DSpace Arşivi :: by Yazar "Aktan, Adem" değerine göre listeleniyor

Yazar "Aktan, Adem" seçeneğine göre listele

Listeleniyor 1 - 20 / 43

Ability of CHA2DS2-VASc/R2CHA2DS2-VASc Scores to Predict Complications Related to Cardiac Implantable Electronic Devices
(John Wiley and Sons Inc, 2025) Söner, Serdar; Aktan, Adem; Kılıç, Raif; Güzel, Hamdullah; Taştan, Ercan; Okşul, Metin; Cömert, Adnan Duha
Background: Globally, the number of cardiac implantable electronic devices (CIEDs) is increasing. In our study, we aimed to investigate whether CHA2DS2-VASc and R2CHA2DS2-VASc scores are predictive of CIED-related complications. Methods: Our investigation was carried out with a multicenter retrospective design. Patients who underwent CIED surgery at two cardiac centers in Turkey between January 2011 and May 2023, 1676, were evaluated. The patients were divided into two groups according to their R2CHA2DS2-VASc scores. Patients with R2CHA2DS2-VASc ≥ 5 were included in group 1 (380 patients), and patients with R2CHA2DS2-VASc < 5 (1296 patients) were included in group 2. The primary outcome was defined as the cumulative events. Each component of cumulative events, such as hematoma, pericardial effusion, pneumothorax, and infection, was also defined as a secondary outcome. Results: The study's patient population had an average age of 62.9 ± 14 years. Pneumothorax (1.8% vs. 1.3%, p = 0.444), pericardial effusion or tamponade (0.35% vs. 0.2%, p = 0.659), and clinically significant hematoma (1.1% vs. 0.6%, p = 0.376) were comparable between the groups. Infection-related devices and cumulative events classified as primary outcomes were higher in the R2CHA2DS2-VASc ≥ 5 group (6.1% vs. 1.2%, p < 0.001; 7.6% vs. 3.2%, p < 0.001, respectively). Modeling analyses showed that the CHA2DS2-VASc score and HT were also independent predictors of device-related infection and cumulative events. Conclusion: In the R2CHA2DS2-VASc ≥ 5 groups, infection related to the device system and cumulative events were higher. Patients with an R2CHA2DS2-VASc score of 5 or more and a high CHA2DS2-VASc score should be evaluated more carefully regarding infection and cumulative events before and after the operation. © 2025 Wiley Periodicals LLC.
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Gunlu, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Guzel, Hamdullah
BackgroundIn this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (& GE; 75 years) than in younger (< 75 years) patients.MethodsThis retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point.ResultsThe overall sample included 1923 patients (1419 < 75 years and 504 aged & GE; 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the & GE; 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age & GE; 75 years and infection related to the device system.ConclusionInfection rates were relatively higher in the patient group aged & GE; 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
All-cause Mortality Can Be Predicted in Patients with Chronic Total Occlusion with CONUT and PNI Scores
(2023) Özbek, Mehmet; Demir, Muhammed; Aktan, Adem; Güzel, Tuncay
Objective: CTO is defined as 100% occlusion of a coronary artery for more than one month. Nutritional status has been shown to be a prognostic marker in many clinical situations. CONUT and PNI scores are objective indices that can be calculated based on simple blood parameters and can be used to evaluate the nutritional status of patients. The aim of this study was to examine the effect of nutritional status assessed by CONUT and PNI on all-cause mortality in patients with CTO. Material and Method: The retrospective study included 516 patients who had CTO on coronary angiography. The nutritional status of the patients was evaluated with PNI and CONUT scores, and categorical groups were formed according to these results and compared. Results: All-cause mortality occurred in 127 (24.6%) patients during median follow-up period of 48 months. At the end of the follow-up period, the patients were divided into two groups as survival and non-survival. In terms of all-cause mortality, mean PNI score (47,87±6,31 vs. 42,41±6,57) and median CONUT score (1(2) vs. 3(3)) differed significantly between the surviving and non-surviving groups (p <0.001). Kaplan-Meier analysis showed a significant difference in survival between the PNI and CONUT scores cathegorical groups (p <0.001). Conclusion: Higher CONUT scores and lower PNI scores were found to be associated with poor outcomes in CTO patients. Evaluation and monitoring of nutritional status in CTO patients by these nutritional scores may provide additional prognostic information.
Assessment of left atrial volumes and functions in patients with coronary slow flow
(Galenos Yayınevi, 2021) Aslan, Burhan; Peker, Tezcan; Tenekecioğlu, Erhan; Aktan, Adem; Özbek, Mehmet; Karadeniz, Muhammed; Çil, Habip
Objectives: Coronary slow flow phenomenon (CSFP) is the slow or late progression of the opaque material to the distal vascular structures during angiography in patients with normal or near-normal coronary arteries. This study aims to evaluate left atrial volumes and functions using conventional transthoracic and tissue Doppler echocardiographic parameters in patients with CSFP. Materials and Methods: According to criteria determined by Gibson, 50 patients with slow flow in at least one coronary artery were included as cases, and 40 subjects with normal coronary flow were included as controls. Results: In the transmitral and tissue Doppler analysis, mitral early velocity (E), mitral late velocity/mitral early velocity (E/A), and Em were significantly lower in the coronary slow flow (CSF) group. LA, Am, mitral early velocity/earlydiastolic velocity (E/Em), LAVmax, LAVmin, LAVpreA, index volumes, LAAEV, LATEV, and LAAEF were found to be higher in the CSF group. A significant positive correlation was observed between Frame LAD and LAAEF (r=0.66, p<0.001) and between Frame LAD and E/Em (r=0.34, p<0.001). A significant negative correlation was found between LAAEF and E/A ratio (r=-0.4, p=0.003). There was also a significant positive correlation between LAPEF and E/A (r=0.44, p<0.001) and between the mean frame and LAAEF (r=0.4, p=0.002). Conclusion: Impaired LV diastolic functions and significant changes in LA volumes were found in patients with CSFP.
Assessment of the neutrophil/lymphocyte ratio in patients with supraventricular tachycardia
(Turkish Soc Cardiology, 2016) Aydin, Mesut; Yildiz, Abdulkadir; Yuksel, Murat; Polat, Nihat; Aktan, Adem; Islamoglu, Yahya
Objective: The neutrophil/lymphocyte ratio (NLR) has been evaluated as a new predictor of cardiovascular risk. Inflammation has been shown to be associated with various arrhythmias including supraventricular tachycardias (SVTs). In this study, we aimed to investigate the relation between NLR and SVT in patients with a documented atrial tachyarrhythmia. Methods: The study used a retrospective cross-sectional design. Patients who had SVT but were otherwise healthy were included. The exclusion criteria included drug use (except antiarrhythmic agents), morbid obesity, acute or chronic infection, inflammatory diseases, systemic diseases, and cancer. Total and differential leukocyte counts and routine biochemical tests were performed before the ablation procedure. Results: The study included 150 patients with SVT and 98 healthy controls. The biochemical and hematological parameters were comparable between the groups, except neutrophil and lymphocyte counts. The neutrophil count was significantly higher (4.7 +/- 1.5x10(3)/mu L versus 4.1 +/- 1.0x10(3)/mu L; p<0.001) and lymphocyte count was significantly lower (2.2 +/- 0.6x10(3)/mu L versus 2.5 +/- 0.6x10(3)/mu L; p=0.001) in the SVT group than in the control group. As a result, the SVT group had significantly higher NLR values than the control group (2.2 +/- 0.9 versus 1.7 +/- 0.5; p<0.001). In addition, NLR values were higher in patients in whom tachycardia was induced during an electrophysiological study (EPS) (2.3 +/- 0.9 versus 2.0 +/- 0.8; p=0.02). The association between NLR and SVT remained significant after multivariate analysis (odds ratio: 1.5, 95% confidence interval: 1.001-2.263, p=0.049). Conclusion: Our study indicated that NLR values were significantly higher in patients with documented SVT than in control subjects. Inducibility of SVT during EPS was associated with higher NLR values.
Association Between ABO Blood Group, Peripheral Artery Disease Lesion Severity, and Coronary Artery Disease Coexistence
(Elsevier Inc., 2025) Evsen, Ali; Aktan, Adem; Kılıç, Raif; Özbek, Mehmet
Background: This study aims to investigate the relationship between ABO blood groups and the severity of peripheral artery disease (PAD) lesions, the coexistence of coronary artery disease (CAD) with PAD, and to identify which blood groups may be more predisposed to these conditions. Methods: This study, which has a single-center and retrospective design, includes 305 patients diagnosed with peripheral artery disease (PAD) between 2015 and 2021. The patients were selected from those with at least 50% stenosis detected by computed tomography (CT) angiography. The severity of PAD lesions was evaluated according to the TransAtlantic Inter-Society Consensus (TASC-II) classification, and the presence of CAD was determined by simultaneous conventional coronary angiography. Demographic data, comorbidities, and laboratory results were collected, and statistical analyses were performed using chi-square tests, logistic regression, and t-tests. All of these patients were divided into 2 groups based on their ABO blood types: O and non-O blood groups. Results: This study demonstrates a significant relationship between blood group classification and both the severity of PAD and the prevalence of CAD. Patients with non-O blood groups exhibited a higher likelihood of having severe PAD lesions (TASC-C and TASC-D) compared to those with O blood groups, who more frequently had milder lesions (TASC-A and TASC-B) (P < 0.001). The prevalence of CAD was also significantly higher among patients with non-O blood groups than those with the O blood group (54.4% vs. 36.4%; P = 0.003). In the logistic regression analysis, non-O blood groups, alongside age, hypertension (HT), and chronic kidney disease (CKD), emerged as independent predictors of severe PAD (P < 0.001 for non-O blood groups). Similarly, older age and non-O blood group status were identified as significant independent predictors of CAD (P = 0.004). These findings suggest that blood group classification, particularly non-O groups, may influence the severity and coexistence of PAD and CAD. Conclusion: Our study reveals a significant association between ABO blood groups and both the severity of PAD and the association of CAD, and shows that non-O blood groups are linked to more severe forms of these conditions. These findings highlight the potential role of ABO blood groups in cardiovascular risk stratification, suggesting a need for further research to confirm these associations and understand their clinical implications. © 2025 Elsevier Inc.
Catastrophic embolism of a suddenly ruptured isolated cardiac cyst hydatid: An unusual case report
(Bayçınar Tıbbi Yayıncılık, 2023) Özbek, Mehmet; Demir, Muhammed; Karaçalılar, Mehmet; Aktan, Adem
Hydatid cysts can be located in any organ or tissue system. Cardiac hydatid cyst is a rare, but fatal pathology. A 21-year-old male Syrian refugee patient with no previous known medical conditions was admitted to the hospital for chest pain and shortness of breath. He had increasing leg pain for 12 hours. Hydatid cyst rupture was detected on echocardiography. The peripheral artery thrombus and hydatid cyst membrane were removed with the embolectomy. The patient had renal and cranial infarctions. He underwent fasciotomy due to compartment syndrome. In conclusion, delayed diagnosis and treatment of cardiac hydatid cysts may result in a poor prognosis associated with the risk of rupture and is responsible for the spread of infection throughout the body as a result of the rupture. Even if there is an early diagnosis, surgical treatment supported by medical treatment is recommended very early.
Clinical characteristics of the patients presented with supraventricular tachycardia in southeast Anatolian region of Turkey
(Dicle Üniversitesi Tıp Fakültesi, 2014) Aydın, Mesut; Yıldız, Abdulkadir; Aktan, Adem; Polat, Nihat; Yüksel, Murat; Akıl, Mehmet Ata; Özbek, Hilal; İslamoğlu, Yahya
Objective: In this study, we aimed to evaluate the characteristic of patients with supraventricular tachycardia for proper diagnosis and treatment in Southeast Anatolian region. Methods: The study was has a retrospective cross-sectional design. One hundred eighty-seven consecutive patients who underwent catheter ablation of SVT between June 2012 and April 2014 at the Dicle University Heart Hospital were included in the study. In those patients, in hom the arrhythmia substrate was identified, ablation therapy was carried out using radiofrequency (RF) energy. Results: Among SVTs 119 (63.6%) patients had atrioventricular nodal re-entry tachycardia (AVNRT), 20 (10.7%) patients had concealed atrioventricular re-entry tachycardia (AVRT), 40 (21.4%) patients had Wolf Parkinson White (WPW) syndrome, and 8 (4.3%) patients had atrial tachycardia. RF ablation was applied on 184 patients. Overall RF ablation success rate was 96.2%. Overall recurrence was 8 (4%) of 187 patients during the followup period 12 ± 6 (1-23) months. The recurrence was 4 (3.4%) of 119 patients in AVNRT, 2(5%) of 40 patients in WPW syndrome and 2 (10%) of 20 patients in concealed AVRT. There was no statistically significant difference between groups in terms of recurrence. Two patients having AVNRT ablation died due to acute coronary syndrome in clinical follow-up. Conclusion: The acute and long-term success rates of SVT ablation were in accordance with literature. The other characteristics of SVT were similar with the current data
Comparison of Evolut-R 34 mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors
(Kare Publ, 2024) Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Demir, Muhammed; Gunlu, Serhat; Arslan, Bayram; Ertas, Faruk
Objective: The main purpose of this study was to evaluate and compare the in -hospital, 1 -month and 1 -year post -procedure outcomes of patients treated with Evolut-R 34 mm and Evolut-R 23/26/29 mm devices. Additionally, the study aimed to identify factors that could predict the occurrence of >= mild paravalvular leaks (PVL). Methods: Between April 2015 and May 2022, 269 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with Evolut-R 34 mm (n = 66, 24.5%) and Evolut-R 23/26/29 mm (n = 203, 75.5%) devices in a single center were retrospectively analyzed. Results: Patients in the Evolut-R 34 mm group had a lower female sex ratio (16.7% vs. 66.5%, P < .001, respectively), ejection fraction (50.7 +/- 10.1% vs. 54.5 +/- 9.3%, P = .016, respectively), and mean aortic gradient (7.4 +/- 3.3 vs. 9.2 +/- 5.0, P = .026, respectively) compared to the Evolut-R 23/26/29 mm group. The groups did not exhibit any statistically significant distinctions with regard to technical success, the need for a permanent pacemaker, occurrences of stroke, major vascular complications, PVL, major adverse cardiovascular and cerebrovascular events, or mortality. Peak velocity was confirmed as a significant pre- dictor of >= mild PVL in both patient groups in the receiver operating characteristic curve analysis. In logistic regression analysis; In patients with Evolut-R 34 mm valve, pre-TAVI aortic valve peak velocity (odds ratio (OR) = 23.202; P = .019) and calcium volume 800 Hounsfield Units (mm(3)) (OR = 1.017; P < .001) were independent predictors of >= mild PVL. Conclusion: The Evolut-R 34 mm valve has shown comparable in -hospital results with smaller valve sizes. Pre-TAVI aortic valve peak velocity and calcium volume predicted >= mild PVL in Evolut-R 34 mm patients.
A comparison of postoperative complications following cardiac implantable electronic device procedures in patients treated with antithrombotic drugs
(Wiley, 2022) Demir, Muhammed; Özbek, Mehmet; Polat, Nihat; Aktan, Adem; Yıldırım, Bünyamin; Argun, Lokman; İldırımlı, Kamran; Toprak, Nizamettin
Background The incidence of postoperative complications following cardiac implantable electronic device (CIED) procedures in patients treated with antithrombotic drugs has not been studied sufficiently. Here we present a comparison of complications after CIED implantations. Methods Using an observational study design, the study included 1807 patients with a taking antiplatelet drugs (n: 1601), nonvitamin K anticoagulants (NOAC) (n: 136), and warfarin (n: 70) undergoing CIED surgery. Primary endpoint was accepted as cumulative events including composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to device system. Secondary outcomes included each compenent of cumulative events. Multivariable analysis was performed to identify predictors of cumulative events. Results The overall cumulative event rate was 3.7% (67 of 1807). Cumulative events occured 3.1% (50 of 1601) in the antiplatelet, 5.1% (7 of 136) NOAC, and 14.3% (10 of 70) warfarin groups (p < 0.001). CSH occurred in 2 of 70 patients (2.9%) in the warfarin group, as compared with 5 of 1601 (0.3%) in the antiplatelet group (p: 0.032). However, no significant differences were found between NOAC and warfarin groups in terms of CSH (0.7% vs. 2.9% respectively, p: 0.267). Warfarin treatment was an independent predictor of cumulative events and increased 2.9-fold the risk of cumulative events. Major surgical complications were rare and did not differ significantly between the study groups. Conclusions The incidence and severity of complications may be lower in patients treated with periprocedurally antiplatelet or NOAC therapy when compared with warfarin therapy. Further randomized control studies are required to confirm our findings
Comparison of the real-life clinical outcomes of warfarin with effective time in therapeutic range and non-vitamin K antagonist oral anticoagulants: Insight from the AFTER-2 trial
(Polish Cardiac Soc, 2023) Aktan, Adem; Guzel, Tuncay; Aslan, Burhan; Kilic, Raif; Gunlu, Serhat; Ozbek, Mehmet; Arslan, Bayram
Background: It is unclear whether warfarin treatment with high time in therapeutic range (TTR) is as effective and safe as non-vitamin K antagonist oral anticoagulants (NOACs). It is crucial to compare warfarin with effective TTR and NOACs to predict long-term adverse events in patients with atrial fibrillation. Aims: We aimed to compare the long-term follow-up results of patients with atrial fibrillation (AF) who use vitamin K antagonists (VKAs) with effective TTR and NOACs. Methods: A total of 1140 patients were followed at 35 different centers for five years. During the follow-up period, the international normalized ratio (INR) values were studied at least 4 times a year, and the TTR values were calculated according to the Roosendaal method. The effective TTR level was accepted as >60% as recommended by the guidelines. There were 254 patients in the effective TTR group and 886 patients in the NOAC group. Ischemic cerebrovascular disease/transient ischemic attack (CVD/TIA), intracranial bleeding, and mortality were considered primary endpoints based on one-year and five-year follow-ups. Results: Ischemic CVD/TIA (3.9% vs. 6.2%; P = 0.17) and intracranial bleeding (0.4% vs. 0.5%; P = 0.69), the one-year mortality rate (7.1% vs. 8.1%; P = 0.59), the five-year mortality rate (24% vs. 26.3%; P = 0.46) were not different between the effective TTR and NOACs groups during the follow-up, respectively. The CHA2DS2-VASC score was similar between the warfarin with effective TTR group and the NOAC group (3 [2-4] vs. 3 [2-4]; P = 0.17, respectively). Additionally, survival free-time did not differ between the warfarin with effective TTR group and each NOAC in the Kaplan-Meier analysis (dabigatran; P = 0.59, rivaroxaban; P = 0.34, apixaban; P = 0.26, and edoxaban; P = 0.14). Conclusion: There was no significant difference in primary outcomes between the effective TTR and NOAC groups in AF patients.
Dependence of clinical outcomes on time of hospital admission in patients with ST-segment elevation myocardial infarction
(King Faisal Specialist Hospital and Research Centre, 2023) Özbek, Mehmet; Ildirimli, Kamran; Arık, Baran; Aktan, Adem; Coşkun, Mehmet Sait; Evsen, Ali; Güzel, Tuncay; Acet, Halit; Demira, Muhammed
BACKGROUND: There are conflicting results in studies investigating the effects of percutaneous coronary intervention (PCI) on the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) during or outside of usual hospital working hours. While some researchers have reported higher mortality rates in STEMI patients admitted outside of working hours, others did not find a statistically significant difference. OBJECTIVES: Investigate the short-term endpoints and long-term outcomes of STEMI patients by time of admission. DESIGN: Retrospective SETTING: Tertiary percutaneous coronary intervention center. PATIENTS AND METHODS: Patients were grouped by admission, which consisted of four intervals: 06:00 to <12:00, 12:00 to <18:00, 18:00 to <24:00, and 24:00 to <06:00. We analyzed demographic, clinical and mortality by admission time interval and mortality by multivariate analyses, including the time intervals. MAIN OUTCOME MEASURES: Clinical data and mortality SAMPLE SIZE: 735 patients; median (IQR) age 62 (22) years; 215 (29.3%) women. RESULTS: Patients admitted at night were 1.37 times more likely to experience pulmonary edema than patients whose symptoms started in the daytime (P=.012); 32.9% of the patients whose symptoms started at night presented with Killip class II-IV, while during the daytime, 21.4% presented with Killip class II-IV (P=.001). Among the patients, the most common was inferior STEMI (38.6%). However, no-reflow was significantly higher during the daytime compared to the nighttime (P=.12). The risk of the cardiac arrest on admission was 1.2 times higher in patients admitted at night (P=.034). Neither time interval of admission nor several other variables had an effect on clinical outcome or mortality. CONCLUSIONS: While patients admitted at night presented with pulmonary edema and cardiogenic shock more frequently, no reflow was observed during the day after the procedure. Although patients admitted at night with STEMI presented with worse clinical conditions, similar results were observed between the groups in clinical outcomes. LIMITATIONS: More “real world” results might have been obtained if the study had replicated more typical referral conditions for PCI. CONFLICT OF INTEREST: None.
Distribution of Accessory Pathways in Atrioventricular Reentrant Tachycardia in Southeast Anatolian Region of Turkey
(2015) İslamoğlu, Yahya; Özaydoğdu, Necdet; Polat, Nihat; Akıl, Mehmet Ata; Aydın, Mesut; Aktan, Adem; Acet, Halit
Amaç: Güneydoğu Anadolu bölgesinde atriyoventriküler reentran taşikardilerdeki (AVRT) aksesuar yolları değerlendirmeyi amaçladık. Yöntem: Çalışma retrospektif kesitsel olarak yapıldı. Haziran 2012- Temmuz 2014 tarihleri arasında ardışık olarak AVRT nedeniyle ablasyon tedavisi yapılan hastaları çalışmaya dahil ettik. Bütün hastalar elektrofizyoloji laboratuvarına sedasyon yapılmadan alındı. 3 diyagnostik kateter kullanılarak elektrofizyolojik çalışma yapıldı. Koroner sinüse diyagnostik kateter yerleştirildi. Aksesuar yol tespit edildiğinde radyofrekans enerji kullanılarak tedavi yapıldı. Aksesuar yolların lokalizasyonu floroskopik olarak sol ön oblik pozisyonda belirlendi. Bulgular: Çalışmaya 64 AVRTli hasta dahil edildi (%63 kadın, yaş ortalaması 34±14). Atriyoventriküler reentran taşikardili hastaların 20 (%31)si gizli AVRT, 44 (%63)ü WPW sendromu olduğu saptandı. Aksesuar yolların bulunduğu yerlerin sol serbest duvar %59, posteroseptum %34, sağ serbest duvar %6 ve anteroseptum %3 olarak saptadık. Aksesuar yollar karşılaştırıldı. Gruplar arasında istatistiksel olarak herhangi bir fark yoktu. Sonuç: Aksesuar yolların bulunduğu bölgelerin dağılımı literatür ile benzer bulundu. Atriyoventriküler reentran taşikardiler arasında herhangi bir fark olmadığını belirlendi.
The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement
(Soc Brasil Cirurgia Cardiovasc, 2024) Aktan, Adem; Demir, Muhammed; Guzel, Tuncay; Karahan, Mehmet Zulkuf; Aslan, Burhan; Kilic, Raif; Gunlu, Serhat
Introduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in -hospital complications as well as mortality of patients undergoing Evolut (TM) R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium -3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in -hospital mortality. Patients were divided into two groups, AA <= 48(degrees) and AA > 48(degrees), based on the mean AA measurement (48.3 +/- 8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted.
The effect of atherogenic plasma index on collateral development in patients with chronic coronary total occlusion
(2021) Güzel, Tuncay; Bilik, Mehmet Zihni; Arslan, Bayram; Kılıç, Raif; Aktan, Adem
Aim: To demonstrate the correlation between coronary collateral circulation (CCC) and atherogenic plasma index (AIP), one of the factors associated with the formation of collateral vessels. Methods: Hospital records of patients with chronic total occlusion (100% stenosis) in at least one coronary artery were evaluated. Triglycerides, HDL level, triglyceride/HDL ratio and atherogenic plasma index before coronary angiography were assessed for the 451 patients who met the study criteria. Results: Comparison of the two groups in terms of laboratory findings showed that triglyceride/HDL ratio (5.04±3.13 vs 3.56±2.12, p<0.001) and AIP (0.63±0.25 vs 0.48±0.25, p<0.001) were higher with statistical significance in the weak collateral group. The ROC analysis revealed an association between weak collateral formation and atherogenic plasma index with 64.7% sensitivity and 66.2% specificity using a cut-off value of 0.58 for AIP. Accordingly, low AIP was found to be an independent predictor of good collateral artery formation. Conclusion: This study suggests that a high atherogenic plasma index may be an independent factor associated with poor collateral formation.
The effect of body mass index on complications in cardiac implantable electronic device surgery
(Wiley, 2024) Guzel, Tuncay; Demir, Muhammed; Aktan, Adem; Kilic, Raif; Arslan, Bayram; Gunlu, Serhat; Altintas, Bernas
Background Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications.Methods1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m(2)), overweight (25 <= BMI < 30 kg/m(2)), and obese (BMI >= 30 kg/m(2)). The primary endpoint was accepted as cumulative events, including the composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of cumulative events.Results The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156-3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470-9.204, p < .001), BMI (OR:1.069, 95%CI:1.012-1.129, p = .01) were independent predictors of cumulative events rates.Conclusions Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.
Effect of cardio-gastric interaction on atrial fibrillation in GERD patients
(Dicle Üniversitesi Tıp Fakültesi, 2023) Günlü, Serhat; Araç, Eşref; Aktan, Adem; Kayan, Fethullah; Altıntaş, Bernas; Karahan, Mehmet Zülkif
Objective: Atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) are very common in daily clinical practice. Post-prandial AF episodes have been reported in GERD patients. Although it was reported in previous studies that it was caused by sympathovagal imbalance, there are no studies on cardiac conduction system involvement. In this study, we aimed to evaluate whether the risk of developing AF increases in untreated GERD patients with non-invasive electrophysiological tests. Methods: The research was prospectively performed. Endoscopy was performed on the individuals due to reflux complaints. ECG was recorded at 25mm/s and 10 mm/mV amplitude, and 24-hour Holter ECG (three-channel; V1, V2, and V5) was performed. ECG parameters were measured and Holter ECG results were analyzed. Results: A total of 120 individuals, 60 patients and 60 controls, were included. No significant statistically differences existed between groups for hypertension, diabetes, smoking, or dyslipidemia (p>0.05). In terms of heart rate, Pmax, Pmin, QTd, and QTcd, there were no significant differences across the two groups (p>0.05). P-wave dispersion (Pd) was substantially higher in the study group (p=0.014). Comparing the heart rate variabilities of 24-hour Holter ECG recordings across the groups, the standard deviation of R-R intervals (SDNN) was substantially higher in the study group (p<0.001). Low Frequency (LF) and LF/HF were significantly higher in the control group (p<0.001 and p=0.003, respectively). AF was detected in nine individuals on Holter ECG. Conclusion: Pd duration and risk of developing AF were higher in GERD patients.
The effect of chronic DOAC treatment on clinical outcomes of hospitalized patients with COVID-19
(John Wiley and Sons Inc, 2021) Aslan, Burhan; Akyüz, Abdurrahman; Işık, Ferhat; Çap, Murat; İnci, Umit; Kaya, İlyas; Karahan, Mehmet Zülküf; Aktan, Adem; Bilge, Önder; Özbek, Mehmet Nuri
Background: Recent findings indicate that thrombosis is one of the underlying pathophysiology and complication of COVID-19 infection. Therefore, the prognosis of the disease may be more favourable in people who were under oral anticoagulant treatment before the COVID-19 diagnosis. This study aims to evaluate the effects of chronic DOAC use on ICU admission and mortality in hospitalized patients due to COVID-19 infection. Method: Between 1 September and 30 November 2020, 2760 patients hospitalized in our hospital due to COVID-19 were screened. A total of 1710 patients who met the inclusion criteria were included in the study. The patients were divided into two groups as those who use DOAC due to any cardiovascular disease before the COVID-19 infection and those who do not. Results: Seventy-nine patients were enrolled in the DOAC group and 1631 patients in the non-DOAC group. Median age of all study patient was 62 (52-71 IQR) and 860 (50.5%) of them were female. The need for intensive care, in-hospital stay, and mechanical ventilation were observed at higher rates in the DOAC group. Mortality was observed in 23 patients (29%) in the DOAC group, and it was statistically higher in the DOAC group (P =.002). In the multivariable analysis, age (OR: 1.047, CI: 1.02-1.06, P <.001), male gender (OR: 1.8, CI: 1.3-2.7, P =.02), lymphocyte count (OR: 0.45, CI: 0.30-0.69, P <.001), procalcitonin (OR: 1.12, CI: 1.02-1.23, P =.015), SaO2 (OR: 0.8, CI: 0.77-0.82, P <.001) and creatinine (OR: 2.59, CI: 1.3-5.1, P =.006) were found to be associated with in-hospital mortality. DOAC treatment was not found to be associated with lower in-hospital mortality in multivariable analysis (OR:1.17, CI: 0.20-6.60, P =.850). Conclusion: Our study showed that the use of DOAC prior to hospitalization had no protective effect on in-hospital mortality and intensive care need in hospitalized COVID-19 patients.
The effect of COVID-19 pandemic on time in therapeutic range in patients using warfarin
(Wolters Kluwer Medknow Publications, 2022) Aktan, Adem; Güzel, Tuncay; Arslan, Bayram; Özbek, Mehmet; Demir, Muhammed; Aslan, Burhan
Introduction: Patients receiving anticoagulant therapy experience a serious problem at a time when the rates of outpatient visits for the international normalized ratio (INR) monitoring are gradually decreasing owing to the risk of virus transmission during the pandemic. The aim of this multicenter study was to investigate how the coronavirus disease 2019 pandemic affected the time in therapeutic range (TTR) value, which shows the use of effective doses of warfarin, and its monitoring in patients using warfarin. Materials and Methods: A total of 158 patients with 3 consecutive prepandemic INR levels and at least 3 postpandemic INR levels without time limitation were retrospectively evaluated. TTR values were calculated and the preepidemic and postepidemic values were compared. TTR was obtained using the conventional method. Results: The mean preepidemic and postepidemic TTR values were found to be 64.4 (61.8%-67.0%) and 34.9 (30.8%-39.0%), respectively. TTR rate was statistically significantly lower in the postpandemic period than in the prepandemic period (P < 0.001). While the prepandemic TTR of 68 (43%) patients was <60, the postpandemic TTR of 125 (79%) patients was <60. Discussion and Conclusion: Patients using warfarin were found to have lower TTR values during the pandemic. One of the most important reasons for this result is patients' delayed admission to the hospital due to fear of infection. The importance of regular follow-ups and alternative solutions should be emphasized for the effective treatment of these patients.
The effect of nutritional scores on mortality in COVID-19 patients
(Assoc Medica Brasileira, 2022) Aktan, Adem; Guzel, Tuncay; Demir, Muhammed; Ozbek, Mehmet
OBJECTIVES: While studies on the treatment for the coronavirus disease 2019 (COVID-19) pandemic continue all over the world, factors that increase the risk of severe disease have also been the subject of research. Malnutrition has been considered an independent risk factor. Therefore, we aimed to investigate the clinical effect of dietary habits and evaluate the prognostic value of the Controlling Nutritional Status score in the COVID-19 patients we followed up.METHODS: A total of 2760 patients hospitalized for COVID-19 were examined. Patients were retrospectively screened from three different centers between September 1 and November 30, 2020. A total of 1488 (53.9%) patients who met the criteria were included in the study. Risk classifications were made according to the calculation methods of prognostic nutritional index and Controlling Nutritional Status scores and total scores. The primary outcome of the study was in-hospital mortality.RESULTS: The groups with severe Controlling Nutritional Status and prognostic nutritional index scores had a significantly higher mortality rate than those with mild scores. In the multivariable regression analysis performed to determine in-hospital mortality, the parameters, such as age (OR 1.04; 95%CI 1.02-1.06, p<0.001), admission oxygen saturation value (SaO2) (OR 0.85; 95%CI 0.83-0.87, p<0.001), and Controlling Nutritional Status score (OR 1.34; 95%CI 1.23-1.45, p<0.001), were independent predictors. The patient groups with a low Controlling Nutritional Status score had a higher rate of discharge with recovery (p<0.001).CONCLUSIONS: Higher Controlling Nutritional Status scores may be effective in determining in-hospital mortality in patients with COVID-19. Nutrition scores can be used as a useful and effective parameter to determine prognosis in patients with COVID-19.

Yazar "Aktan, Adem" seçeneğine göre listele

Sayfa Başına Sonuç

Sıralama seçenekleri