Browsing by Author "Muderrisoglu, İbrahim Haldun"

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    Efficacy and Safety of Switching from Clopidogrel to Ticagrelor at the Time of Discharge in STEMI Patients Treated with a Pharmacoinvasive Approach
    (2021) Coner, Ali; Muderrisoglu, İbrahim Haldun; 0000-0002-5711-8873; ABD-7321-2021
    Objective: The aim of the study was to search for the efficacy and safety of switching from clopidogrel to ticagrelor at the time of discharge in ST-segment elevation myocardial infarction (STEMI) patients treated with a pharmacoinvasive approach. Materials and Methods: STEMI patients who were managed with pharmacoinvasive approach were involved in the study population. Patients were divided into two groups as clopidogrel and ticagrelor depending on the choice of P2Y12 inhibitor at the time of discharge. All-cause mortality, stent thrombosis, recurrent myocardial infarction, need for target lesion revascularization, and any major bleeding (BARC classification >= 2) were defined as composite clinical end points at the end of the 12th month follow-up. Results: A total of 194 patients (male: 156 patients, 80.4%; mean age 60.2 +/- 11.5 years) were involved in the study population (130 clopidogrel and 64 ticagrelor patients). The median time interval for switching time to ticagrelor was 48 (48-72) h. In a subgroup analysis for patients with a stented segment >= 30 mm, discharge with clopidogrel was related to 6.9 times increase in composite end points compared to patients discharged with ticagrelor (odds ratio: 6.955, confidence interval 95%: 1.512-30.980, p=0.012). Conclusion: Switching from clopidogrel to ticagrelor at the 48th h following fibrinolytic administration had similar safety end points in STEMI patients managed with pharmacoinvasive approach. In a subgroup of study patients with a total stent length of >= 30 mm, switching to ticagrelor was found to be superior to clopidogrel regarding composite clinical end points.
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    Relationship Between Preoperative Diastolic Transpulmonary Gradient With Pulmonary Vascular Resistance and 1-Year and Overall Mortality Rates Among Patients Undergoing Cardiac Transplant
    (2019) Ciftci, Orcun; Unsal, Esma Nur; Dellaloglu, Zeynep; Aydan, Alp; Aksoy, Gokcen; Karakas, Makbule; Aydmalp, Alp; Sezgin, Atilla; Muderrisoglu, İbrahim Haldun; Haberal, Mehmet; 0000-0001-8926-9142; 30251939; W-5233-2018
    Objectives: Cardiac transplant is a life-saving procedure for patients with end-stage heart failure. Preoperative pulmonary vascular resistance is indicative of intrinsic pulmonary vascular disease and correlates with posttransplant survival. However, its measurement is costly and time consuming. Therefore, simpler techniques are required. Diastolic transpulmonary gradient reportedly indicates intrinsic pulmonary vascular disease. Here, we investigated the relationship between preoperative diastolic transpulmonary gradient with preoperative pulmonary vascular resistance and 1-year and overall mortality among cardiac transplant patients. Materials and Methods: Fifty-one patients who underwent cardiac transplant between 2006 and 2017 were included. All patients underwent preoperative right and left heart catheterization and oxygen study. Among these, diastolic transpulmonary gradient, mean transpulmonary gradient, and pulmonary vascular resistance were correlated with one another and 1st-year and overall mortality rates. Patients were grouped according to whether they received diastolic transpulmonary gradient or not, and both groups were compared with respect to 1-year and overall mortality. Binary logistic regression analysis was done to test whether diastolic transpulmonary gradient was a significant predictor of 1-year and overall mortality. Results: Mean patient age was 45.5 +/- 9.8 years. The 1-year and overall mortality rates were 21.6% (11/51) and 37.3% (19/51), respectively. Diastolic transpul monary gradient was significantly correlated with pulmonary vascular resistance, 1-year mortality, and overall mortality (P<.05) and was a significant predictor of 1-year and overall mortality (odds ratio 6.0; 95% confidence interval, 1.4-25.3; P <.05 and odds ratio 4.8; 95% CI, 1.4-17.5; P <.05, respectively). Patients with a diastolic transpulmonary gradient of >= 7 mm Hg had significantly higher 1-year and overall mortality (P<.05). Conclusions: Diastolic transpulmonary gradient can be used as a promising easy-to-use parameter of intrinsic pulmonary vascular disease and a predictor of 1-year and overall mortality among patients undergoing cardiac transplant.