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Akn F.,Mugla University | Ayca B.,Bagclar Education and Research Hospital | Celik O.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | Sahin C.,Mugla University
Anadolu Kardiyoloji Dergisi | Year: 2015

Objective: The heterogeneity in the degree of collateralization among patients with coronary artery disease (CAD) remains incompletely understood. We evaluated the predictors of poorly developed coronary collateral circulation (CCC) in patients with stable coronary artery disease. Methods: Current study is a retrospective study, consisting of 118 patients with poor CCC and 130 patients with good CCC. We investigated predictors of poor coronary collaterals in a cohort of 248 patients who had high-grade coronary stenosis or occlusion on their angiograms. To classify CCC, we used the Rentrop classification. Results: Patients with poorly developed CCC had significantly higher neutrophil-to-lymphocyte ratio (N/L) compared with those with well-developed CCC, (4.2±2.8 vs. 3±3.1, p=0.001), whereas mean platelet volume, red cell distribution width and uric acid were not significantly different. Logistic regression analysis showed that N/L ratio (odds ratio 1.199, 95% confidence interval 1.045-1.375) and serum triglyceride levels [odds ratio (OR)=1.006, 95% confidence interval (CI)=1.001-1.010] were independent predictors of poorly developed CCC. Conclusion: An elevated level of N/L ratio is independently associated with a significant impairment in coronary collateralization. Our findings suggest that N/L ratio is an inexpensive, universally available hematological marker for sufficiency of CCC in patients with stable coronary artery disease. © 2015 by Turkish Society of Cardiology.


Ayca B.,Bacilar Education and Research Hospital | Celik O.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | Sahin I.,Bacilar Education and Research Hospital | Yildiz S.S.,Bacilar Education and Research Hospital | And 4 more authors.
Angiology | Year: 2015

We investigated whether the neutrophil to lymphocyte ratio (NLR) can predict stent thrombosis (STh) and high mortality rate in patients with ST-segment elevation myocardial infarction (STEMI). We analyzed data of 102 patients with STh and 450 patients with STEMI admitted to 2 high volume hospitals. Preprocedural NLR was significantly higher in patients with STh (P <.001). There was a significantly higher mortality rate in patients with high NLR during hospitalization (P <.001). Also, in the STh group there was a significantly higher mortality rate in patients with high NLR (P <.001). In receiver-operating characteristic analysis, NLR >4.8 had 56% sensitivity and 68% specificity for predicting STh. The NLR >4.9 had 70% sensitivity and 65% specificity for predicting in-hospital mortality. On multivariate regression analysis, NLR was found to be significantly related to STh. In patients with STEMI, preprocedural high NLR is associated with both STh and higher mortality rates. © The Author(s) 2014.


Akin F.,Mugla University | Ayca B.,Bagcilar Education and Research Hospital | Kose N.,Mugla University | Celik O.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | And 6 more authors.
Journal of Investigative Medicine | Year: 2014

Background and Aim: Vitamin D deficiency is common and may contribute to cardiovascular diseases. We hypothesized that serum 25-hydroxyvitamin D [25(OH)D] levels would be inversely associated with inflammation and with diastolic dysfunction. We therefore investigated the link between serum vitamin D levels (i) echocardiographic measures and (ii) inflammatory parameters. Methods: The cross-sectional study included 281 patients who were referred to coronary angiography for stable angina pectoris. Patients were recruited between December 2010 and November 2011. Patients with established congestive heart failure, gout, chronic kidney disease (estimated glomeruler filtration rate <60 mL/min per 1.73 m2), and acute infection were not included. We measured serum 25(OH)D levels, C-reactive protein and fibrinogen levels. A radioimmunoassay procedure was used to measure 25(OH)D (DiaSorin, Stillwater, MN). We also performed standardized left ventricular (LV) echocardiograms, and echocardiographic data were used for classification of systolic and diastolic dysfunction. We analyzed the relation between serum levels of 25(OH)D and inflammatory markers and echocardiographic measures of LV mass and diastolic dysfunction. Results: At baseline, subjects had a mean age of 59.5 ± 10 years, and 43.4% were women. Left ventricular mass index, left atrial diameter, isovolumic relaxation time, and E/E′ ratio were significantly higher in patients with lower 25(OH)D levels. In ordinal logistic regression analysis, higher 25(OH)D was negatively associated only with LV mass index (odds ratio [OR], 0.965; 95% confidence interval [95% CI], 0.939-0.992; P = 0.015), isovolumic relaxation time (OR, 0.962; 95% CI, 0.939-0.985; P = 0.001), E/E′ ratio (OR, 0.874; 95% CI, 0.811-0.942; P = 0.008), and C-reactive protein (OR, 0.802; 95% CI, 0.668-0.962; P = 0.021). Conclusions: Serum levels of 25(OH)D are significantly associated with LV diastolic dysfunction and LV mass index, although the effect size is rather small. Longitudinal studies in larger populations are needed to establish firmly or refute a causal relationship between vitamin D levels and diastolic dysfunction and LV mass index. Copyright © 2013 by The American Federation for Medical Research.


Celik O.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | Ozturk D.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | Ayca B.,Bacilar Education and Research Hospital | Yalcln A.A.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | And 6 more authors.
Angiology | Year: 2015

We hypothesized that contrast media volume-estimated glomerular filtration rate (CV-e-GFR) ratio may be a predictor of contrast media-induced acute kidney injury (CI-AKI). We investigated the associations between CV-e-GFR ratio and CI-AKI in 597 patients undergoing primary percutaneous coronary intervention (pPCI). An absolute ≥0.3 mg/dL increase in serum creatinine compared with baseline levels within 48 hours after the procedure was considered as CI-AKI; 78 (13.1%) of the 597 patients experienced CI-AKI. The amount of contrast during procedure was higher in the CI-AKI group than in those without CI-AKI (153 vs 135 mL, P =.003). The CV-e-GFR ratio was significantly higher in patients with CI-AKI than without (2.3 vs 1.5, P <.001). In multivariate analysis, independent predictors of CI-AKI were low left ventricular ejection fraction (P =.018, odds ratio [OR] = 0.966), e-GFR <60 mL/min (P =.012, OR = 2.558), and CV-e-GFR >2 (P <.001, OR = 5.917). In conclusion, CV-e-GFR ratio is significantly associated with CI-AKI after pPCI. © The Author(s) 2014.


Akin F.,Mugla University | Celik O.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | Ayc a B.,Bacilar Education and Research Hospital | Yalc in A.A.,Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital | And 2 more authors.
Angiology | Year: 2014

We evaluated the association between estimated glomerular filtration rate (eGFR) and slow coronary flow (SCF) in patients with normal to mildly impaired renal function; 211 patients with angiographically proven SCF and 219 controls were studied. Patients were categorized based on the angiographic findings as with or without SCF. We used the Modification of Diet in Renal Disease equation to calculate eGFR. The frequency of mildly decreased eGFR, serum uric acid levels, and eGFR was higher in the SCF group. Patients with mildly impaired renal function had higher thrombolysis in myocardial infarction frame counts in 3 major coronary arteries. In logistic regression analysis, uric acid (odds ratio [OR] = 1.323, 95% confidence interval [CI] = 1.109-1.572, P =.002) and eGFR (OR = 0.972, 95% CI = 0.957-0.987, P < .001) were independent correlates of SCF. In conclusion, eGFR was significantly correlated with SCF in patients with normal to mildly impaired renal function. © The Author(s) 2014.

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