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Öğe Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease(Sage Publications Inc, 2014) Kaya, Hasan; Ertas, Faruk; Islamoglu, Yahya; Kaya, Zekeriya; Atilgan, Zuhal Ariturk; Cil, Habib; Caliskan, AhmetThe aim of this study is to investigate the association between neutrophil to lymphocyte ratio (NLR) and severity of coronary atherosclerosis. A total of 172 patients undergoing coronary angiography were included in the study. Control group consisted of patients with normal coronary arteries. Patients with coronary stenosis were divided into 2 groups by use of Gensini scores. The NLR was higher in severe atherosclerosis group compared with mild atherosclerosis and control groups (P < .001). In correlation analysis, NLR showed significant correlation with Gensini score. A cutoff value of 2.5 for NLR predicted severe atherosclerosis with a sensitivity and specificity of 62% and 69%, respectively. After multivariate analysis, high levels of NLR were independent predictors of severe atherosclerosis together with glucose and high-density lipoprotein. Our study suggests that the NLR is a predictor of severe atherosclerosis that may be useful for cardiac risk stratification in patients with coronary artery disease.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 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 KahyaObjectives: 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.Öğe Epidemiology, anticoagulant treatment and risk of thromboembolism in patients with valvular atrial fibrillation: Results from Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)(Via Medica, 2014) Kaya, Hasan; Ertas, Faruk; Kaya, Zekeriya; Eren, Nihan Kahya; Yuksel, Murat; Koroglu, Bayram; Kose, NuriBackground: The aim of this study was to perform a multicenter, prospective investigation regarding the epidemiology, the current effectiveness of therapeutic anticoagulation, and the risk of thromboembolism in patients with valvular atrial fibrillation (AF) based on the records of the Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. Methods: Patients were selected from a total of 2,242 consecutive admissions that presented with AF diagnosed via electrocardiogram. Those diagnosed with non-valvular AF were excluded from the AFTER study population, which left 497 patients with valvular AF for analysis. Results: The etiology of valvular AF in patients was either attributed to rheumatic mitral valve stenosis (n = 217) or possessing a prosthetic heart valve (n = 280). Out of all the patients with valvular AF, 83.1% were taking warfarin for anticoagulation. Only 36.1% demonstrated a therapeutic international normalized ratio (INR), and among those patients it was found that 19.1% exhibited a labile INR. Multivariate analysis revealed that age was the only independent predictor of thromboembolic events in patients with valvular AF. Conclusions: Many valvular AF patients are not maintained at therapeutic INR levels, which poses a threat to patient health as they age and are at greater risk for thromboembolism.Öğe Evaluation of the long-term effect of percutaneous balloon valvuloplasty on the right ventricular function using tissue Doppler imaging in patients with mitral stenosis(Turkish Soc Cardiology, 2014) Kaya, Zekeriya; Karapinar, Hekim; Kaya, Hasan; Esen, Ozlem Batukan; Akcakoyun, Mustafa; Acar, Goksel; Esen, Ali MetinObjectives: We investigated the long-term effects of percutaneous mitral balloon valvuloplasty (PMBV) on the right ventricular function using tissue Doppler imaging. Study design: Twenty-seven patients who underwent successful PMBVs were enrolled in the study. Echocardiographic examination, including color tissue Doppler imaging, was done from the lateral tricuspid ring 24 hours before the intervention. The echocardiographic examination was repeated 24 hours, and 6 months after the intervention. Results: At 24 hours after the intervention, significant increases were observed in S, and A' wave velocities (9.52 +/- 1.85 cm/s vs. 10.92 +/- 1.20 cm/s, p= 0.012; -10.44 +/- 2.64 cm/s vs. -11.73 +/- 2.05 cm/s, p= 0.029, respectively). E' wave velocity and E'/A' ratio did not change significantly (p> 0.05 for both). At 6. postprocedural month, S wave velocity was similar to the value in the early postoperative period, but higher than the baseline level (9.52 +/- 1.85 cm/s vs. 10.69 +/- 1.72 cm/s, p= 0.023). However, A' wave velocity in the late postoperative period was decreased compared to the early period and was not significantly different from the baseline level (-10.44 +/- 2.64 cm/s vs. -10.74+/- 2.63 cm/s, p> 0.05). The increase in E' wave velocity in the late period when compared to the baseline level was found to be statistically significant (7.85 +/- 1.54 cm/s vs. -9.21 +/- 1.81 cm/s, p= 0.046). Conclusion: Right ventricular systolic function improved in the early period, and this improvement was seen to continue in the late post-PMBV period.. Diastolic function did not improve in the early period, but did improve in the late period. Right atrium systolic function improved in the early period; however, in the late period, levels returned to baseline levels.Öğe A forgotten vasoconstrictive peptide in the pathogenesis of contrast induced nephropathy: Urotensin-II(Elsevier Ireland Ltd, 2013) Ulas, Turgay; Tursun, Irfan; Dal, Mehmet Sinan; Demir, Mehmet Emin; Kaya, Zekeriya[Abstract Not Available]Öğe General Features of Infective Endocarditis in the South-Eastern and Eastern Anatolia: A Retrospective, Multicenter Study(Dr M N Khan, 2012) Islamoglu, Yahya; Aksakal, Enbiya; Kaya, Zekeriya; Atilgan, Zuhal; Kayan, Fethullah; Sunbul, Sumen; Kalkan, KamuranThe present study aimed to evaluate general features of infective endocarditis (LE) in multiple tertiary university hospital. The study included 44 patients (23 women, 21 men; mean age 44 +/- 19 years; range 15 to 85 years) who were diagnosed as having definite IE, according to the modified Duke criteria, between June 2007 and June 2011. Data were reviewed on age, sex, underlying heart disease, echocardiographic and microbiological findings, treatment, complications, and mortality. Infective endocarditis developed on a native valve in 30 (72.7%), a mechanical prosthetic valve in 12 (27.3%). Prosthetic valves 12 (27.3%) were the most common preexisting valvular abnormality. The mitral valve was the most commonly affected valve in both native valves (50%) and prosthetic valves (66.6%). The most frequent symptom was fever (n=27, 61.4%). Electrocardiography showed abnormal findings in 22 cases (50%). Transthoracic and/or transesophageal echocardiography showed a vegetation in 41 cases (93.2%), and absce 3 cases (6.8%). Staphylococci (29.6%) and streptococci (25%) were the most common causative agents,and Brucella were 15.9%. Cultures were negative in 7 cases (15.9%). Nine patients (20.4%) underwent surgical treatment. Embolic events (n=6, 35.3%) were the major complications. In-hospital mortality occurred in 6 cases (13.6%). The data reflect epidemiological, clinical, and microbiological profile of IE in multiple tertiary hospital located in the South-eastern and Eastern Anatolia.Öğe İnfektif endokarditin klinik sonuçları üzerine hematolojik ve biyokimyasal parametrelerin etkisi(Dicle Üniversitesi Tıp Fakültesi, 2011) İslamoğlu, Yahya; Büyükkaya, Eyüp; Kaya, Zekeriya; Aksakal, Enbiya; Kalkan, Kamuran; Özaydoğdu, Necdet; Sümbül, Sümen; Soydinç, SerdarAmaç: Çalışmamızda İnfektif endokarditli (İE) hastalarda hematolojik parametrelerdeki değişiklikleri ve bu değişikliklerin komplikasyon ve mortalite oranları ile ilişkisini araştırmayı amaçladık. Gereç ve yöntem: Dicle Üniversitesi, Atatürk Üniversitesi ve Harran Üniversitesi Tıp Fakültelerinin kardiyoloji bölümlerinde İE tanısı ile Haziran 2007 den Haziran 2011 tarihleri arasında yatırılan 44 hasta retrospektif olarak değerlendirildi. İE tanısında Duke kriterleri esas alındı. Hematolojik ve biyokimyasal parametreler kaydedildi. Bulgular: Yaşayan hastalar ile karşılaştırıldığında, İE bağlı ölen hastalarda ortalama yaş, beyaz küre sayısı, nötrofil sayısı, ortalama trombosit hacmi ve komplikasyon oranı daha yüksek bulundu (sırasıyla, p <0.004, p <0.05, p <0.03, p <0.05, p <0.01, p <0.004). Ancak trombosit sayısı daha düşüktü (p <0.05). Bununla birlikte komplikasyon gelişen hastalar ile komplikasyon gelişmeyen hastalar karşılaştırıldığında laboratuar bulguları açısından gruplar arasında fark yoktu (p>0.05). Sonuç: İnfektif endokarditde yaş, ortalama trombosit hacmi ve komplikasyon varlığı mortalite için risk faktörleri olarak kullanılabilir. Ayrıca kan kültüründe S.aureus üremesi yüksek komplikasyon oranları ile ilişkilidir.Öğe Kalpteki ‘Fetüs’: Bir miksoma olgusu(2012) Kaya, Hasan; Karapınar, Hekim; Çalışkan, Ahmet; Kaya, Zekeriya; Yüksel, MuratErişkin yaş grubunda en sık rastlanan primer kardiyak tümör olan miksomalar patolojik olarak iyi huylu kitlelerdir. Miksomalı hastalar asemptomatik olarak tesadüfen saptanabildiği gibi çok farklı klinik belirti ve bulgularla ortaya çıkabilirler. Bunlardan biri de periferik embolidir. Bu yazıda akut arter embolisi ile başvuran sinüs ritmindeki genç bayan hastada emboli kaynağı olarak tespit edilen ve cerrahi olarak eksize edilen bir miksoma olgusu sunulmaktadır. Miksomanın ekokardiyografik görüntüsü anne karnındaki bir fetüsü andırmasıyla dikkat çekiciydi.Öğe Mitral darlığı olan hastalarda perkütan valvüloplastinin sağ kalp fonksiyonları üzerine uzun dönem etkisinin doku Doppler görüntüleme ile değerlendirilmesi(2014) Kaya, Hasan; Kaya, Zekeriya; Esen, Özlem Batukan; Esen, Ali Metin; Kırma, Cevdet; Açar, Göksel; Karapınar, HekimAmaç: Bu çalışmada, perkütan mitral balon valvüloplastinin (PMBV) sağ kalp fonksiyonları üzerine uzun dönem etkisini doku Doppler görüntüleme yöntemi işe araştırdık. Çalışma planı: Çalışmaya başarılı PMBV yapılan 27 hasta alındı. Tüm hastalara işlemden 24 saat önce triküspit halkası dış yanından renkli doku Doppler görüntüleme kaydını içeren ekokardiyografi incelemesi yapıldı. İşlemden 24 saat ve 6 ay sonra aynı inceleme tekrarlandı. Bulgular: İşlem sonrası 24. saatde S dalga hızında ve A dalga hızında anlamlı artış izlendi (sırasıyla, S dalga hızı için 9.52±1.85 cm/sn ve 10.92±1.20 cm/sn, p=0.012; A dalga hızı için -10.44±2.64 cm/sn ve -11.73±2.05 cm/sn, p=0.029). E dalga hızında ve E/A oranında anlamlı değişim izlenmedi (her ikisi için de p>0.05). Altıncı ayda S dalga hızının işlemden hemen sonraki ile benzer ve işlem öncesine göre ise daha yüksek olduğu gözlendi (9.52±1.85 cm/sn ve 10.69±1.72 cm/ sn, p=0.023). A dalga hızının ise geç dönemde erken döneme göre azaldığı ve işlem öncesinden anlamlı farklı olmadığı bulundu (-10.44±2.64 cm/sn ve -10.74±2.63 cm/sn, p>0.05). E dalga hızında işlem öncesi dönemle karşılaştırıldığında geç dönemde görülen artış anlamlı bulundu (-7.85±1.54 cm/sn ve -9.21±1.81 cm/sn, p=0.046). Sonuç: Perkütan mitral balon valvüloplasti ile sağ ventrikül sistolik fonksiyonları erken dönemde düzelmekte ve bu düzelme uzun dönemde benzer şekilde devam etmektedir. Sağ ventrikül diyastolik fonksiyonlarında erken dönemde düzelme görülmez iken geç dönemde düzelme gözlenmektedir. Sağ atriyum sistolik fonksiyonları ise erken dönemde düzelirken uzun dönemde işlem öncesi değerlere geri dönmektedir.Öğe Urotensin-II and endothelin-I levels after contrast media administration in patients undergoing percutaneous coronary interventions(Isfahan Univ Med Sciences, 2013) Ulas, Turgay; Buyukhatipoglu, Hakan; Dal, Mehmet S.; Kirhan, Idris; Kaya, Zekeriya; Demir, Mehmet E.; Tursun, IrfanBackground: Contrast induced kidney injury is an acute renal dysfunction that is secondary to the administration of radio contrast media. The purpose of this study was to evaluate the levels of urotensin-II (UT-II) and endothelin-I (ET-I) after contrast media administration in patients undergoing percutaneous coronary interventions. Materials and Methods: In this prospective cohort study, we evaluated 78 patients with coronary artery disease who were scheduled for and ultimately underwent percutaneous coronary interventions. As a contrast material, nonionic contrast media was used in various amounts (70-480 mL). Blood and urine samples were obtained to measure U-II, ET-I just before and at the twenty-fourth hour of percutaneous coronary interventions. Results: Compared to baseline, twenty-fourth hour creatinine levels were significantly increased (P < 0.001). The twenty-fourth hour serum and urine levels of both UT-II and ET-I were also significantly increased compared to baseline (P < 0.001 for all) and 24th hour serum and urine UT-II (r = 0.322, P = 0.004; r = 0.302, P = 0.007 respectively), ET-I (r = 0.511, P < 0.001; r = 0.266, P = 0.019 respectively) levels were significantly correlated with the amount of contrast media. Conclusion: Our study indicates that; increased UT-II and ET-I levels seem to be a consequence of hazardous effects of contrast media on blood vessels and the kidney.
