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Öğe Apparently low serum asymmetric dimethylarginine is associated with fasting glucose and tends toward association with type-2 diabetes(Turkish Soc Cardiology, 2014) Onat, Altan; Koroglu, Bayram; Can, Gunay; Karagoz, Ahmet; Yuksel, Murat; Aydin, MesutObjective: We investigated the association of serum asymmetric dimethylarginine (ADMA) with metabolic syndrome (MetS), type-2 diabetes and coronary heart disease (CHD) in the general population. Methods: Cross-sectional and, at 2000 person-years' follow-up, prospective analysis. Adults with measured serum ADMA level (n=848) were analyzed using tertiles or dichotomized values. ADMA concentrations were measured by a validated commercial ELISA kit. Results: Dichotomized subjects of combined sexes with low (<= 0.68 mu ol/L) ADMA values had significantly higher fasting glucose, total cholesterol, apolipoprotein B and lower diastolic blood pressure. In linear regression analyses comprising age, smoking, triglyceride, HDL-cholesterol, C-reactive protein and waist circumference as well, creatinine was significantly and independently associated with ADMA, further in women glucose (inversely). In logistic regression analyses uniformly adjusted for age, smoking status and waist girth, prevalent MetS tended to positive independent association with ADMA tertiles only in men. Combined prevalent and incident diabetes weakly tended to be associated with the lowest (vs mid-and highest) ADMA tertiles in combined gender; and prevalent and incident CHD was not associated with ADMA tertiles in either sex. Conclusion: Apparently low circulating ADMA is independently associated with fasting glucose and tends to be so with type-2 diabetes. The lack of anticipated positive associations of ADMA with cardiometabolic disorders is likely due to autoimmune responses operating against serum ADMA under oxidative stress, rendering partial failure in immunoassay.Öğe Assessment of atrial electromechanical delay and P-Wave dispersion in patients with Psoriasis(Echocardiography- A Journal Cardiovascular Ultrasound and Allied Techniques, 2014) Yildiz, Abdulkadir; Ucmak, Derya; Oylumlu, Mustafa; Akkurt, Meltem Z.; Yuksel, Murat; Akil, Mehmet Ata; Polat, Nihat; Aydin, Mesut; Bilik, M. Zihni; Acet, HalitBackground: In this study, we sought to evaluate atrial electromechanical properties and conduction homogeneity by tissue Doppler imaging and electrocardiography in patients with psoriasis. Methods: Thirty-four patients with psoriasis and 30 age-and gender-matched healthy controls were included in the study. Atrial electromechanical coupling intervals were assessed by means of tissue Doppler echocardiography and P-wave dispersion (Pd) was calculated from electrocardiogram. Results: A total of 64 subjects (33 male) with a mean age of 36.8 +/- 11.9 years were included in the study. Basal characteristics were similar between 2 groups. Intra-atrial (15 +/- 7 ms vs. 12 +/- 5 ms, P = 0.009) and inter-atrial (28 +/- 7 ms vs. 23 +/- 7 ms, P = 0.002) electromechanical delays were significantly higher in patients with psoriasis compared with control groups. P-maximum (112 +/- 16 ms vs. 103 +/- 8 ms, P = 0.006) and Pd (35 +/- 9 ms vs. 20 +/- 6 ms, P < 0.001) were also prolonged in patients with psoriasis. Conclusion: This study demonstrated that atrial electromechanical coupling intervals and P-wave dispersion were prolonged in patients with psoriasis, which may cause an increased risk of atrial fibrillation in this patient group.Öğe Assessment of Serum ADMA Levels and Aortic Elastic Properties in Patients With Ankylosing Spondilitis(Elsevier Science Inc, 2013) Kaya, Hasan; Tekbas, Ebru Onturk; Ertas, Faruk; Inci, Umit; Oylumlu, Mustafa; Yuksel, Murat; Aydin, Mesut[Abstract Not Available]Öğe 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, YahyaObjective: 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.Öğe The Association between Neutrophil to Lymphocyte Ratio and Presence of Ventricular Premature Contractions(Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Polat, Nihat; Acet, Halit; Bilik, Mehmet Zihni; Aydin, Mesut[Abstract Not Available]Öğe The Association between Neutrophil/Lymphocyte Ratio and Functional Capacity in Patients with Idiopathic Dilated Cardiomyopathy(Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Tuncez, Abdullah; Grbovic, Enis; Polat, Nihat; Yuksel, Murat; Aydin, Mesut; Oylumlu, Mustafa[Abstract Not Available]Öğe The Association Between the Neutrophil-to-Lymphocyte Ratio and the Presence of Ventricular Premature Contractions in Young Adults(Sage Publications Inc, 2015) Yildiz, Abdulkadir; Oylumlu, Mustafa; Yuksel, Murat; Aydin, Mesut; Polat, Nihat; Acet, Halit; Akil, Mehmet AtaInflammation has recently emerged in the pathogenesis of several cardiovascular disorders, including arrhythmias. The neutrophil-lymphocyte ratio (NLR) is a simple marker for the assessment of inflammatory status. Therefore, we aimed to investigate the relationship between the NLR and the ventricular premature contraction (VPC) existence. Patients aged between 18 and 40 years who were referred to the cardiology clinic were enrolled in the study. All patients' complete blood counts and 24-hour Holter recordings were analyzed. The NLR was higher within the VPC group compared to the control group (P < .001). According to the NLR tertiles, VPCs were more common in the higher NLR tertile (P < .001). A cutoff point of 1.80 for the NLR had 71% sensitivity and 60% specificity in predicting VPC in apparently healthy individuals. After multivariate analysis, only the NLR remained significant predictor of presence of VPC. In conclusion, the NLR is independently and significantly associated with VPC existence.Öğe Association of Neutrophil-Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis(Sage Publications Inc, 2014) Polat, Nihat; Yildiz, Abdulkadir; Yuksel, Murat; Bilik, Mehmet Zihni; Aydin, Mesut; Acet, Halit; Akil, Mehmet AtaThe aim of the study is to investigate the association between the severity of rheumatic mitral valvular disease (RMVD) and the neutrophil-lymphocyte ratio (NLR). A total of 227 patients were enrolled in the study and divided into 3 groups. Patients in group 1 had rheumatic mitral stenosis (RMS), those in group 2 had RMVD without stenosis, and those in group 3 served as the control group. Group 1 was further divided into 2 groups, severe mitral stenosis (MS) and mild to moderate MS. The NLR was significantly higher in patients with severe MS when compared to those with mild to moderate MS (P = .002) while lymphocyte count was lower (P = .034). Using a cutoff level of 2.56, the NLR predicted severe RMS with a sensitivity of 75% and specificity of 74%. In conclusion, as an inexpensive, simple, and accessible marker of inflammation, the NLR may be useful in predicting the presence and severity of MS in patients with RMVD.Öğe Carotid Artery Stiffness in Patients With Neurally Mediated Syncope(Amer Inst Ultrasound Medicine, 2012) Elbey, Mehmet Ali; Atilgan, Zuhal; Cil, Habib; Kaya, Hasan; Ertas, Faruk; Aydin, Mesut; Ozaydogdu, NecdetObjectives-Neurally mediated syncope is defined as a transient loss of blood flow to the brain, resulting in vasodilatation, bradycardia, or both. The pathophysiologic mechanisms of neurally mediated syncope are not clear. In this study, we investigated carotid artery elasticity parameters in patients with neurally mediated syncope. Methods-The study was conducted on 41 patients who were examined by the tilt table test. Group 1 constituted of 21 patients who had a positive response to the tilt table test. Clinical and hemodynamic parameters were compared with patients in a negative tilt table test group (group 2). The systolic and diastolic diameters of the carotid arteries, carotid distensibility, carotid strain, carotid stiffness index, and carotid elastic modulus of the left carotid arteries were calculated by a high-resolution ultrasound device. Results-No differences in hemodynamic variables or clinical parameters were detected between the groups. Carotid distensibility (mean +/- SD, 1.6 +/- 0.6 versus 2.2 +/- 0.8 cm(2) x dyne(-1) x 10(-6); P = .044) and strain (6.8% +/- 1.7% versus 8.2% +/- 1.9%; P = .026) were lower in group 1 than in group 2. The carotid elastic modulus (0.88 +/- 0.33 versus 0.74 +/- 0.25 cm(2) x dyne(-1) x 10(-6); P = .002) and stiffness index (6.7 +/- 0.4 versus 6.2 +/- 0.5; P = .038) were higher in group 1. Conclusions-In this study, we concluded that elastic properties of the carotid artery are impaired in patients with neurally mediated syncope. This finding suggests that impaired carotid arterial elasticity may be a factor in the pathophysiologic mechanisms of neurally mediated syncope.Öğe Clinical Characteristics and Outcome of Cardiovascular Implantable Electronic Device Infections in Turkey(Sage Publications Inc, 2016) Aydin, Mesut; Yildiz, Abdulkadir; Kaya, Zeynettin; Kaya, Zekeriya; Basarir, Ahmet Ozgur; Cakmak, Nazmiye; Donmez, IbrahimInfection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality.Öğe Coexistence of permanent junctional reciprocating tachycardia with rheumatic valvular disease; a case sucessfully treated with radiofrequency ablation(Aves Press Ltd, 2015) Aydin, Mesut; Yildiz, Abdulkadir; Yuksel, Murat; Islamoglu, YahyaA seventeen years old female had presented with palpitation. On the electrocardiography (ECG), long RP, narrow QRS tachycardia, inverted P waves in leads D2, D3 and aVF were noticed. On transthoracic echocardiography, rheumatic mitral valvular disease (RMVD) with normal ventricular systolic function was observed. Eccentric mitral regurgitation was also present. Electrophysiology study (EPS) was performed at our institution. According to EPS and surface ECG findings our diagnosis was permanent junctional reciprocating tachycardia (PJRT). Atrial activation appeared earliest and nearly ostium of the coronary sinus. The accessory pathway was detected near the coronary sinus ostium. RF ablation was performed, successfully. Tachycardia was terminated in three seconds. Permanent junctional reciprocating tachycardia can rarely coexist with RMVD. Here, we are reporting a case of PJRT and RMVD coexistence that underwent successful radiofrequency (RF) catheter ablation. This case report confirms that RF catheter ablation should be considered as the treatment of choice in adult patients with PJRT for the following reasons: catheter ablation is highly successful, the complication rate is low, and PJRT may lead to tachycardia induced cardiomyopathy, which is reversible.Öğe Distinction of hypertriglyceridemic waist phenotype from simple abdominal obesity: interaction with sex hormone-binding globulin levels to confer high coronary risk(Taylor & Francis Ltd, 2017) Karagoz, Ahmet; Onat, Altan; Aydin, Mesut; Can, Gunay; Simsek, Baris; Yuksel, MuratObjective: The associations of total testosterone (TT) and sex hormone-binding globulin (SHBG) with the hypertriglyceridemic waist (HtgW) phenotype and coronary heart disease (CHD) risk have scarcely been examined. We explored such cardiometabolic risk mediations in middle-aged adults. Methods: Participants (n = 1924) in a population-based study were studied by forming categories consisting of abdominal obesity, hypertriglyceridemia, both (HtgW), or none ('healthy'). Cardiometabolic risk was prospectively analyzed (mean follow-up 5.7 years). Results: With reference to the healthy group, SHBG values in HtgW were significantly lower, alike serum HDL-cholesterol. ApolipoproteinB-containing lipoproteins, fasting glucose and complement C3 levels, inverse to lipoprotein[Lp](a) especially in female participants with HtgW phenotype compared with those in the 'healthy' category, suggested the operation of aggregation to Lp(a). Multivariable Cox regression analysis in a model comprising age, waist circumference and systolic blood pressure showed significant protection by SHBG against incident diabetes which tended to be so with TT in men. Sex hormones were not associated with risk of incident CHD or MetS. In another multivariable model, compared to the ` healthy' and the hypertriglyceridemia categories, dichotomized high and, in females, low SHBG values within the HtgW category, positively predicted CHD at significant over 2-fold relative risks. Conclusion: HtgW phenotype distinguishes itself from the (virtually neutral) simple abdominal obesity in independently conferring high CHD risk when elevated or reduced SHBG levels interact. Underlying operation of Lp(a) aggregation is suggested.Öğe Distribution of Accessory Pathways in Atrioventricular Reentrant Tachycardia in Southeast Anatolian Region of Turkey(Duzce Univ, 2015) Aydin, Mesut; Polat, Nihat; Yuksel, Murat; Yildiz, Abdulkadir; Acet, Halit; Bilik, Mehmet Zihni; Akil, Mehmet AtaObjective: We aimed to evaluate distribution of accessory pathway (AP) in atrioventricular reentrant tachycardia (AVRT) in southeast Anatolian region of Turkey. Methods: The study was a retrospective cross-sectional design. Consecutive patients who underwent catheter ablation of AVRT between June 2012 and July 2014 were included in the study. All patients were taken to the electrophysiology laboratory in the non-sedated state and underwent an initial diagnostic study using three diagnostic catheters. The one of them was placed in coronary sinus. In those patients, in whom the AP was identified, ablation therapy was carried out using radiofrequency energy. We decided distribution of AP on fluoroscopy. Fluoroscopic images are obtained in and the left anterior oblique orientation. Results: The study population consisted of 64 AVRT patients (63% female; mean age 34 +/- 14). Among AVRT 20(31%) patients had concealed AVRT, 44 (69%) patients had Wolf Parkinson White syndrome. Distribution of AP was 59% at the left free wall, 34% at the posteroseptum, 6% at the right free wall, and 3% at the anteroseptum. The locations of APs were compared. There was no any statistically significant among groups. Conclusion: Distribution of AP location was in accordance with literature. The other characteristic of AVRT were similar with the current data.Öğe High adiponectin levels fail to protect against the risk of hypertension and, in women, against coronary disease: involvement in autoimmunity?(Baishideng Publishing Group Inc, 2013) Onat, Altan; Aydin, Mesut; Can, Gunay; Koroglu, Bayram; Karagoz, Ahmet; Altay, ServetAIM: To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome. METHODS: Middle-aged adults representative of a general population with baseline circulating adiponectin measurements (n = 1224) were analyzed prospectively at a mean of 3.8 years' follow-up, using continuous values or sex-specific tertiles. Total adiponectin was assayed by an ELISA kit. Type-2 diabetes was identified by criteria of the American Diabetes Association. Hypertension was defined as a blood pressure >= 140 mmHg and/or >= 90 mmHg and/or use of antihypertensive medication. Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders. RESULTS: In models of multiple linear regression, sex hormone-binding globulin, fasting insulin (inverse) and, in men, age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine. Cox regression analyses for incident coronary heart disease (CHD), adjusted for sex, age, non-HDL cholesterol, waist circumference and C-reactive protein, revealed significant inverse association with adiponectin tertiles in men but not women (HR = 0.66; 95% CI: 0.32-1.38 for highest tertile). Cox regression for type-2 diabetes in a similar model (wherein glucose replaced non-HDL cholesterol), adiponectin tertiles appeared to protect in each gender. HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles (P -trend = 0.67). CONCLUSION: High adiponectin levels failed to protect against the development of hypertension and, in women, against CHD, presumably paralleling impairment in renal function as well. Involvement of adiponectin in autoimmune complex with loss of antioxidative- antiatherogenic properties may be underlying. (C) 2013 Baishideng. All rights reserved.Öğe Impact of insulin resistance on contrast induced nephropathy in patients undergoing percutaneous coronary intervention(Springer India, 2014) Elbey, Mehmet Ali; Evliyaoglu, Osman; Simsek, Ziya; Oylumlu, Mustafa; Akil, Mehmet Ata; Aydin, Mesut; Bilik, ZihniContrast-induced nephropathy (CIN) is a common complication following percutaneous coronary intervention (PCI). Contrast-induced nephropathy after emergency PCI in subjects with insulin resistance (IR) has not been studied before. In this prospective study we determined the relation between IR on CIN, among those undergoing PCI due to acute coronary syndrome. One hundred twenty four consecutive acute coronary syndrome patients with diabetes (N = 44), insulin resistance (N = 38) and normal glycemic metabolism (N = 42) were included in the study. They were all treated with PCI. Pre- and post procedural creatinines were measured and independent predictors of CIN were analyzed. IR was defined as a HOMA level (HOMA-IR = Serum Glucose (mg/dL) X Plasma Insulin (micro unit/mL) / 405 > 2.5. Patients with IR or diabetes had significantly higher levels of creatinine after procedure, serum cholesterol, glucose, contrast volume, hospital stay and HOMA. Female gender, frequency of CIN and multivessel disease were also higher in these patients. On the other hand they had significantly lower ejection fraction. Logistic regression analysis showed that HOMA was the single independent risk factor for CIN in patients with acute coronary syndrome treated with PCI. Insulin resistance is an independent risk factor for CIN in patients with acute coronary syndrome treated with PCI. It carries a similar risk with diabetes and proper prophylaxis should be performed.Öğe Impaired fasting glucose: Pro-diabetic, atheroprotective and modified by metabolic syndrome(Baishideng Publishing Group Inc, 2013) Onat, Altan; Aydin, Mesut; Can, Gunay; Cakmak, H. Altug; Koroglu, Bayram; Kaya, Aysem; Ademoglu, EvinAIM: To investigate whether impaired fasting glucose (IFG) confers cardiovascular risk. METHODS: A non-diabetic population-based sample representative of middle-aged and elderly Turks was studied at 8.5 years' follow-up for incident diabetes and coronary heart disease (CHD). Metabolic syndrome (MetS) was defined by ATP-III criteria modified for male abdominal obesity, and IFG and type 2 diabetes were identified by criteria of the American Diabetes Association. Stratification by presence of MetS was used. Outcomes were predicted providing estimates for hazard ratio (HR) obtained by use of Cox proportional hazards regression analysis in models that controlled for potential confounders. RESULTS: In 3181 adults (aged 52 +/- 11.5 years at baseline), analysis stratified by MetS, gender and IFG status distinguished normoglycemic subjects by a hypertriglyceridemic waist phenotype consisting of significantly higher waist circumference, fasting triglyceride and lower high-density lipoprotein-cholesterol, regardless of gender and MetS. Additionally, lipoprotein (Lp) (a) tended to be lower in (especially female) participants with MetS. Multivariable linear regression in a subset of the sample demonstrated decreased Lp (a) levels to be associated with increased fasting glucose and insulin concentrations, again particularly in women. In Cox regression analysis, compared with normoglycemia, baseline IFG adjusted for major confounders significantly predicted incident diabetes at a 3-fold HR in men and only women with MetS. Cox models for developing CHD in 339 individuals, adjusted for conventional risk factors, revealed that IFG status protected against CHD risk [HR = 0.37 (95% CI: 0.14-0.998)] in subjects free of MetS, a protection that attenuated partly in male and fully in female participants with MetS. CONCLUSION: IFG status in non-diabetic people without MetS displays reduced future CHD risk, yet is modulated by MetS, likely due to autoimmune activation linked to serum Lp (a). (C) 2013 Baishideng. All rights reserved.Öğe The importance of hematologic indices in the risk stratification of patients with acute decompensated systolic heart failure(Aves, 2015) Polat, Nihat; Yildiz, Abdulkadir; Bilik, Mehmet Zihni; Aydin, Mesut; Acet, Halit; Kaya, Hasan; Demir, MuhammedObjectives: In patients with heart failure, a variety of hemogram parameters are known to be of prognostic significance. This study aimed to investigate which of these parameters is/are useful in predicting one-year all-cause mortality in patients with acute decompensated heart failure (ADHF). Study design: Patients who were hospitalized between September 2012-March 2013 in our hospital with systolic-ADHF with ejection fraction <= 40%, symptoms, and findings of congestion were enrolled retrospectively in the study. The study population was divided into two groups based on one-year-mortality. Results: 119 patients with ADHF (mean-age 67 +/- 14 years; 55% male) were enrolled in the study. One-year-mortality occurred in 29% of patients. Hemoglobin levels, platelet, basophil and lymphocyte counts were significantly lower, while red-cell distribution width (RDW) was found to be significantly higher in the one-year-mortality group. Neutrophil, monocyte, and eosinophil counts were similar in the two groups. Furthermore, lower estimated glomerular-filtration-rate (eGFR) and unused angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were associated with mortality. Age, presence of hypertension, right-ventricular diameter, eGFR, ACE/ARB treatment, hemoglobin levels, RDW and platelet, leukocyte, lymphocyte, basophil, neutrophil, monocyte, and eosinophil-counts were found to have prognostic significance in univariate analysis. In multivariate analysis, decreased platelet, lymphocyte-counts and hemoglobin level on admission and unused ACE/ARB treatment at discharge (p<0.05) were found to be independent factors predicting one-year-mortality. Conclusion: Among hematological indices; hemoglobin level, platelet and lymphocyte counts are readily available, useful and inexpensive markers for the prediction of one-year all-cause mortality in ADHF patients.Öğe Normal thyroid-stimulating hormone levels, autoimmune activation, and coronary heart disease risk(Springer, 2015) Onat, Altan; Aydin, Mesut; Can, Gunay; Celik, Etem; Altay, Servet; Karagoz, Ahmet; Ademoglu, EvinWhether euthyroid status affects cardiovascular disease risk is unclear. We aimed to investigate whether serum thyroid-stimulating hormone (TSH) levels within the normal range are related to the risk of coronary heart disease (CHD). In participants of the Turkish Adult Risk Factor Study (mean age 52.7 +/- A 11.5), in whom TSH was measured in the 2004/05 survey, cross-sectional and longitudinal analyses were performed. Subjects with TSH concentrations < 0.3 and > 4.2 mIU/L were excluded to ensure euthyroid status leaving 956 individuals as the study sample. Mean follow-up was 4.81 +/- A 1.3 years. Men had 18 % lower (p < 0.001) geometric mean TSH levels (1.10 mIU/L) than women (1.35 mIU/L). Correlations of TSH with risk variables were notably virtually absent except weakly positive ones in men with age and systolic blood pressure (SBP). The age-adjusted TSH mid-tertile in men was associated with lowest lipoprotein [Lp](a), apoB, and total cholesterol values. Incident CHD was predicted in Cox regression analyses in men [HR of 2.45 (95 %CI 1.05; 5.74] and in combined sexes by the lowest compared with the highest TSH tertile, after adjustment for age, smoking status, SBP, and LDL-cholesterol. Analysis for combined prevalent and incident CHD stratified by metabolic syndrome (MetS) confirmed the independent association with the lowest TSH tertile in men, specifically in men without MetS. TSH levels within normal range, low due to partial assay failure, may manifest as independent predictors of incident CHD, particularly in middle-aged men. Autoimmune responses involving serum Lp(a) under oxidative stress might be implicated mechanistically.Öğe A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level(Termedia Publishing House Ltd, 2014) Acet, Halit; Ertas, Faruk; Akil, Mehmet Ata; Polat, Nihat; Aydin, Mesut; Akyuz, Abdurrahman; Aycicek, HilalIntroduction: Previous studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (TB) levels and pre-primary percutaneous coronary intervention (PCl) with patency of IRA flow in STEMI patients has not been investigated. Aim: To evaluate the association of TB with pre-primary PCl, coronary flow and in-hospital major adverse cardiac events (MACE) in patients with STEMI. Material and methods: A total of 360 consecutive patients with STEMI (mean age = 61.4+/-13.7 years) admitted within 12 h from the time of symptom onset were enrolled. Patients were divided into 2 groups based on the serum TB levels. We defined normal flow as pre-PCl TIMI 3 flow, while impaired flow was defined as pre-PCl TIMI 2 flow. Results: Pre-PCl impaired flow was higher in the TB group than pre-PCl normal flow (p < 0.001). In-hospital mortality and MACE were significantly higher in the high TB group (p = 0.002, p < 0.001 respectively). In the receiver operating characteristic curve analysis, TB > 0.825 mg/dl predicted impaired IRA flow before p-PCl with a sensitivity of 79% and specificity of 71%. Conclusions: The TB is an inexpensive and readily available marker for STEMI patients undergoing PCl. It can be used for risk stratification in this patient population.Öğe PREDICTORS OF SUBCLINICAL ATHEROSCLEROSIS IN PREMENOPAUSAL WOMEN(Carbone Editore, 2014) Aydin, Mesut; Alemdar, Recai; Cil, Habib; Besir, Fahri Halit; Ozhan, Hakan; Aydin, Yusuf; Bulur, SerkanAims: We aimed to investigate the predictors of Carotid intima media thickness (CIMT) in premenopausal women. Background: CIMT was shown to be a strong coronary artery disease predictor in both pre- and postmenopausal women. Materials and methods: The study was conducted on 2298 participants. The final cohort included 783 pre-menopausal women (with a mean age of 39 +/- 11). Carotid intima media thickness was measured in all of the participants. Results: Mean CIMT of premenopausal women was 0.51 +/- 0.14 mm. Age- adjusted correlates of CIMT was SBP (r = 0.138; p=<0.001), DBP (r=0.095; p=-0.012) and LDL/HDL (r =0.077; p=0.041) ratio. Linear regression analysis was done in order to find independent covariates of carotid intima media thickness in two different models. Only age and systolic blood pressure were independently associated with CIMT. Logistic regression analysis revealed that only age was an independent predictor of subclinical atherosclerosis. Hypertension had the highest Odds ratio with borderline significance. Conclusion: The age and systolic blood pressure were independently associated with CIMT in premenopausal healthy Turkish women. Hypertension might be the best target for a modifiable risk factor for CIMT and future cardiovascular risk in this population.
