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    Decreased Elabela level in the first 24 hours of ST Elevation Myocardial Infarction patients
    (Association of Clinical Biochemistry Specialists (Klinik Biyokimya Uzmanlari Dernegi), 2024) Canpolat Erkan, Revsa Evin; Adiyaman, Mehmet Sahin
    Objectives: Cardiovascular diseases are among the leading causes of death worldwide. ST Elevation Myocardial Infarction (STEMI) is one of the most important causes of cardiovascular mortality and morbidity. It has been determined that Elabela (ELA), a member of the apelinergic system, increases myocardial contractility and coronary vasodilation, and decreases blood pressure. The aim of this study was to evaluate the relationship between circulating ELA levels and various clinical, biochemical, and angiographic parameters in STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods: Seventy-four patients hospitalized with the diagnosis of STEMI who underwent coronary angiography and primary PCI, and seventy-four patients with chest pain but no pathology detected in coronary angiography, were included in the study as the control group. Coronary lesion severity was measured using the SYNTAX score tool. Routine laboratory tests and ELA levels were measured. Results: Plasma levels of ELA were significantly lower in patients with STEMI (0.68±0.68 ng/mL) than in controls (1.34±0.88 ng/mL, p<0.001). Glucose, cholesterol, LDL, CRP, troponin I, and SYNTAX score levels were statistically higher in the STEMI group, while ELA and HDL levels were lower. There was a high level of negative correlation between ELA and troponin I, SYNTAX score, cholesterol, LDL, and CRP. Conclusion: In this study, it was determined that the level of ELA decreased in the first 24 hours of STEMI patients. In addition, a highly negative correlation was found between ELA and troponin I and SYNTAX scores. © 2024, Association of Clinical Biochemistry Specialists (Klinik Biyokimya Uzmanlari Dernegi). All rights reserved.
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    Relationship between Nadir Hematocrit during Cardiopulmonary Bypass and Postoperative Hyperglycemia in Nondiabetic Patients
    (Forum Multimedia Publishing, Llc, 2014) Sevuk, Utkan; Cakil, Nevzat; Altindag, Rojhat; Baysal, Erkan; Altintas, Bernas; Yaylak, Baris; Adiyaman, Mehmet Sahin
    Background: Hyperglycemia is common after cardiac surgery in both diabetic and nondiabetic patients and is associated with increased morbidity and mortality. Association between nadir hematocrit levels on cardiopulmonary bypass (CPB) and postoperative hyperglycemia is not clear. This study was carried out to determine the relationship between nadir hematocrit during CPB and postoperative hyperglycemia in nondiabetic patients. Methods: Records of 200 nondiabetic patients undergoing coronary artery bypass grafting operation were retrospectively reviewed. In the first analysis, patients were divided into two subgroups according to the presence or absence of hyperglycemia. Further analysis was made after dividing the patients into 3 subgroups according to nadir hematocrit levels on CPB (less than 20%; 20% to 25%; greater than or equal to 25%). Results: Compared to patients without hyperglycemia, patients with postoperative hyperglycemia had significantly lower preoperative hematocrit levels (p = 0.004) and were associated with lower nadir hematocrit levels during CPB (p=0.002). Peak intensive care unit blood glucose levels and number of blood transfusions were significantly higher in patients with nadir hematocrit levels less than 20. (p<0.001 and p<0.001 respectively). Logistic regression analysis demonstrated that nadir hematocrit levels less than 20% (OR 2.9, p=0.009) and allogenic blood transfusion (OR 1.5, p=0.003) were independently associated with postoperative hyperglycemia. Conclusions: Nadir hematocrit levels on CPB less than 20% and allogenic blood transfusions were independently associated with postoperative hyperglycemia in nondiabetic patients. Patients with a nadir hematocrit levels less than 20 % during CPB should be closely monitored for hyperglycemia in the perioperative period.
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    Relationship between thyroid function and carotid artery plaque ulceration
    (Springer Heidelberg, 2015) Sevuk, Utkan; Bahadir, Mehmet Veysi; Altindag, Rojhat; Baysal, Erkan; Altintas, Bernas; Yaylak, Baris; Adiyaman, Mehmet Sahin
    Carotid artery plaque ulceration (PU) is known to be associated with cerebrovascular events (CVE). Even within euthyroid ranges, thyroid function has been reported to be associated with carotid atherosclerosis. However, the relationship between thyroid function and carotid PU remains unclear. Our aim was to determine the relationship between thyroid function and PU in patients with internal carotid artery stenosis (ICS). Records of patients with CVE were retrospectively reviewed. A total of 250 consecutive patients with ICS who had computed tomography angiography (CTA) of the carotid arteries following hospitalization were included in the study. CTA was used for the evaluation of carotid artery plaque morphology and ulceration. Plaque morphology was classified as fatty, mixed or calcified. Patients were divided into two groups according to the presence or absence of PU. Subclinical hypothyroidism (SCH) and hypothyroidism were significantly more common in patients with PU (p < 0.001 and p = 0.003, respectively). Patients with PU had higher incidence of low-normal FT4 levels (p = 0.02). Compared with patients who had no PU, patients with PU had decreased FT4 levels and elevated TSH levels (p = 0.001 and p = 0.001, respectively). TSH level (OR 1.33, p = 0.001), SCH (OR 4.2, p = 0.001), hypothyroidism (OR 3.15, p = 0.037), fatty plaque (OR 2.16, p = 0.01) and calcified plaque (OR 0.19, p < 0.001) were independently associated with PU. Our results suggest that SCH and hypothyroidism could be a risk factor for PU and subsequent CVE. Thyroid functions may be useful for risk stratification of patients with ICS.
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    Serum Adropin Level in the Early Period of ST-Elevation Myocardial Infarction and Its Relationship With Cobalamin and Folic Acid
    (Cureus Inc, 2022) Adiyaman, Mehmet Sahin; Erkan, Revsa Evin Canpolat; Kaya, Ilyas; Adiyaman, Ozlem Aba
    Background: Studies on biomarkers in the diagnosis of myocardial infarction are ongoing. Adropin is a biomarker that has been studied and has been shown to have different effects. This study aimed to examine the adropin level of patients with myocardial infarction within the first 24 hours, as well as its relationship with cobalamin and folic acid.Material and methods: The control group included 70 patients whose troponin values did not increase and no coronary lesions were detected. In the ST-elevation myocardial infarction (STEMI) group, 70 patients with ST elevation on ECG and coronary total thrombosis on coronary angiography were evaluated. Coronary lesion severity was measured using the SYNergy between percutaneous coronary intervention (PCI) with TAXUS and Cardiac Surgery (SYNTAX) score tool. Hemogram, troponin, adropin, c-reactive protein (CRP), cobalamin, folic acid, and other biochemical parameters were evaluated in all patients.Results: In the STEMI group, a significant increase was observed in the adropin level along with the troponin and CRP levels in the first 24 hours (p<0.001). Cobalamin and folic acid levels were low in the same group (p:0.016, p<0.001). While a strong negative correlation was observed between adropin and cobalamin, no correlation was found with other parameters.Conclusion: The study supports that adropin could be used as a cardiac biomarker in the early stages of STEMI patients. Another result is with low cobalamin and folic acid levels in patients with myocardial infarction which needs to be further explained with the strong negative correlation between adropin and cobalamin.