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    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.
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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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    The Relationship between Serum Osteopontin Levels and Isolated Coronary Artery Ectasia
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Bilge, Onder; Bilik, Mehmet Zihni; Akil, Mehmet Ata; Oylumlu, Mustafa; Akin, Halil; Altintas, Bernas
    [Abstract Not Available]
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    Öğe
    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.