values among the groups was determined (p=0.004). Significantly decreased VLF and HF values were found in the CAE group, compared with the healthy group (VLF p<0.001; HF, p=0.007). TP, VLF, and HF values were significantly lower (p<0.001, p<0.001, and p<0.001, respectively), but LF and LF/HF values were significantly higher (p<0.001 for both) in the CAD group than in the healthy group. TP values were significantly higher (p<0.001), and LF and LF/HF values were lower in the CAE group, compared with the CAD group (p<0.001 for both). CONCLUSION: A decrease in vagal modulation or an increase in sympathetic activity of cardiac function, assessed by HRV analysis, is worse in patients with CAD than in patients with CAE.

8 Article Does high serum uric acid level cause aspirin resistance? 2016

Yildiz, Bekir S / Ozkan, Emel / Esin, Fatma / Alihanoglu, Yusuf I / Ozkan, Hayrettin / Bilgin, Murat / Kilic, Ismail D / Ergin, Ahmet / Kaftan, Havane A / Evrengul, Harun. ·aDepartment of Cardiology, Pamukkale University, DenizlibIzmir Ataturk Training and Research HospitalcIzmir Bozyaka Training and Research Hospital, IzmirdDepartment of Cardiology, Diskapi Training and Research Hospital, AnkaraeDepartment of Public Health, Pamukkale University, Denizli, Turkey. ·Blood Coagul Fibrinolysis · Pubmed #26656902.

ABSTRACT: In patients with coronary artery disease (CAD), though aspirin inhibits platelet activation and reduces atherothrombotic complications, it does not always sufficiently inhibit platelet function, thereby causing a clinical situation known as aspirin resistance. As hyperuricemia activates platelet turnover, aspirin resistance may be specifically induced by increased serum uric acid (SUA) levels. In this study, we thus investigated the association between SUA level and aspirin resistance in patients with CAD. We analyzed 245 consecutive patients with stable angina pectoris (SAP) who in coronary angiography showed more than 50% occlusion in a major coronary artery. According to aspirin resistance, two groups were formed: the aspirin resistance group (Group 1) and the aspirin-sensitive group (Group 2). Compared with those of Group 2, patients with aspirin resistance exhibited significantly higher white blood cell counts, neutrophil counts, neutrophil-to-lymphocyte ratios, SUA levels, high-sensitivity C-reactive protein levels, and fasting blood glucose levels. After multivariate analysis, a high level of SUA emerged as an independent predictor of aspirin resistance. The receiver-operating characteristic analysis provided a cutoff value of 6.45 mg/dl for SUA to predict aspirin resistance with 79% sensitivity and 65% specificity. Hyperuricemia may cause aspirin resistance in patients with CAD and high SUA levels may indicate aspirin-resistant patients. Such levels should thus recommend avoiding heart attack and stroke by adjusting aspirin dosage.

9 Article Indications and immediate and long-term results of a novel pericardium covered stent graft: Consecutive 5 year single center experience. 2016

Secco, Gioel Gabrio / Serdoz, Roberta / Kilic, Ismail Dogu / Caiazzo, Gianluca / Mattesini, Alessio / Parisi, Rosario / De Luca, Giuseppe / Pistis, Gianfranco / Marino, Paolo Nicola / Di Mario, Carlo. ·NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. · Interventional Cardiology, "Antonio E Biagio E Cesare Arrigo" Hospital, Alessandria, Italy. · Department of Cardiology, Pamukkale University, Denizli, Turkey. · Department of Cardiology, University of Eastern Piedmont, Novara, Italy. ·Catheter Cardiovasc Interv · Pubmed #26541909.

ABSTRACT: BACKGROUND: The use of covered stent grafts during percutaneous coronary intervention (PCI) is a life saving solution to seal acute iatrogenic vessel rupture. However, the presence of an impenetrable mechanical barrier is also appealing during treatment of friable coronary plaques but the synthetic PTFE-membrane that might trigger excessive neointimal proliferation has limited its elective-use. Pericardium tissue may offer an appealing "natural" alternative. Aim of our study is to report the consecutive 5-year single center experience with the use of pericardium-covered stents (PCS) (ITGI-Medical, Israel) in a variety of emergency and elective applications. METHODS: Nineteen consecutive patients undergoing implantation of PCS at the Royal Brompton in the last 5-years. Reasons for PCS implantation included treatment of degenerated vein grafts, large coronary aneurysms, and acute iatrogenic vessel rupture. RESULTS: Angiographic success, defined as the ability of the device to be deployed in the indexed lesion with no contrast extravasation with residual angiographic stenosis <30% and a final thrombolysis in myocardial infarction (TIMI)-3 flow was achieved in all cases. Procedural success, defined as the achievement of angiographic success without any major adverse cardiovascular event (MACE) was achieved in 94.7% of patients. In-stent restenosis (ISR) was observed in 26.3% and all patients underwent successful target vessel revascularization with DES (mean time to restenosis 9.0 ± 4.0 months). At a mean follow-up of 32.5 ± 23.3 months no acute or late stent thrombosis was observed. CONCLUSION: PCSs were effective in the treatment of friable embolization-prone coronary plaques, sealing of acute iatrogenic vessel rupture and exclusion of large aneurysms with no thrombosis but high target lesion revascularization.

10 Article Is high pressure postdilation safe in bioresorbable vascular scaffolds? Optical coherence tomography observations after noncompliant balloons inflated at more than 24 atmospheres. 2016

Fabris, Enrico / Caiazzo, Gianluca / Kilic, Ismail Dogu / Serdoz, Roberta / Secco, Gioel Gabrio / Sinagra, Gianfranco / Lee, Renick / Foin, Nicolas / Di Mario, Carlo. ·NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom. · Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy. · Department of Cardiology, Pamukkale University, Denizli, Turkey. · Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy. · National Heart Centre Singapore, Singapore. ·Catheter Cardiovasc Interv · Pubmed #26370357.

ABSTRACT: OBJECTIVES: Optical coherence tomography (OCT) was used to investigate integrity and expansion of bioresorbable drug-eluting scaffolds (BVS) after high-pressure postdilation (HPPD). BACKGROUND: Because of concerns about the risk of BVS damage, postdilation was not recommended and applied in the existing randomized studies and most registries. Recent real world data suggest incomplete BVS expansion cause higher rates of thrombosis. In vivo confirmation of the safety of high pressure postdilation is of paramount importance. METHODS: Data from final OCT examination of consecutive implanted BVS, postdilated with noncompliant (NC) balloons at pressure ≥24 atm were analyzed. The following stent performance indices were assessed with OCT: mean and minimal lumen and scaffold area, residual area stenosis (RAS), incomplete strut apposition (ISA), tissue prolapse, eccentricity index (EI), symmetry index (SI), strut fractures, and edge dissections. RESULT: Twenty-two BVS postdilated at high pressure were analyzed. The average maximal postdilation balloon inflation (maxPD) was 28 ± 3 atm. High pressure OPN NC Balloon (SIS Medical AG, Winterthur Switzerland) was used in 41% of postdilations with a maximal PD of 30 ± 4.7 atm. Final mean and minimal lumen area were 6.8 ± 1.4 and 5.5 ± 1.4 mm(2) , respectively. OCT showed low percentage of RAS (16 ± 9.6%), and low percentage of ISA (1.8 ± 2.4%). Mean EI was 0.86 ± 0.02 and SI 0.35 ± 0.14. OCT analysis showed one edge dissection and no scaffold fractures. CONCLUSIONS: BVS deployment optimization using HPPD does not cause BVS disruption and is associated with a good BVS expansion, low rate of strut malapposition and edge dissections.

11 Article Atrial tachycardia treated by coil embolization of a giant coronary artery fistula. 2014

Alihanoglu, Yusuf Izzettin / Uludag, Burcu / Kilic, Ismail Dogu / Yildiz, Bekir Serhat / Kocyigit, Ali / Evrengul, Harun. ·Department of Cardiology, Pamukkale University Medical Faculty, Denizli, Turkey. Electronic address: aliizyu@mynet.com. · Department of Cardiology, Pamukkale University Medical Faculty, Denizli, Turkey. · Department of Radiology, Pamukkale University Medical Faculty, Denizli, Turkey. ·Rev Port Cardiol · Pubmed #25442001.

ABSTRACT: Coronary artery fistulas are the second most frequently seen coronary anomaly following abnormalities of coronary artery origin and distribution. A coronary fistula is defined as a direct communication between a coronary artery and any cardiac chamber or vessel. Treatment options include percutaneous embolization and surgical intervention. Herein, we present a case of a giant coronary artery fistula and right atrial tachycardia that was induced during a diagnostic electrophysiologic study but was not inducible after the successful treatment of the fistula. This is the first case indicating this association.

12 Article Management of coronary artery disease in Kyrgyzstan: a comparison with Turkey and europe according to European Action on Primary and secondary prevention by intervention to reduce events III results. 2014

Kutlu, Rasim / Muratalievic, Tolkun Murataliev / Memetoglu, Mehmet Erdem. ·Department of Cardiology, Denizli State Hospital, Denizli, Turkey. dr.rasim@mail.ru. · The National Center of Cardiology and Internal Medicine Named After Academician M. Mirrahimov At Ministry of Health of The Kyrgyz Republic, Bishkek, Kyrgyzstan. · Department of Thoracic and Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey. ·Turk Kardiyol Dern Ars · Pubmed #25362945.

ABSTRACT: OBJECTIVES: The European Action on Primary and Secondary Prevention by Intervention to Reduce Events (EUROASPIRE III) Study in coronary artery disease had been undertaken between the years of 2006 and 2007, with the participation of 22 countries in Europe including Turkey (76 centers). In this study, the situation in the management of coronary artery disease in Kyrgyzstan was compared with EUROASPIRE III findings of Turkey and Europe. STUDY DESIGN: The results of 1067 patients with stable coronary artery disease admitted to 22 centers in Kyrgyzstan were studied retrospectively and compared with the European and Turkish findings in EUROASPIRE III. During the study, the patients were interviewed and examined in the first year after the initial coronary event and/or intervention. RESULTS: The gender distribution of the 1067 patients in the study was 658 female (61.7%) and 409 male (38.3%), and the average age was 68 ± 14 years. The ratio of young patients (<50 years) in Kyrgyzstan and Turkey were higher compared with the other European countries (Kyrgyzstan 28.2%, Turkey 20% and Europe 12.7%). The number of patients followed after the coronary event in Kyrgyzstan was 524 (49.1%). Although there was not a big difference of the classical risk factors between Turkey and Europe, in Kyrgyzstan, smoking (75%), hypertension (84%), dyslipidemia (86.5%), and diabetes (74.4%) were much higher when compared to the other countries. The biggest difference between Kyrgyzstan and the other countries in EUROASPIRE III study including Turkey, was the infrequency of medical (78% vs. 95%) and interventional treatment (1.9% vs. 57%). Also, smoking cessation (27.4% vs.70.8% in Europe), physical activity (17.5% vs. 59.1% in Europe), and weight loss (37.2% vs. 58.2% in Europe) ratios after the coronary event were found to be much lower in Kyrgyzstan than in EUROASPIRE III study. CONCLUSION: When compared to the results of EUROASPIRE III study of Turkey and Europe; the Kyrgyzstan results were found to be behind for the prevention, follow-up and treatment goals set by the guidelines.

13 Article Heart rate recovery after exercise and its relation with neutrophil-to-lymphocyte ratio in patients with cardiac syndrome X. 2014

Yurtdaş, Mustafa / Yaylali, Yalin T / Aladağ, Nesim / Özdemir, Mahmut / Ceylan, Yemlihan / Gençaslan, Murat / Akbulut, Tayyar. ·aDepartment of Cardiology, Van Region Training and Research Hospital bDepartment of Cardiology, Istanbul Hospital, Van cDepartment of Cardiology, School of Medicine, Pamukkale University, Denizli, Turkey. ·Coron Artery Dis · Pubmed #24642808.

ABSTRACT: OBJECTIVES: The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are measures of systemic inflammation. Heart rate recovery (HRR) after exercise is influenced by autonomic function. The aim of this study was to ascertain whether HRR and the Duke Treadmill Score (DTS) values are related to NLR and PLR in patients with cardiac syndrome X (CSX). METHODS: A total of 350 participants were enrolled in the study. Complete blood counts and high-sensitivity C-reactive protein (hsCRP) were obtained. All participants underwent an exercise test. HRR and DTS were calculated after exercise. Abnormal HRR was defined as 12 beats/min or less. RESULTS: CSX and coronary artery disease (CAD) groups had higher NLR, PLR, and hsCRP, and lower HRR and DTS values than the control group (for all, P<0.05). In both CSX and CAD groups, HRR was positively correlated with DTS (r=0.468, P<0.001 and r=0.491, P<0.001, respectively) and negatively correlated with NLR (r=-0.519, P<0.001 and r=-0.612, P<0.001, respectively), PLR (r=-0.422, P<0.001 and r=-0.438, P<0.001, respectively), and hsCRP (r=-0.553, P<0.001 and r=-0.521, P<0.001, respectively). NLR and hsCRP were important two predictors of the presence of lower HRR in both CSX [NLR: odds ratio (OR), 0.395; 95% confidence interval (CI), 0.168-0.925; P=0.032 and hsCRP: OR, 0.748; 95% CI, 0.591-0.945; P=0.015], and CAD groups (NLR: OR, 0.115; 95% CI, 0.026-0.501; P=0.004 and hsCRP: OR, 0.637; 95% CI, 0.455-0.892; P=0.009). CONCLUSION: CSX patients have higher NLR and PLR and slower HRR and lower DTS, similar to CAD patients, suggesting that CSX patients may be at a higher risk for developing cardiovascular events in the future. NLR may predict autonomic imbalance assessed by HRR in CSX.

14 Article Increased plasma high-sensitivity C-reactive protein and myeloperoxidase levels may predict ischemia during myocardial perfusion imaging in slow coronary flow. 2014

Yurtdaş, Mustafa / Yaylali, Yalin Tolga / Kaya, Yüksel / Ozdemir, Mahmut. ·Van Region Training and Research Hospital, Department of Cardiology, Van, Turkey. Electronic address: yurtdasmustafa@hotmail.com. · Pamukkale University, School of Medicine, Department of Cardiology, Denizli, Turkey. · Kafkas University, School of Medicine, Department of Cardiology, Kars, Turkey. · Ipekyolu State Hospital, Department of Cardiology, Van, Turkey. ·Arch Med Res · Pubmed #24316393.

ABSTRACT: BACKGROUND AND AIMS: It is unclear whether changes in plasma levels of inflammatory markers could explain the link between ischemia and slow coronary flow (SCF). The aim of the study was to evaluate the plasma levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, and myeloperoxidase (MPO) during myocardial perfusion imaging (MPI) in SCF patients. METHODS: The study population consisted of 53 SCF patients and 30 controls. Coronary flow rates were documented by TIMI frame count (TFC). Plasma levels of hsCRP, IL-6, MPO, and MPI were obtained in all participants. RESULTS: hsCRP, IL-6 and MPO levels of SCF patients were higher than controls (hsCRP: 4.7 ± 2.5 vs. 1.7 ± 1.1 mg/L, p <0.001; IL-6: 8.2 ± 4.3 vs. 5.2 ± 2.1 pg/mL, p <0.001; and MPO: 75.9 ± 59.6 vs. 24.3 ± 16.7 ng/mL, p <0.001). Twenty-one SCF patients exhibited myocardial perfusion defect (MPD) on MPI. In SCF patients, the highest hsCRP, IL-6 and MPO levels were observed in patients with both MPD and three-vessel slow flow. Mean TFCs were positively correlated with plasma levels of hsCRP (r = 0.424, p = 0.002), IL-6 (r = 0.367, p = 0.007), MPO (r = 0.430, p = 0.001), and reversibility score (r = 0.671, p <0.001) in SCF patients. HsCRP and MPO were the independent variables, which predicted positive MPI results (hsCRP: OR, 2.176; 95% CI, 1.200-3.943; p = 0.010, MPO: OR, 1.026; 95% CI, 1.007-1.046; p = 0.008). CONCLUSIONS: Inflammation may play a crucial role in both the pathogenesis and development of ischemia in SCF. Association of increased levels of inflammatory markers and ischemia suggests that endothelial inflammation may be largely responsible for clinical presentation. New combined treatment regimens should target endothelial activation and inflammation in SCF.

15 Article Surgical pitfalls of minimally invasive direct coronary artery bypass procedure from the viewpoint of a surgeon in the learning curve. 2013

Emrecan, Bilgin / Ozdemir, Ahmet Coşkun. ·Department of Cardiovascular Surgery, Pamukkale University, Denizli, Turkey. ·Wideochir Inne Tech Maloinwazyjne · Pubmed #23630558.

ABSTRACT: INTRODUCTION: Minimally invasive direct coronary artery bypass grafting (MIDCAB) offers arterial revascularization of the left anterior descending (LAD) coronary artery especially in lesions unsuitable for percutaneous coronary interventions. By avoidance of sternotomy and cardiopulmonary bypass its invasiveness is less than that of conventional bypass surgery. AIM: We in this study discuss our surgical experience in the MIDCAB procedure. MATERIAL AND METHODS: Thirteen patients were operated on with the MIDCAB procedure. The inclusion criteria for MIDCAB were pure LAD disease totally occluded or severely stenotic. Patient demographics and preoperative and postoperative data were analyzed. RESULTS: Mean age of the patients was 60.0 ±8.6 years. Patients' preoperative and postoperative levels of cardiac CK-MB (creatine kinase MB) were not significantly different (p = 0.993). However, cardiac troponin I (p < 0.001), hemoglobin (p < 0.001) and hematocrit (p < 0.001) were significantly different. No perioperative myocardial infarctions or cerebrovascular accidents were seen. The patients were discharged at a mean day of 4.77 with oral antiaggregant therapy. No mortality was seen in the study population. CONCLUSIONS: Minimally invasive direct coronary artery bypass is associated with few perioperative complications. Minimally invasive direct coronary artery bypass in our experience is a very good option for single vessel LAD disease.

16 Article The Role of Myocardial Perfusion Gated SPECT Study in Women with Coronary Artery Disease: A Correlative Study. 2012

Akalın, Erdal Nihat / Yaylalı, Olga / Kıraç, Fatma Suna / Yüksel, Doğangün / Kılıç, Mustafa. ·Denizli State Hospital, Department of Nuclear Medicine, Denizli, Turkey. ·Mol Imaging Radionucl Ther · Pubmed #23486759.

ABSTRACT: OBJECTIVE: We aimed to evaluate the role of gated myocardial perfusion SPECT (MPS) and to investigate whether only the invasive coronary angiography (CAG) is sufficient in the diagnosis of the coronary artery disease (CAD) in women. MATERIAL AND METHODS: Sixty-four women (62±10 years) with known CAD were included in this study. They had echocardiography (ECHO), stress/rest gated MPS and invasive CAG. Coronary stenosis as of > 50 % in invasive CAG was accepted as significant. Gated MPS data were compared with invasive CAG and ECHO. RESULTS: Invasive CAG results were abnormal in 34 patients, and normal in 30 cases. Myocardial ischemia was detected by gated MPS in 22/ 30 cases with normal invasive CAG, 6 had mild coronary stenosis in major coronary arteries ranging from 30% to 50% in invasive CAG. 16/ 22 women were diagnosed as metabolic syndrome according to MetSend Diagnostic Criteria and only 8 of 30 patients with normal invasive CAG had false positive MPS data on the reevaluation by a nuclear cardiologist. CONCLUSION: We think that invasive coronary angiography method is not sufficient alone in the diagnosis of CAD in women. Gated MPS study is recommended to achieve the final decision for myocardial ischemia in the cases with CAD and raw data must always be evaluated to avoid attenuation artifacts. CONFLICT OF INTEREST: None declared.

17 Article [A relationship between CRP, adiponectin and Gensini score in the patients with coronary artery disease]. 2011

Dursunoğlu, Dursun / Göksoy, Hidayet / Oztürk, Mehmet / Rota, Simin. ·Pamukkale Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dali, Denizli, Türkiye. dursundursunoglu@yahoo.com ·Anadolu Kardiyol Derg · Pubmed #21421513.

ABSTRACT: OBJECTIVE: We aimed to evaluate serum adiponectin and C-reactive protein (CRP) levels in the different groups of patients with angiographically defined coronary artery disease (CAD). METHODS: Overall 100 patients (80 males, 20 females) with CAD (≥ 50% stenosis) and 45 controls (25 males, 20 females) with normal coronary arteries were included in this cross-sectional observational study. Gensini score was used for evaluation of the severity of coronary lesions on the angiogram. A relationship between Gensini score and serum CRP and adiponectin levels was evaluated by a logistic regression analysis. RESULTS: Mean age of the patients (60.5±10.2 years) was significantly higher than of the controls (55.6±10.4 years, p=0.01). While serum adiponectin levels in CAD patients (2.1±1.2 µmg/dl) were significantly lower than in the controls (3.3±1.8 µmg/dl, p=0.01); serum CRP levels of the patients (2.8±1.5 mg/dl) were significantly higher than of the controls (0.9±0.4 mg/dl). Serum adiponectin and CRP levels were not significantly different between the CAD subgroups (p>0.05). Gensini score was related with serum CRP (odds ratio: 0.98, 95% CI: 1.05-1.35, p=0.01) and adiponectin levels (odds ratio: 1.15, 95% CI: 1.10-1.25, p=0.01) by a logistic regression analysis. CONCLUSION: While serum CRP levels are increased in CAD patients comparing with the controls; serum adiponectin levels are decreased significantly. Serum CRP and adiponectin levels are related to coronary lesions severity on the angiogram.

18 Minor Retrieval of fractured guide wire with balloon support in intermediate coronary artery: A rare complication and management. 2016

Yildiz, Bekir Serhat / Kilic, Ismail Dogu / Alihanoglu, Yusuf Izzettin / Evrengul, Harun. ·Pamukkale University, Medical Faculty, Department of Cardiology, Denizli, Turkey. Electronic address: bserhatyildiz@yahoo.com. · Pamukkale University, Medical Faculty, Department of Cardiology, Denizli, Turkey. · Professor, Pamukkale University, Medical Faculty, Department of Cardiology, Denizli, Turkey. ·Indian Heart J · Pubmed #27316491.

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