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    Does aspirin use prevent acute coronary syndrome in patients with pneumonia: multicenter prospective randomized trial
    (Lippincott Williams & Wilkins, 2013) Oz, Fahrettin; Gul, Sule; Kaya, Mehmet G.; Yazici, Mehmet; Bulut, Ismet; Elitok, Ali; Ersin, Gunay
    Objectives The aim of this study was to test the hypothesis that aspirin would reduce the risk for acute coronary syndromes (ACSs) in patients with pneumonia. Backgrounds Pooled data suggest that pneumonia may trigger an ACS as a result of inflammatory reactions and the prothrombotic changes in patients with pneumonia. Hypothetically considering its antiaggregating and anti-inflammatory effects, aspirin might also be beneficial for the primary prevention of ACS in patients with pneumonia. Methods One hundred and eighty-five patients with pneumonia who had more than one risk factor for cardiovascular disease were randomized to an aspirin group (n = 91) or a control group (n = 94). The patients in the aspirin group received 300 mg of aspirin daily for 1 month. ECGs were recorded on admission and 48 h and 30 days after admission to assess silent ischemia. The level of high-sensitivity cardiac troponin T was measured on admission and 48 h after admission. The primary endpoint was the development of ACS within 1 month. The secondary endpoints included cardiovascular death and death from any cause within 1 month. Results The chi(2)-test showed that the rates of ACS at 1 month were 1.1% (n = 1) in the aspirin group and 10.6% (n = 10) in the control group (relative risk, 0.103; 95% confidence interval 0.005-0.746; P = 0.015). Aspirin therapy was associated with a 9% absolute reduction in the risk for ACS. There was no significant decrease in the risk of death from any cause (P = 0.151), but the aspirin group had a decreased risk of cardiovascular death (risk reduction: 0.04, P = 0.044). Conclusion This randomized open-label study shows that acetyl salicylic acid is beneficial in the reduction of ACS and cardiovascular mortality among patients with pneumonia. Coron Artery Dis 24:231-237 (c) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Coronary Artery Disease 2013, 24:231-237
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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.