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Öğe Acute myocardial infarction with simultaneous involvement of left anterior descending artery and right coronary artery: A subacute stent thrombosis(2014) Tasal, Abdurrahman; Bacaksız, Ahmet; Elbey, Mehmet Ali; Erdoğan, Ercan[Abstract Not Available]Öğe Cardiac device-related infective endocarditis; analysis of 15 cases(Turkish Soc Cardiology, 2013) Elbey, Mehmet Ali; Eren, Nihan Kahya; Kalkan, Mehmet Emin; Demirtas, Sinan; Kahraman, Fatih; Sayin, Rasit; Oylumlu, MustafaObjectives: We aimed to investigate the demographic and clinical characteristics, echocardiographic and microbiologic features, and outcomes of patients with permanent pacemaker (PM), and implantable cardioverter-defibrillator (ICD) - related endocarditis in this study. Study design: The study population consisted of 15 patients with permanent PM and ICD-related endocarditis. Data on patients'demographic characteristics, medications used, clinical, and microbiological data, echocardiographic findings, types, and outcomes of surgical treatments were recorded. Results: The mean age of the patients was 57+/-16. Seven patients (47%) were female. Of the 15 patients with permanent PM and ICD-related endocarditis, 5 died during in-hospital follow-up (33%). In four patients (27%) pulmonary embolism developed. Culture-negative endocarditis was detected in 5 cases (33%). Staphylococci were the most common causative organisms in 60% of the patients. Three (20%). patients underwent surgical treatment Conclusion: Cardiac device-related endocarditis remains a rare complication of intracardiac device implantation still with higher mortality rates.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 Comparison of left ventricular functional parameters obtained from three different commercial automated software cardiac quantification program packages and their intraobserver reproducibility(Springer, 2011) Dostbil, Zeki; Ariturk, Zuhal; Cil, Habib; Elbey, Mehmet Ali; Tekbas, Ebru; Yazici, Mehmet; Yildiz, IsmailObjective ECG-gated myocardial perfusion scintigraphy (MPS) can be used to determine several cardiac functional parameters (e. g., left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV)). In this study, we aimed to compare these cardiac functional parameters calculated by the following cardiac quantification programs: Emory Cardiac Toolbox (ECTb), Quantitative Gated SPECT (QGS), and Myometrix. We also evaluated reproducibility of the cardiac programs. Methods Fifty-seven patients (27 male, 30 female) at Elazig Research and Training Hospital from 2008 to 2009 were included in this study. In all patients, (99m)Tc-MIBI ECG-Gated (8-bin frame mode) myocardial perfusion scintigraphies were performed. By using 3 different cardiac quantification programs (ECTb, QGS, and Myometrix); LVEF, EDV, and ESV were calculated. The same raw data of MPS images were reprocessed at different time periods, and these 3 parameters were recalculated. LVEF, EDV, and ESV yielded by 3 different programs were compared for interprogram variability assessment, and parameters calculated at two different time periods were compared to evaluate intraprogram reproducibility. Results There were statistically significant differences between ECTb, QGS, and Myometrix programs for LVEF, EDV, and ESV (p < 0.001). There was also a statistically significant correlation between LVEF and EDV (p < 0.001, r = 0.546; p < 0.001, r = 0.45, respectively), but no statistically significant correlation was present between the ESV values (p > 0.05, r = 0.09). Statistically significant differences were not found between the values of LVEF, EDV, and ESV obtained from the first and second reconstruction analysis of 3 cardiac quantification programs. Discussion Different MPS cardiac software programs give variable (but correlated) LVEF and left ventricular volumetric measures. Those obtained from different cardiac softwares cannot be used interchangeably. Our findings have shown that ECTb, QGS, and Myometrix programs are reproducible, with respect to LVEF, EDV, and ESV.Öğe Congenital left ventricular diverticulum(Turkish Soc Cardiology, 2011) Elbey, Mehmet Ali; Cakici, Musa; Alici, Hayri; Davutoglu, Vedat[Abstract Not Available]Öğe Demographical data and outcomes of surgically treated patients with the diagnosis of infective endocarditis: a multi-center retrospective study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Oylumlu, Mustafa; Elbey, Mehmet Ali; Kalkan, Emin; Akdag, Serkan; Ozbek, Kerem; Eren, Nihan Kahya; Topcu, SelimBackground: This study aims to investigate the demographic and clinical characteristics and echocardiographic and microbiological findings of the patients as well as the outcomes of surgery undergoing surgical treatment with the diagnosis of infective endocarditis in Turkey. Methods: Between January 2005 and August 2012 116 patients (65 males, 51 females; mean age 43 +/- 16 years; range 14 to 80 years) with the diagnosis of infective endocarditis who underwent surgery in 13 tertiary university/research and education hospitals were included in this multi-center study. Demographic and clinical characteristics of the patients, and echocardiographic and microbiological findings, surgical indications and outcomes of surgery were retrospectively analyzed. Results: The most common symptom on admission and physical finding was fever. Blood cultures were negative in 35 patients (30%). Staphylococci were the most common microbiological pathogens (22%). Congestive heart failure was the most common indication for surgery in 56 patients (48%). Valve repair was performed in 12 patients (10%), valve replacement was the procedure of choice in 104 patients (90%). Thirty-three patients undergoing surgical treatment died in the postoperative period. The mortality rate was 28%. Independent predictors of surgical mortality were Class 3-4 functional capacity, elevated C-reactive protein, and renal dysfunction. Conclusion: Although complicated cases of infective endocarditis can be treated through surgery, surgical morbidity and mortality is still high.Öğe Early assessment of percutaneous coronary interventions for chronic total occlusions analyzed by novel echocardiographic techniques(Hospital Clinicas, Univ Sao Paulo, 2013) Erdogan, Ercan; Akkaya, Mehmet; Bacaksiz, Ahmet; Tasal, Abdurrrahman; Sonmez, Osman; Elbey, Mehmet Ali; Kul, SerefOBJECTIVE: Successful revascularization of chronic total occlusions has been associated with improved left ventricular systolic function, reduced anginal symptoms, increased exercise capacity, and increased survival. This study was conducted to determine the impact of revascularization in chronic total occlusion on left ventricular function using novel echocardiographic techniques. METHODS: A total of 129 patients with chronic total occlusion who underwent revascularization between April 2011 and November 2012 were included in this study. Echocardiographic assessments with two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography were performed before the procedure and one month after the procedure. The left ventricular ejection fraction, left ventricular volumes, and three-dimensional systolic dyssynchrony index were quantified. RESULTS: An immediate procedural success was obtained in 118 patients (91.5%). There were no acute or subacute stent thromboses during follow-up. The mean left ventricular ejection fraction significantly increased (p < 0.001), while the left ventricular end-diastolic and end-systolic volumes significantly decreased (p = 0.001 and p < 0.001, respectively). The three-dimensional systolic dyssynchrony index also decreased significantly (p < 0.001). The global longitudinal strain showed a significant increase after successful revascularization (p < 0.001). An increase in the global longitudinal strain was correlated with an increase in the left ventricular ejection fraction (r = 0.27, p = 0.02). The patients with a left ventricular ejection fraction >= 50% displayed a greater improvement in the global longitudinal strain, and the patients with diabetes showed less improvement. CONCLUSIONS: Using novel echocardiographic techniques, our results showed that restoring the coronary blood flow in chronic total occlusion patients reduces the left ventricular volumes and improves the left ventricular ejection fraction and the global longitudinal strain of hibernating myocardium.Öğe Effect of imaging time on post stress left ventricular ejection fraction and volume measures by gated myocardial perfusion single photon emission computed tomography(2010) Çil, Habib; Arıtürk, Zuhal; Tekbaş, Ebru; Dostbil, Zeki; Taşdemir, Bekir; Elbey, Mehmet AliAmaç: Efor sonrası sol ventrikül ejeksiyon fraksiyonu (LVEF) ve sol ventrikül volüm değerlerinin koroner arter hastalığı bulunan hastalardaki kardiyak ölüm tahmininde katkısı vardır. Bu çalışmada, efor sonrası görüntüleme zamanının Quantitative Gated SPECT (QGS-Cedars-Sinai) programı ile hesaplanan efor sonrası LVEF, end-diastolik volüm (EDV) ve end-sistolik volüm (ESV) üzerine etkisini araştırmayı amaçladık. Hastalar ve yöntem: Bu çalışma 2008 ve 2009 yıllarında Elazığ Eğitim ve Araştırma Hastanesi Nükleer Tıp Birimine göğüs ağrısı nedeniyle Kardiyoloji Kliniğinden gönderilen 36 hasta üzerinde yapıldı. Tüm hastalara efor esnasında yapılan 99mTc-Mibi enjeksiyonunu takiben 20. ve 40. dakikalarda EKG-gated (8-bin frame modunda) miyokard perfüzyon SPECT sintigrafisi uygulandı. Kardiyak kantifikasyon yazılımı olan QGS programı kullanılarak LVEF, EDV ve ESV hesaplandı. İlk ve ikinci görüntülemelerden elde edilen LVEF, EDV ve ESV değerleri istatistiksel olarak birbirleri ile karşılaştırıldı.Bulgular: İlk ve ikinci görüntülemelerden elde edilen LVEF, EDV ve ESV değerleri arasında istatistiksel olarak anlamlı farklılık bulunmadı (p>0.05).Sonuç: Efor sonrası sol ventrikül fonksiyon parametreleri koroner arter hastalığı bulunan hastalardaki prognoz değerlendirmesinde önemlidir. Efor bitiminden 20-40 dakika sonra yapılan miyokard perfüzyon SPECT sintigrafisi efor sonrası LVEF, EDV ve ESV değerleri açısından tekrarlanabilir değerler vermektedir.Öğe Factors affecting mortality in penetrating cardiac injuries: our 10-year results(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2011) Yavuz, Celal; Cil, Habib; Basyigit, Ismail; Demirtas, Sinan; Islamoglu, Yahya; Tekbas, Guven; Elbey, Mehmet AliBackground: In this study, we investigated the factors affecting survival in patients who were admitted to our center because of a penetrating heart injury and given treatment. Methods: Ninety-four patients with penetrating heart injuries (82 males, 12 females, mean age 25.9 +/- 12.7 years; range 3 to 67 years) admitted to our clinic between November 2000 and June 2010 were retrospectively evaluated. We recorded the demographic features, transfer time to hospital, way of transfer, clinical condition at admission, and reasons for the patient injuries. Additionally, the presence of hemothorax, pericardial hematoma, tamponade, coronary artery injury, the method of decision for surgery (operation following resuscitation thoracotomy, clinical follow-up or some diagnostic methods), the injured chamber of the heart, presence of accompanying injury in another organ, heart rhythm at the beginning of the surgery, and the surgical approach used were recorded. Results: The mortality rate was 13.8% in our study. Survival was not found to be related to age, gender, reason of injury (gunshot, stabbing, iatrogenic injuries), and presence of tamponade, and coronary artery injury. However, a significant relationship was found between survival and the way of transfer (ambulance or other vehicles), transfer time to hospital, clinical condition at admission, the method of decision for surgery, heart rhythm before the surgery, presence of pericardial hematoma or hemothorax, injured heart chamber, and presence of accompanying injury in another organ. Conclusion: The transfer time to hospital is the most important modifiable factor that may affect the outcomes in penetrating heart injuries. Shortening this time will dramatically improve the survival in these patients who have a very high mortality.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 Infective endocarditis in Turkey: Changing trends in epidemiology (Author`s Reply)(2014) Elbey, Mehmet Ali[Abstract Not Available]Öğe Infective endocarditis in Turkey: changing trends in epidemiology Reply(Turkish Soc Cardiology, 2014) Elbey, Mehmet Ali[Abstract Not Available]Öğe Kardiyak cihazlara bağlı olarak gelişen enfektif endokardit; 15 olgunun analizi(2013) Eren, Nihan Kahya; Demirtaş, Sinan; Elbey, Mehmet Ali; Oylumlu, Mustafa; Kalkan, Mehmet Emin; Sayın, Muhammet Raşit; Kayan, FethullahAmaç: Bu çalışmada, kalıcı pacemaker (PM) ve implante edilebilir kardiyoversiyon defibrilatörleri (ICD) ile ilişkili endokarditin demografik, klinik ekokardiyografik ve mikrobiyolojik özellikleri ve sonuçlarının araştırılması amaçlandı.Çalışma planı: Kalıcı PM ve ICD endokarditi tanısı olan 15 hasta çalışmaya alındı. Hastaların demografik özelikleri, kullandıkları ilaçlar, klinik ve mikrobiyolojik özellikleri, ekokardiyografi sonuçları, cerrahi tedavi ve sonuçları kaydedildi.Bulgular: Hastaların ortalama yaşı 57±16 ve 7si (%47) kadındı. Kalıcı PM ve ICDsi olan 15 hastadan 5i takip sırasında kaybedildi (%33). Dört hastada pulmoner emboli gelişti (%27). Kan kültürü 5 hastada (%33) negatif bulundu. Hastaların %60ında üretilen stafilokoklar en sık saptanan mikrobiyolojik ajanlardı. Üç hastaya (%20) cerrahi tedavi uygulandı.Sonuç: Kardiyak cihazlarla ile ilişkili endokardit, kardiyak cihaz implantasyonun nadir bir komplikasyonu olmasına rağmen mortalitesi halen yüksek olan bir hastalıktır.Öğe 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, SerkanObjective: 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.Öğe Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide(Via Medica, 2012) Islamoglu, Yahya; Cil, Habib; Atilgan, Zuhal; Elbey, Mehmet Ali; Tekbas, Ebru; Yazici, MehmetIngestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (ML) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint. (Cardiol J 2012; 19, 1: 86-88)Öğe Noninvasive Electrophysiological Effects of Lightning Strike: Case Series(Aves, 2011) Islamoglu, Yahya; Cil, Habib; Basturk, Mustafa; Tekbas, Ebru; Elbey, Mehmet AliObjectives: Lightning is a frequent natural disasters, and may result in death at a rate of up to 20-30% of affected patients. The most common cause of death in these cases is cardiac arrest. In addition, deaths can occur due to injury of the respiratory center. Material and Methods: In the literature, there are many case reports regarding lightning injuries. Howewer, there are only a few studies on the effects of lightning strike on the heart. In this paper, we specifically investigate the noninvasive electrophysiological effects of lightning strike on the heart. Results: Ventricular fibrillation, asystole, supraventricular tachycardia, QT prolongation and nonspecific ST-T changes may occur in patients with lightning injury. However, there is no typical electrocardiogram (ECG) sign/signs of lightning injury. Conclusion: Electrocardiographic changes due to lightning strike depend on the severity and duration of exposure of the body.Öğe A Novel-Modified Provisional Bifurcation Stenting Technique: Jailed Semi-Inflated Balloon Technique(Wiley-Blackwell, 2015) Cayli, Murat; Seker, Taner; Guer, Mustafa; Elbasan, Zafer; Sahin, Durmus Yildiray; Elbey, Mehmet Ali; Cil, HabibObjectiveWe proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi-inflated balloon technique (JSBT). BackgroundCurrently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri-procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach. MethodsBetween September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.611.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month. ResultsThe majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in-hospital stay and 1 month follow-up. ConclusionsThe JSBT technique can be successfully performed in both LM and non-LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome. (J Interven Cardiol 2015;28:420-429)Öğe Penetran kalp yaralanmalarında mortaliteye etki eden faktörler: 10 yıllık sonuçlarımız(2011) Eren, Mehmet Nesimi; Başyiğit, İsmail; İslamoğlu, Yahya; Elbey, Mehmet Ali; Yavuz, Celal; Çil, Habib; Tekbaş, GüvenAmaç: Bu çalışmada penetran kalp yaralanması nedeni ile merkezimize getirilen ve tedavisi yapılan hastalarda sağkalımı etkileyen faktörler araştırıldı. Çalışma planı: Kasım 2000- Haziran 2010 tarihleri arasında penetran kalp yaralanması nedeniyle kliniğimize başvuran 94 hasta (82 erkek 12 kadın; ort yaş 25.9±12.7 yıl; dağılım 3-67 yıl) retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, hastaneye getirilme süresi, hastaneye getiriliş şekilleri, başvuru sırasındaki klinik durumları ve yaralanma nedenleri kaydedildi. Buna ek olarak, hemotoraks, perikart hematomu, tamponad, koroner arter hasarının varlığı, ameliyata karar verme şekli (resüsitasyon torakotomisi, klinik takip veya bazı diyagnostik yöntemlerden sonra ameliyat), yaralanan kalp boşluğu, eşlik eden ek organ yaralanması varlığı, ameliyat başlangıcındaki kalp ritmi ve uygulanan cerrahi yaklaşım kaydedildi. Bulgular: Çalışmamızda mortalite oranı %13.8 olarak bulundu. Yaş, cinsiyet, yaralanma nedeni (ateşli silah, kesici/delici alet ve iyatrojenik yaralanmalar), tamponad ve koroner arter hasarının varlığı, sağkalım ile ilişkili bulunmadı. Ancak, hastaneye geliş şekli (ambulans veya diğer araçlar), hastaneye varış süresi, hastaneye geliş kliniği, ameliyata karar verme şekli, ameliyat öncesi kalp ritmi, perikart hematomu veya hemotoraks varlığı, yaralanan kalp boşluğu ve eşlik eden diğer organ yaralanması varlığı ile sağkalım arasında anlamlı ilişki saptandı. Sonuç: Penetran kalp yaralanmalarında sonuçları etkileyebilen en önemli değiştirilebilir faktör hastaneye varış süresidir. Bu sürenin kısaltılması, çok yüksek mortaliteye sahip bu grup hastalarda sağkalımı belirgin olarak artırabilecektir.Öğe Predictors of mortality in patients with prosthetic valve infective endocarditis: A nation-wide multicenter study(Via Medica, 2013) Elbey, Mehmet Ali; Kalkan, Mehmet Emin; Akdag, Serkan; Ozbek, Kerem; Eren, Nihan Kahya; Demirtas, Sinan; Akil, Mehmet AtaBackground: Our aim was to investigate the clinical and prognostic features of the patients with prosthetic valve endocarditis (PVE) in a multicenter nation-wide study. Methods: The present nation-wide study consisted of 75 consecutive patients with PVE treated at 13 major hospitals in Turkey from 2005 to 2012. Results: The patients who died during follow-up were significantly older than the survivors and had higher C-reactive protein (CRP), creatinine, poor NYHA functional class and large vegetations. High creatinine level (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.14-6.13), poor functional status (OR 24.5; 95% CI 3.1-196.5) and high CRP (OR 1.02; 95% CI 1.00-1.03) measured on admission were independent risk associates for in-hospital mortality Conclusions: High creatinine level, poor functional status and high CRP measured on admission were independent risk associates for in-hospital mortality, whereas a NYHA class of III/IV and high CRP reflected independent risk for stroke/mortality end point.Öğe Predictors of warfarin use in patients with non-valvular atrial fibrillation who presented to the cardiology outpatient clinic of a tertiary hospital in Turkey: an observational study(Tubitak Scientific & Technological Research Council Turkey, 2012) Ertas, Faruk; Kaya, Hasan; Ariturk Atilgan, Zuhal; Elbey, Mehmet Ali; Aydin, Mesut; Akil, Mehmet Ata; Oylumlu, MustafaAim: The aim of this study was to investigate the predictors of warfarin use in patients with non-valvular atrial fibrillation (AF). This study was the first to be conducted in a Turkish population. Materials and methods: Patients who presented to our outpatient clinic with the diagnosis of AF between September 2008 and October 2009 were enrolled. The patients were classified according to the CHADS2 risk scoring system recommended by the AHA/ACC/ESC guidelines for the classification of stroke risk in non-valvular AF patients. The probable variables influencing the use of warfarin were determined as age, sex, income level, healthcare coverage, lifestyle, place of residence, classification of AF, hypertension, diabetes mellitus, coronary artery disease, thyrotoxicosis, cardiac insufficiency, left ventricular dysfunction, stroke risk stratification, and history of stroke or systemic embolism (SE). Results: Among the 570 patients enrolled in the study, 144 were excluded because of insufficient patient information or refusal to participate, while 101 patients were excluded due to valvular AE Thus, the evaluation was based on 325 patients (133 males and 192 females; mean age: 65 +/- 10). According to the CHADS2 scoring, 62.2% of the patients were at high risk, 26.8% were at moderate risk, and 11.1% were at low risk. Only 19.7% of the patients were on warfarin treatment. In the logistic regression analysis, a history of stroke or SE, high income level, and the presence of persistent and permanent AF were found to be positive predictors of warfarin use, while advanced age was a negative predictor of warfarin use. Conclusion: This study demonstrated that a history of stroke or SE, high income level, presence of persistent and permanent AF, and advanced age are independent predictors of warfarin use in non-valvular AF patients.
