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    Association of omentin Val109Asp polymorphism with coronary artery disease
    (2014) Karabacak, Ahmet; Başar, Cengiz; Bulur, Serkan; Aslantaş, Yusuf; Özhan, Hakan; Memişoğulları, Ramazan; Kaya, Ertuğrul
    Objective: Coronary artery disease (CAD) is the most important morbidity and mortality disease in the world. It is also one of the leading causesof death in Turkey. Omentin, a recently found adipocytokine, is reported to regulate insulin sensitivity. It has anti-inflammatory properties and isinversely associated with CAD. Omentin gene polymorphism in patients with CAD has not been studied yet. The aim of this study is to investigatethe relationship between omentin Val109Asp polymorphism and CAD.Methods: This is an observational study on genetic association. 157 consecutive patients who had undergone coronary angiography wereincluded in the study. Seventy-five of them had CAD and the rest serves the control group. Val109Asp polymorphism was analyzed and com-pared. Chi-square test was used in comparison of genotype frequencies, whereas ANOVA and chi-square tests were used in comparison ofclinical characteristics according to the genotypes.Results: There was no significant difference between CAD patients and control subjects regarding omentin Val109Asp polymorphism. However, a 2.5fold increase in Val/Val (homozygous mutant) genotype was detected in patients with CAD. The OR (80% Cl) for Val/Val genotype was 3.46 (1.14-10.49).Conclusion: Although no significant difference was detected regarding omentin Val109Asp polymorphism, Val/Val genotype frequency was found to bemore in patient group than control group. In conclusion, it may be speculated that Val/Val genotype increases the tendency for CAD, but this experimentshould done with larger population to clarify this issue.
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    An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER*-2 study design
    (Türk Kardiyoloji Derneği, 2015) Ertaş, Faruk; Kaya, Hasan; Yıldız, Abdulkadir; Davutoğlu, Vedat; Kiriş, Abdulkadir; Dinç, Lale; Kafes, Habibe; Avcı, Anıl; Çalapkorur, Bekir; Ertaş, Gökhan; Gül, Mehmet; Ay, Nuray Kahraman; Bulur, Serkan; Durukan, Mine; Eren, Murat; İlhan, İbrahim; Küçük, Murathan; Özpelit, Ebru; Şimşek, Hakkı; Uçar, F. Mehmet; Yıldız, Ahmet; Şahin, Yıldıray; Ayhan, Erkan; Çağlayan, Emre; Güngör, Hasan; Özyurtlu, Ferhat; Şen, Nihat; Vatan, Bülent; Vatansever, Fahriye; Kobat, Mehmet Ali; Temiz, Ahmet; Taylan, Gökay; Dönmez, İbrahim; Erkuş, M. Emre; Söylemez, Selami; Zengin, Halit; Gündüz, Mahmut; Tuncez, Abdullah; Karavelioğlu, Yusuf; Gökdeniz, Tayyar; Koza, Yavuzer; Aktop, Ziyaeddin; Katlandur, Hüseyin; Özer, Pelin Karaca; Yüksel, Murat; Acet, Halit; Çil, Habib; Alan, Sait; Toprak, Nizamettin
    Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.).
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    Epidemiology of atrial fibrillation in Turkey: preliminary results of the multicenter AFTER* study
    (Turkish Soc Cardiology, 2013) Ertas, Faruk; Kaya, Hasan; Kaya, Zekeriya; Bulur, Serkan; Kose, Nuri; Gul, Mehmet; Eren, Nihan Kahya
    Objectives: Although atrial fibrillation (AF) is one of the most common rhythm disorders observed in clinical practice, a multicenter epidemiological study has not been conducted in our country. This study aimed to assess our clinical approach to AF based upon the records of the first multicenter prospective Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. Study design: Taking into consideration the distribution of the population in our country, 2242 consecutive patients with at least one AF attack determined by electrocardiographic examination in 17 different tertiary health care centers were included in the study. Inpatients and patients that were admitted to emergency departments were excluded from the study. Epidemiological data of the patients and the treatment administered were assessed. Results: The mean age of the patients was determined as 66.8+/-12.3 years with female patients representing 60% of the study population. While the most common AF type in the Turkish population was non-valvular AF (78%), persistent/permanent AF was determined in 81% of all patients. Hypertension (% 67) was the most common comorbidity in patients with AF. While a stroke or transient ischemic attack or history of systemic thromboembolism was detected in 15.3% of the patients, bleeding history was recorded in 11.2%. Also, 50% of the patients were on warfarin treatment and 53% were on aspirin treatment at the time of the study. The effective INR level was detected in 41.3% of the patients. The most frequent cause of not receiving anticoagulant therapy was physician neglect. Conclusion: These results demonstrate the necessity for improved quality of physician care of patients with AF, especially with regards to antithrombotic therapy.
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    Impact of Body Mass Index on Left Ventricular Diastolic Dysfunction
    (Wiley, 2012) Cil, Habib; Bulur, Serkan; Turker, Yasin; Kaya, Ahmet; Alemdar, Recai; Karabacak, Ahmet; Aslantas, Yusuf
    Background: The prevalence of obesity is increasing in the developed and developing world. It is an independent risk factor for heart failure. Left ventricular (LV) diastolic dysfunction has been demonstrated to be a strong predictor of heart failure. In the present study we aimed to assess the impact of body weight on LV diastolic function. Methods: The study was conducted on 2,228 participants (1,424 women, 804 men with a mean age of 49). Traditional and tissue Doppler echocardiographic examination were performed in all of the participants. The demographic and echocardiographic data were compared. Multivariate logistic regression analysis was used to assess the independent predictors of association of LV diastolic function. The study sample was divided into four groups: group 1 (body mass index [BMI] < 25.0 kg/m2), group 2 (BMI 25.029.9 kg/m2), group 3 (BMI = 3039.9 kg/m2), and group 4 (BMI = 40 kg/m2). Results: Septal E was significantly lower in groups 2 and 3 compared to group 1 (P = 0.003). Septal A and septal A were significantly higher whereas septal E and lateral E were significantly lower in the groups 2, 3, and 4 compared to the normal weight group (P < 0.001). Lateral A, deceleration time, and ejection time were significantly higher in obese when compared to the normal weight (P = 0.025, P < 0.001, and P = 0.009, respectively). The E/E ratio was significantly higher in groups 2, 3, and 4 compared to the group 1 (P < 0.001). Logistic regression analysis revealed that age, BMI (OR = 1.060 [95% CI = 1.040 and 1.080]; P < 0.001), hypertension, and diabetes mellitus were independent predictors of LV diastolic dysfunction. Conclusion: BMI is an independent predictor of LV diastolic dysfunction along with age, hypertension, and diabetes mellitus. (Echocardiography 2012;29:647-651)
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    MELEN study: Rationale, methodology and basic results
    (Tıp Araştırmaları Derneği, 2011) Aydın, Yusuf; Özhan, Hakan; Albayrak, Sinan; Türker, Yasin; Bulur, Serkan; Erden, İsmail; Beşir, Fahri Halit; Çil, Habip
    Aim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adults by utilizing newest techniques. Besides prevalence and types of endemic goiter will be established which was an important health problem in the Black sea region Method: The study was conducted on 2230 participants (1427 women, 803 men with a mean age of 49). The participants underwent a Doppler Ultrasound examination of carotid intima media thickness, echocardiographic examination, ECG recording, bioempedance meter analysis of body composition, pulmonary function test and various biochemical analysis. Result: Twenty nine percent of the population had hypertension, 12% had diabetes mellitus and 17% were smokers. Thyroid ultrasonography revealed that 29% of the cohort had goiter. Echocardiographic measurements showed that 39% of the participants had diastolic dysfunction. Comparison of males with females showed that men had significantly higher visceral fat, triglyceride, hemoglobin and CIMT whereas women had higher mean diastolic blood pressure, HDL and total cholesterol. Conclusion: According to the histories of patients, hypertension, diabetes mellitus and smoking were very frequent among Turkish adults. Among the objectively measured variables, diastolic dysfunction, visceral adiposity and goiter were strikingly high.
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    A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis
    (Turkish Soc Cardiology, 2013) Elbey, Mehmet Ali; Akdag, Serkan; Kalkan, Mehmet Emin; Kaya, Mehmet G.; Sayin, M. Rasit; Karapinar, Hekim; Bulur, Serkan
    Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.
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    PREDICTORS OF SUBCLINICAL ATHEROSCLEROSIS IN PREMENOPAUSAL WOMEN
    (Carbone Editore, 2014) Aydin, Mesut; Alemdar, Recai; Cil, Habib; Besir, Fahri Halit; Ozhan, Hakan; Aydin, Yusuf; Bulur, Serkan
    Aims: 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.