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Öğe Association Between ABO Blood Group, Peripheral Artery Disease Lesion Severity, and Coronary Artery Disease Coexistence(Elsevier Inc., 2025) Evsen, Ali; Aktan, Adem; Kılıç, Raif; Özbek, MehmetBackground: This study aims to investigate the relationship between ABO blood groups and the severity of peripheral artery disease (PAD) lesions, the coexistence of coronary artery disease (CAD) with PAD, and to identify which blood groups may be more predisposed to these conditions. Methods: This study, which has a single-center and retrospective design, includes 305 patients diagnosed with peripheral artery disease (PAD) between 2015 and 2021. The patients were selected from those with at least 50% stenosis detected by computed tomography (CT) angiography. The severity of PAD lesions was evaluated according to the TransAtlantic Inter-Society Consensus (TASC-II) classification, and the presence of CAD was determined by simultaneous conventional coronary angiography. Demographic data, comorbidities, and laboratory results were collected, and statistical analyses were performed using chi-square tests, logistic regression, and t-tests. All of these patients were divided into 2 groups based on their ABO blood types: O and non-O blood groups. Results: This study demonstrates a significant relationship between blood group classification and both the severity of PAD and the prevalence of CAD. Patients with non-O blood groups exhibited a higher likelihood of having severe PAD lesions (TASC-C and TASC-D) compared to those with O blood groups, who more frequently had milder lesions (TASC-A and TASC-B) (P < 0.001). The prevalence of CAD was also significantly higher among patients with non-O blood groups than those with the O blood group (54.4% vs. 36.4%; P = 0.003). In the logistic regression analysis, non-O blood groups, alongside age, hypertension (HT), and chronic kidney disease (CKD), emerged as independent predictors of severe PAD (P < 0.001 for non-O blood groups). Similarly, older age and non-O blood group status were identified as significant independent predictors of CAD (P = 0.004). These findings suggest that blood group classification, particularly non-O groups, may influence the severity and coexistence of PAD and CAD. Conclusion: Our study reveals a significant association between ABO blood groups and both the severity of PAD and the association of CAD, and shows that non-O blood groups are linked to more severe forms of these conditions. These findings highlight the potential role of ABO blood groups in cardiovascular risk stratification, suggesting a need for further research to confirm these associations and understand their clinical implications. © 2025 Elsevier Inc.Öğe Dependence of clinical outcomes on time of hospital admission in patients with ST-segment elevation myocardial infarction(King Faisal Specialist Hospital and Research Centre, 2023) Özbek, Mehmet; Ildirimli, Kamran; Arık, Baran; Aktan, Adem; Coşkun, Mehmet Sait; Evsen, Ali; Güzel, Tuncay; Acet, Halit; Demira, MuhammedBACKGROUND: There are conflicting results in studies investigating the effects of percutaneous coronary intervention (PCI) on the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) during or outside of usual hospital working hours. While some researchers have reported higher mortality rates in STEMI patients admitted outside of working hours, others did not find a statistically significant difference. OBJECTIVES: Investigate the short-term endpoints and long-term outcomes of STEMI patients by time of admission. DESIGN: Retrospective SETTING: Tertiary percutaneous coronary intervention center. PATIENTS AND METHODS: Patients were grouped by admission, which consisted of four intervals: 06:00 to <12:00, 12:00 to <18:00, 18:00 to <24:00, and 24:00 to <06:00. We analyzed demographic, clinical and mortality by admission time interval and mortality by multivariate analyses, including the time intervals. MAIN OUTCOME MEASURES: Clinical data and mortality SAMPLE SIZE: 735 patients; median (IQR) age 62 (22) years; 215 (29.3%) women. RESULTS: Patients admitted at night were 1.37 times more likely to experience pulmonary edema than patients whose symptoms started in the daytime (P=.012); 32.9% of the patients whose symptoms started at night presented with Killip class II-IV, while during the daytime, 21.4% presented with Killip class II-IV (P=.001). Among the patients, the most common was inferior STEMI (38.6%). However, no-reflow was significantly higher during the daytime compared to the nighttime (P=.12). The risk of the cardiac arrest on admission was 1.2 times higher in patients admitted at night (P=.034). Neither time interval of admission nor several other variables had an effect on clinical outcome or mortality. CONCLUSIONS: While patients admitted at night presented with pulmonary edema and cardiogenic shock more frequently, no reflow was observed during the day after the procedure. Although patients admitted at night with STEMI presented with worse clinical conditions, similar results were observed between the groups in clinical outcomes. LIMITATIONS: More “real world” results might have been obtained if the study had replicated more typical referral conditions for PCI. CONFLICT OF INTEREST: None.Öğe Evaluation of epicardial fat tissue and echocardiographic parameters in patients with silent enemy subclinical hypothyroidism(John Wiley and Sons Inc., 2022) Evsen, Ali; Demir, Muhammed; Günlü, SerhatBackgroundTo evaluate epicardial adipose tissue (EAT) which is known to be closely associated with metabolic syndrome and cardiovascular risk factors (hypertension, diabetes mellitus, obesity, age, smoking) and which is a more specific marker of visceral adiposity than waist circumference using echocardiographic examination in subclinical hypothyroidism which is one of the most common endocrine system diseases in the community but is mostly missed due to its asymptomatic nature.Materials and methods: The study included 60 individuals aged 18–65 years, comprising 30 patients with newly diagnosed subclinical hypothyroidism and 30 age- and gender-matched control subjects that had a normal thyroid hormone profile. 2D transthoracic echocardiography was utilized for measuring EAT thickness and other basic echocardiographic parameters.ResultsNo significant difference was found between the two groups with regard to gender, age, body mass index (BMI), and other diameters and measurements obtained by 2D transthoracic echocardiography. EAT thickness was significantly higher in the patient group compared to the control group (p < .001).ConclusionEpicardial adipose tissue (EAT) is increased in patients with subclinical hypothyroidism.Öğe Hematological predictors of silent new cerebral ischemic lesions in carotid artery stenting: A retrospective study(Elsevier Sci Ltd, 2024) Altunova, Mehmet; Demir, Yusuf; Gulmez, Recep; Evsen, Ali; Aktemur, Tugba; Sahin, Ahmet Anil; Arslan, EnesBackground: Silent new cerebral ischemic lesions (sNCIL) are a common complication of carotid artery stenting (CAS) that can lead to an increase in morbidity and mortality. We aimed to evaluate the impact of hematological parameters on sNCIL in patients undergoing CAS. Methods: We retrospectively evaluated 103 patients who underwent CAS, with a mean age of 70.5 +/- 6.7 years, and 31 (20.1 %) of whom were female. Stents were placed for internal carotid artery revascularization. The presence of new hyperintense lesions on diffusion-weighted imaging (DWI) without neurological symptoms was considered as sNCIL in cases without apparent neurological findings. Patients were categorized into two groups based on DWI results: positive (29) and negative (74). Results: In the study population, sNCIL was observed in 29 patients (28.2 %). The DWI-positive group exhibited significantly higher Plateletcrit (PCT) levels, advanced age, and a lack of embolic protection device usage compared to the DWI-negative group. The Receiver Operating Characteristic (ROC) analysis identified a PCT value of 0.26 as the optimal threshold, detecting the development of sNCIL with a sensitivity of 75.9 % and specificity of 59.1 % (AUC: 0.700; 95 % CI: 0.594 -0.806, p = 0.002). Conclusion: To be determined by a simple blood parameter, PCT can predict the risk of sNCIL before CAS and holds clinical value in the treatment of patients with carotid artery stenosis.Öğe Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR(Galenos Publ House, 2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Koseoglu, MehmetIntroduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) x albumin (g/L) x lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4 +/- 8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.Öğe Is plasma atherogenic index or LDL/HDL ratio more predictive of peripheral arterial disease complexity?(Sage Publications Ltd, 2024) Evsen, Ali; Aktan, Adem; Altunova, Mehmet; Ozbek, MehmetIntroduction: The most basic and well-known cause of peripheral arterial disease (PAD) is atherosclerosis. One of the main factors causing atherosclerosis is dyslipidemia. We will evaluate whether specific ratios of dyslipidemia, such as the atherogenic plasma index (AIP) and LDL/HDL ratio, which have recently been used in practice, can help us to predict the complexity of PAD in the clinic. Methods: A total of 305 patients with PAD admitted to our clinic were retrospectively included in this study. After evaluation according to angiography images using TASC-II classification, patients were divided into TASC A-B and TASC C-D. AIP was evaluated with the following formula: Log (TG/HDL). Cut-off values for AIP and LDL/HDL were determined on the ROC (receiver operating characteristic) curve. Logistic regression analysis were conducted to predict peripheral arterial disease complexity. Results: The mean ages of Group 1 (n:180, 68.3% male) and Group 2 (n:125, 77.6% male) patients were 64.10 +/- 12.39 and 64.94 +/- 11.12 years, respectively. The prevalence of diabetes mellitus (DM, p < 0.016) and coronary artery disease (CAD, p < 0.001) was higher in group 2. Group 2 had higher TG (p = 0.045), LDL-C (p = 0.004), AIP (p = 0.010), LDL/HDL (p < 0.001), and lower HDL-C (p = 0.015). In multivariate logistic regression analysis evaluating parameters in predicting PAD complexity, DM (OR: 1.66 Cl 95%: 1.01-2.73 p = 0.045), CAD (OR: 2.86 Cl 95%: 1.75-4.69 p < 0.001) and LDL/HDL (OR: 1.47 Cl 95%: 1.10-1.96 p = 0.008) were independent variables. Conclusion: In our study, we compared LDL/HDL ratio and AIP in PAD for the first time in the literature and showed that LDL/HDL ratio is a more valuable ratio and an independent predictor of PAD complexity.Öğe Long-Term Outcomes of Endovascular Intervention for Iliac Artery Stenosis: A Single-Center Experience(2024) Altunova, Mehmet; Tasbulak, Omer; Evsen, Ali; Uzun, Nedim; Demir, Yusuf; Panc, Cafer; Atmaca, SezginAbstract Objectives: This study aims to evaluate the technical success, safety, and long-term outcomes of iliac artery endovascular procedures performed at our institution between 2017 and 2022 and to investigate potential risk factors associated with in-stent restenosis (ISR). Methods: This single-center, observational, retrospective cohort study included 398 patients who underwent endovascular intervention for symptomatic iliac artery stenosis. Data were obtained from electronic records, and patients were followed up clinically and radiologically. Multivariate Cox regression analysis was used to identify independent predictors of ISR. Results: ISR was observed in 11.3% of patients during a mean follow-up of 34.7 months. Atrial fibrillation (AF) (p=0.019) and stent diameter (p=0.006) emerged as independent determinants of ISR development. Kaplan-Meier analysis showed a significant difference in ISR between patients with and without AF (log-rank p = 0.022). Conclusion: This study highlights AF and stent diameter as independent predictors of ISR in long-term follow-ups after iliac artery stenting. Patients with AF may require closer monitoring, while appropriate stent selection is crucial in minimizing ISR risk. These findings contribute to optimizing patient management strategies in peripheral artery disease.Öğe The role of non-invasive oscillometric method to detect aortic stiffness in patients with subclinical hypothyroidism(Taylor & Francis Ltd, 2024) Evsen, Ali; Oylumlu, MustafaIntroduction: Subclinical hypothyroidism (SCH) is a biochemical condition that is diagnosed when peripheral free thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone (TSH) levels are mildly elevated. The aim of this study was to investigate the relationship between SCH and arterial stiffness using two different non-invasive methods, including echocardiography and oscillometric arteriography. Material and Methods: The study included 33 newly diagnosed SCH patients and 34 age- and gender-matched healthy controls. Systolic and diastolic diameters and elastic parameters of the aorta were calculated by 2D Transthoracic echocardiography (TTE). Central blood pressure and aortic stiffness values of patient groups were measured noninvasively from the brachial artery using Mobil-O-Graph arteriography. Pulse wave velocity (PWV) and augmentation index (AIx) were used as arterial stiffness indicators. Results: There was no significant difference between SCH and control groups with regard to age, gender, and body mass index (BMI). Aortic strain and aortic distensibility, were significantly lower in the SCH group than in the control group (p < 0.001). PWV and AIx which measured by Mobil-O-Graph arteriography were found to be significantly higher in the subclinical hypothyroid group compared to the control group (p < 0.05). Conclusion: Aortic stiffness assessed by TTE and Mobil-O-Graph arteriography deteriorated in patients with SCH after excluding other cardiovascular risk factors. The assessment of aortic stiffness by the oscillometric method was easy and useful for widespread clinical use.Öğe Subklinik hipotiroidili hastalarda aortik elastik özellikler ve ekokardiyografik parametrelerin değerlendirilmesi(Dicle Üniversitesi, Tıp Fakültesi, 2020) Evsen, Ali; Oylumlu, MustafaGiriş ve Amaç: Hipotiroidi, doku düzeyinde tiroid hormonu eksikliği veya nadiren de olsa etkisizliği sonucu meydana gelen, metabolik yavaşlama ile giden bir hastalıktır. Hipotiroidi kardiyovasküler morbidite ve mortaliteyi etkilemektedir. Subklinik hipotiroidi ise serumda serbest tiroid hormon seviyeleri normal iken yüksek TSH düzeylerinin saptandığı biyokimyasal bir tanımlamadır. Amacımız yaşadığımız populasyonda en sık rastlanılan endokrin sistem hastalıklarından biri olan ancak çoğunluğunun semptom oluşturmadığı için tanı konulamadığı ve atlandığı subklinik hipotiroidinin, arteriyel sertlik gibi yapılan birçok çalışmada kardiyovasküler morbidite ve mortalite için risk faktörü olduğu kabul edilen bir süreçle ilişkisinin olup olmadığını iki farklı yöntemle non-invaziv olarak incelemektir. Materyal ve Metod: Çalışmaya yeni tanı almış 33 subklinik hipotiroidili hasta ile cinsiyet ve yaş bakımından birbirine yakın olacak şekilde rastgele seçilen 34 kişilik sağlıklı kontrol grubu eklendi. 2D Transtorasik Ekokardiyografi ile aortun sistolik ve diyastolik çapları ve elastik parametreleri hesaplandı. Epikardiyal yağ dokusu (EFT) kalınlığı ve diğer basic ekokardiyografi parametreleri ölçüldü. Hasta gruplarının santral kan basınçları ve aortik sertlik (stiffness) değerleri brakiyal arterden Mobil-O-Graph arteriyograf cihazı ile non-invazif olarak ölçüldü. Arteriyel sertlik göstergeleri olarak nabız dalga hızı (PWV) ve Augmentasyon indexi (Aix) kullanıldı. Bulgular: Kontrol grubu ile subklinik hipotiroidi arasında cinsiyet, yaş ve vücut kütle indeksi açısından fark yoktu. Aortun elastik parametrelerinden olan aortik strain ve aortik distensibilite, subklinik hipotiroidi grubunda kontrol grubuna göre istatistiksel olarak anlamlı düzeyde düşük bulundu (p<0,001). 2D Transtorasik Ekokardiyografi ile ölçülen Interventriküler septum (IVS) kalınlığı, sol ventrikül ejeksiyon fraksiyonu (LVEF), sol ventrikül sistol sonu çap (LVESD), sol ventrikül diyastol sonu çap (LVEDD), parasternal uzun eksen (PSLAX) sol atriyum çapı (LA), Mitral E/A, sol ventrikül septal E'/A', sol ventrikül lateral E'/A', deselerasyon zamanı (DT), aortun sistolik çapları, AP4 boşlukta bakılan sağ atriyum (RA) ve sağ ventrikül (RV) çapları ve triküspid annular plane systolic excursion (TAPSE) değerleri arasında istatistiksel açıdan anlamlı bir fark gözlenmedi (p>0,05). 2D Transtorasik Ekokardiyografi ile ölçülen epikardiyal yağ dokusu kalınlığı ise subklinik hipotiroidi grubunda kontrol grubuna kıyasla istatistiksel açıdan anlamlı düzeyde artmış bulundu (p<0,05). Osilometrik yöntem olan Mobil-O-Graph arteriyograf cihazı ile ölçülen ve arteriyel sertlik göstergesi olarak kabul edilen PWV ve Aix subklinik hipotiroidi grubunda kontrol grubuna kıyasla istatistiksel açıdan anlamlı düzeyde yüksek saptandı (p<0,05). Sonuç: Diğer kardiyovasküler risk faktörleri ekarte edilecek şekilde subklinik hipotiroidili hastalarda aortun elastik parametrelerinde bozulma ve epikardiyal yağ dokusunda artış mevcuttur.
