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    EFFECT OF THE PROGNOSTIC NUTRITION INDEX ON LONG-TERM OUTCOMES IN UNPROTECTED LEFT MAIN CORONARY ARTERY REVASCULARIZATION
    (Russian Heart Failure Soc, 2023) Guzel, Tuncay; Avci, Eyup; Kiris, Tuncay; Arik, Baran; Arslan, Bayram; Ildirimli, Kamran; Yildirim, Bunyamin
    Objective The prognostic nutritional index (PNI) is a practical, applicable, prognostic scoring system. However, its clinical significance in unprotected left main coronary artery (ULMCA) patients undergoing percutaneous coronary intervention (PCI) has not yet been clarified. This study aimed to examine the relationship between malnutrition as assessed by PNI and major adverse cardiac events (MACE) in ULMCA patients undergoing PCI.Material and methods 185 patients who were hospitalized in our clinic underwent coronary angiography, had a critical LMCA lesion, and underwent angiography-guided PCI were included. The study population was divided into tertiles based on the PNI values. A high PNI (n=142) was defined as a value in the third tertile (>= 34.0), and a low PNI (n=43) was defined as a value in the lower 2 tertiles (< 34.0). The primary endpoint was MACE.Results MACE and mortality rates in the low PNI group were significantly higher compared to the high PNI group (51 % vs. 30 %, p=0.009; 44 % vs. 20 %, p=0.002, respectively). High PNI (HR:1.902; 95 % CI:1.112-3.254; p=0.019), previous stroke (HR:3.025; 95 % CI:1.038-8.810; p=0.042) and SYNTAX score (HR:1.028; 95 % CI:1.004-1.057, p=0.023) were independent predictors of MACE in the multivariable cox regression analyzes.Conclusions In patients undergoing ULMCA PCI, nutritional status can be considered an indicator of MACE rates by evaluating the PNI score. This index can be used for risk classification.
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    Monocyte to high-density lipoprotein cholesterol and lymphocyte to monocyte ratios are predictors of in-hospital and long-term mortality in patients with acute coronary syndrome
    (Wiley, 2021) Oylumlu, Muhammed; Oylumlu, Mustafa; Arik, Baran; Demir, Muhammed; Ozbek, Mehmet; Arslan, Bayram; Acun, Baris
    Objective We aimed to determine the relationship between LMR and MHR and in-hospital and long-term mortality in patients with ACS. Methods We retrospectively collected patients with ACS undergoing coronary angiography between January 2012 and December 2013. Results In total, 825 patients with a mean age of 62.4 +/- 12.9 years (71.3% male) were enrolled in the study. Patients were divided into three tertiles based on MHR levels and LMR levels. In-hospital mortality of the patients was significantly higher amongst patients in the upper MHR tertile when compared with the lower and middle MHR tertile groups [30 (10.9%) vs 8 (2.9%) and 14 (5.1%); P < .001, P = .009, respectively]. Five-year mortality of the patients was significantly higher amongst patients in the upper MHR tertile when compared with the lower and middle MHR tertile groups [84 (30.5%) vs 48 (17.5%) and 57 (20.7%); P < .001, P = .005, respectively]. In-hospital mortality of the patients was significantly higher amongst patients in the lower LMR tertile when compared with the upper and middle LMR tertile groups [25 (9.1%) vs 10 (3.6%) and 17 (6.2%); P = .007, P = .130, respectively]. Five -year mortality of the patients was significantly higher amongst patients in the lower LMR tertile when compared with the upper and middle LMR tertile groups [77 (28.0%) vs 47 (17.1%) and 65 (23.6%); P = .001, P = .142, respectively]. Conclusion We have shown that high MHR and low LMR were significant and independent predictors of in-hospital and long-term mortality in patients with ACS.
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    A new trend to reduce adverse events in patients undergoing transcatheter aortic valve implantation: cusp overlap technique: a cross sectional study
    (Springer, 2023) Guzel, Tuncay; Demir, Muhammed; Aktan, Adem; Arik, Baran; Argun, Lokman; Ildirimli, Kamran; Sutcu, Mihriban
    BackgroundTranscatheter aortic valve implantation (TAVI) is currently the treatment of choice for the majority of patients at moderate or high surgical risk. However, some complications occur frequently with this procedure. In this study, we aimed to assess whether the cusp-overlap view (COP) technique may be associated with a reduced incidence of some of these complications compared with the classical three-cusp view (TCV) technique. MethodsIn this single-center, retrospective study we investigated; technical success, postprocedural permanent pacemaker implantation (PPMI), new-onset stroke, pericardial tamponade, arrhythmia development, acute renal failure, major bleeding, major vascular complications, procedure-related coronary obstruction, new-onset left bundle branch block (LBBB), paravalvular leak, peri-procedural myocardial infarction (MI), day of hospitalization, death, and major adverse cardiac and cerebrovascular events (MACCE) were determined as the clinical endpoints. ResultsA total of 281 consecutive patients who met the study criteria and underwent elective or emergency transfemoral TAVI using the self-expandable CoreValve Evolut valve were included. 176 consecutive patients implanted with the classical TCV technique and 105 consecutive patients implanted with the COP technique were compared. Compared with the TCV group, patients in the COP group had lower PPMI (3.8% vs. 10.8%, p = 0.039), in-hospital mortality (1.9% vs. 8.5%, p = 0.018), and 1-year death (4.8% versus 18.8%, p = 0.001), and MACCE rates (12.4% vs 31.3%, p < 0.001). ConclusionThe COP technique may help to reduce the conduction disturbances, PPMI requirement and complication rates that may develop following TAVI. In addition, it is an interesting result that it reduces mortality and MACCE rates in long-term follow-ups.
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    Novel predictor of pulmonary arterial hypertension: Monocyte to HDL cholesterol ratio
    (Lippincott Williams & Wilkins, 2022) Bilik, Mehmet Zihni; Oylumlu, Muhammed; Oylumlu, Mustafa; Acun, Baris; Arik, Baran; Arslan, Bayram; Acet, Halit
    Monocyte to HDL cholesterol ratio (MHR), lymphocyte to monocyte ratio (LMR), and neutrophil to lymphocyte ratio (NLR) have been proposed as novel systemic inflammatory markers. The aim of this study was to explore the association between MHR, LMR and NLR with pulmonary arterial hypertension (PAH). The study is a single-center, retrospective Cross-sectional study. The study group consisted of 73 patients with PAH and the control group 77 participants without cardiac pathology as determined by echocardiography. On admission, blood sampling to calculate MHR, LMR, NLR, and detailed clinical data were obtained. According to the Pearson test, systolic pulmonary artery pressure (PAP) value Higher MHR, NLR and lower LMR that indicates an enhanced inflammation were significantly increased in patients with PAH when compared with controls. Compared to many other inflammatory markers, these markers are widely available. positively correlated with the MHR and NLR (r:.35, P < .001 and r:.33, P < .001, respectively), but negatively correlated with LMR (r: -.26, P = .001). After multivariate logistic regression analysis, MHR, LMR, and NLR remained as significant predictors of PAH (OR: 2.651, 95% CI: 1.227-5.755, P = .007; OR: 0.647, 95% CI:0.450-0.931, P = .005; OR: 1.350, 95% CI: 1.054-1.650 P = .030, respectively).
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    Oral Anticoagulant Use and Long-Term Follow-Up Results in Patients with Non-valvular Atrial Fibrillation in Turkey AFTER-2 Study
    (Kare Publ, 2022) Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Arslan, Bayram; Arik, Baran; Yentur, Merve; Yildiz, Halil
    Background: The aim of this study was to investigate the frequency of oral anticoagulant drugs and time in therapeutic range in patients receiving warfarin in addition to the epidemiological trial of non-valvular atrial fibrillation previously conducted in Turkey (The Atrial Fibrillation: Epidemiological Registry trial). Furthermore, the prevalence of major adverse events and mortality rates of the patients were evaluated during the long-term follow-up period. Methods: We created a national data registry for non-valvular atrial fibrillation patients, reflecting all geographic regions by population density. In that context, the study included all consecutive atrial fibrillation patients older than 18 years of age who were admitted to the cardiology outpatient clinic except for patients those with prosthetic heart valves and rheumatic mitral valve stenosis. Results: This study included 2592 patients from 35 different centers. The mean age was 68.7 +/- 11.1 years, and 55.5% of the patients were female. The most common comorbid diseases were chronic kidney disease (69%) and hypertension (65.5%). The time in therapeutic range rate in the general population was 40%, and the mortality rate at 5-year follow-up was 29.4%. Conclusion: The Atrial Fibrillation: Epidemiological Registry 2 study showed higher use of anticoagulant in non-valvular atrial fibrillation patients than in previous national studies. Furthermore, this study demonstrated that most of the non-valvular atrial fibrillation patients are in the high-risk group and the time in therapeutic range rates are still low in Turkey. As a result, this is a significant reason for switching from warfarin to non-K vitamin-dependent new oral anticoagulant treatments.