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Öğe The Association Between the Ratio of Fibrinogen to Albumin With Contrast-Induced Nephropathy After Carotid Angiography: Reply(Sage Publications Inc, 2020) Ertas, Faruk; Avci, Eyup; Kiris, Tuncay[Abstract Not Available]Öğe Bleeding risk in patients with acute coronary syndrome in a Turkish population: Results from the Turkish Acute Coronary Syndrome Registry (TACSER) study(Wiley, 2020) Avci, Eyup; Kiris, Tuncay; Akgun, Didar Elif; Celik, Aykan; Akcay, Filiz Akyildiz; Acar, Burak; Kurmus, OzgeObjective Bleeding is one of the most important causes of mortality in patients with acute coronary syndrome (ACS). This study therefore aimed to investigate bleeding risk in patients with ACS who were scheduled to receive dual antiplatelet therapy (DAPT) in Turkey. Methods This was a multicentre, observational, cross-sectional cohort study. The study population included 963 patients with ACS from 12 centres in Turkey. We used the Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score to predict the bleeding risk for all the patients. The patients were divided into high (>= 25) or low (<25) bleeding risk groups based on their PRECISE-DAPT scores. Results The mean PRECISE-DAPT score was 21.9. Overall, 32.2% of the patients had high PRECISE-DAPT scores (>= 25). Compared with the male patients, the female patients had higher PRECISE-DAPT scores (28.2 +/- 15.7 vs 18.4 +/- 13.6,P < .001). Among the females, the rate of patients with a PRECISE-DAPT score >= 25 was 53%, while among the male patients, the score occurred at a rate of 22%. The female patients had lower haemoglobin (Hb) levels than the male patients (12.1 +/- 1.7 vs 13.8 +/- 1.9,P < .001) and lower creatinine clearance (70.7 +/- 27.5 vs 88.7 +/- 26.3,P < .001). The in-hospital bleeding rates were higher among the patients with high PRECISE-DAPT scores than among those who did not have high scores. Furthermore, the patients with high PRECISE-DAPT scores had a higher in-hospital mortality rate compared with those with low PRECISE-DAPT scores (1% vs 0%,P = .11). Conclusions The mean PRECISE-DAPT score was high among the patients with ACS in this study, indicating that the bleeding tendency was high. This study showed that the PRECISE-DAPT score may help physicians determine the type and duration of DAPT, especially in patients with ACS in Turkey.Öğe Comparison of long-term outcome of patients with ST-segment elevation myocardial infarction between pre-COVID-19 and COVID-19 era(Wiley, 2022) Kiris, Tuncay; Avci, Eyup; Ekin, Tuba; Akgun, Didar Elif; Tiryaki, Mucahit; Yidirim, Arafat; Hazir, KutluhanAims: To compare major cardiovascular and cerebrovascular events (MACCE) rates between patients in the pre-COVID-19 era and COVID-19 era, and to assess the impact of the presence of COVID-19 (+) on long-term MACCE in ST-segment elevation myocardial infarction (STEMI) in Turkey. Methods: Using the TURSER study (TURKISH ST-segment elevation myocardial infarction registry) data, the current study included 1748 STEMI patients from 15 centres in Turkey. Patients were stratified into COVID-19 era (March 11st-May 15st, 2020; n = 723) or pre-COVID-19 era (March 11st-May 15st, 2019; n = 1025) cohorts. Long-term MACCE rates were compared between groups. In addition, the effect of COVID-19 positivity on long-term outcomes was evaluated. The primary outcome was the occurrence of MACCE at long-term follow-up, and the secondary outcome was hospitalization with heart failure. Results: The MACCE and hospitalization with heart failure rates between pre-COVID-19 era and COVID-19 era were 23% versus 22% (p = .841), and 12% versus 8% (p = .002), respectively. In the COVID-19 era, the rates of MACCE and hospitalization with heart failure COVID-19-positive versus COVID-19-negative patients were 40% versus 20%, (p < .001), and 43% versus 11% (p < .001), respectively. Conclusion: There was no difference between the pre-COVID-19 era and the COVID-19 era in terms of MACCE in STEMI patients in Turkey. In the COVID-19 era, STEMI patients positive for COVID-19 had a higher rate of MACCE and heart failure hospitalization at the long-term follow-up.Öğe EFFECT OF THE PROGNOSTIC NUTRITION INDEX ON LONG-TERM OUTCOMES IN UNPROTECTED LEFT MAIN CORONARY ARTERY REVASCULARIZATION(Russian Heart Failure Soc, 2023) Guzel, Tuncay; Avci, Eyup; Kiris, Tuncay; Arik, Baran; Arslan, Bayram; Ildirimli, Kamran; Yildirim, BunyaminObjective The prognostic nutritional index (PNI) is a practical, applicable, prognostic scoring system. However, its clinical significance in unprotected left main coronary artery (ULMCA) patients undergoing percutaneous coronary intervention (PCI) has not yet been clarified. This study aimed to examine the relationship between malnutrition as assessed by PNI and major adverse cardiac events (MACE) in ULMCA patients undergoing PCI.Material and methods 185 patients who were hospitalized in our clinic underwent coronary angiography, had a critical LMCA lesion, and underwent angiography-guided PCI were included. The study population was divided into tertiles based on the PNI values. A high PNI (n=142) was defined as a value in the third tertile (>= 34.0), and a low PNI (n=43) was defined as a value in the lower 2 tertiles (< 34.0). The primary endpoint was MACE.Results MACE and mortality rates in the low PNI group were significantly higher compared to the high PNI group (51 % vs. 30 %, p=0.009; 44 % vs. 20 %, p=0.002, respectively). High PNI (HR:1.902; 95 % CI:1.112-3.254; p=0.019), previous stroke (HR:3.025; 95 % CI:1.038-8.810; p=0.042) and SYNTAX score (HR:1.028; 95 % CI:1.004-1.057, p=0.023) were independent predictors of MACE in the multivariable cox regression analyzes.Conclusions In patients undergoing ULMCA PCI, nutritional status can be considered an indicator of MACE rates by evaluating the PNI score. This index can be used for risk classification.Öğe Impact of COVID-19 outbreak on patients with ST-segment elevation myocardial infarction (STEMI) in Turkey: results from TURSER study (TURKISH St-segment elevation myocardial infarction registry)(Springer, 2021) Kiris, Tuncay; Avcı, Eyüp; Ekin, Tuba; Akgün, Didar Elif; Tiryaki, Mücahit; Yidirim, Arafat; Hazır, Kutluhan; Murat, Bektaş; Yeni, Mehtap; Altındağ, Rojhad; Gül, Sefa; Arık, Baran; Güzel, Tuncay; Murat, Selda; Öz, Ahmet; Karabacak, Mustafa; Aktaş, Zihni; Yıldırım, Tarık; Kılıçaslan, Barış; Ergene, Asim OktayObjective We aimed to investigate both the impact of COVID-19 pandemic on ST-segment elevation myocardial infarction (STEMI) admission, and demographic, angiographic, procedural characteristics, and in-hospital clinical outcomes of patients with COVID-19 positive STEMI in Turkey. Methods This was a multi-center and cross-sectional observational study. The study population included 1788 STEMI patients from 15 centers in Turkey. The patients were divided into two groups: COVID-19 era (March 11st–May 15st, 2020; n=733) or pre- COVID-19 era group (March 11st–May 15st, 2019; n=1055). Also, the patients in COVID-19 era were grouped as COVID-19 positive (n=65) or negative (n=668). Results There was a 30.5% drop in STEMI admission during COVID-19 era in comparison to pre-COVID-19 era. The patients admitted to the medical centers during COVID-19 era had a longer symptom-to-frst medical contact time [120 (75–240) vs. 100 (60–180) minutes, p<0.001]. COVID-19 positive STEMI patients had higher thrombus grade and lower left ventricular ejection fraction compared to COVID-19 negative patients. COVID-19 positive patients had higher mortality (28% vs. 6%, p<0.001) and cardiogenic shock (20% vs. 7%, p<0.001) rates compared with those without COVID-19. Matching based on propensity scores showed higher mortality and high thrombus grade in STEMI patients who were infected by SARS-COV-2 (each p<0.05). Conclusions We detected signifcantly lower STEMI hospitalization rates and signifcant delay in duration of symptom onset to frst medical contact in the context of Turkey during the COVID-19 outbreak. Moreover, high thrombus grade and mortality were more common in COVID-19 positive STEMI patients.Öğe The Ratio of Fibrinogen to Albumin as a Predictor of Contrast-Induced Nephropathy After Carotid Angiography(Sage Publications Inc, 2019) Ertas, Faruk; Avci, Eyup; Kiris, TuncayContrast-induced nephropathy (CIN) is acute kidney failure that occurs after exposure to contrast agent. There is no sensitive biomarker to predict the development of CIN. In a retrospective study, we investigated the predictive value of the fibrinogen to albumin ratio (FAR) to determine the risk of CIN in patients (N = 246) who underwent carotid angiography. Contrast-induced nephropathy was defined as a 0.5 mg/dL or 25% increase in serum creatinine levels 48 to 72 hours following exposure to a radiocontrast agent. Patients were grouped according to whether they developed CIN or not, that is, CIN(-) and CIN(+) groups, respectively. Contrast-induced nephropathy developed in 39 (15.8%) of all the patients. The fibrinogen levels, neutrophil to lymphocyte ratio (NLR), and FAR in the CIN (+) group were higher than in the CIN (-) group (P < .001). Multivariate analysis showed that age, diabetes, NLR, platelet-lymphocyte ratio, and FAR were independent risk factors for CIN. The area under the curve (AUC) of FAR was 0.800 for the prediction of CIN, and the best cutoff value was 57.4 with sensitivity, specificity, positive predictive value, and negative predictive value of 74.4%, 60.8%, 26.4%, and 92.7%, respectively. The FAR may be useful as a predictor of CIN.
