Browsing by Author "Ozcalik, Emre"

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    The effects of a low international normalized ratio on thromboembolic and bleeding complications in patients with mechanical mitral valve replacement
    (2014) Bal, Ugur; Aydinalp, Alp; Yilmaz, Kerem; Ozcalik, Emre; Hasirci, Senem; Atar, Ilyas; Gultekin, Bahadir; Sezgin, Atilla; Muderrisoglu, Haldun
    Background: Mechanical heart valve replacement has an inherent risk of thromboembolic events (TEs). Current guidelines recommend an international normalized ratio (INR) of at least 2.5 after mechanical mitral valve replacement (MVR). This study aimed to evaluate the effects of a low INR (2.0-2.5) on thromboembolic and bleeding complications in patients with mechanical MVR on warfarin therapy. Methods: One hundred and thirty-five patients who underwent mechanical MVR were enrolled in this study. The end points of this study were defined as TEs (valve thrombosis, transient ischemic attack, stroke) and bleeding (all minor and major bleeding) complications. Patients were followed up for a mean of 39.6 months and the mean INR of the patients was calculated. After data collection, patients were divided into 3 groups according to their mean INR, as follows: group 1 (n = 34), INR < 2.0; group 2 (n = 49), INR 2.0-2.5; and group 3 (n = 52), INR > 2.5. Results: A total of 22 events (10 [7.4%] thromboembolic and 12 [8.8%] bleeding events) occurred in the follow-up period. The mean INR was an independent risk factor for the development of TEs. Mean INR and neurological dysfunction were independent risk factors for the development of bleeding events. A statistically significant positive correlation was found between the log mean INR and all bleeding events, and a negative correlation was found between the log mean INR and all TEs. The total number of events was significantly lower in group 2 than in groups 1 and 3 (P = 0.036). Conclusions: This study showed that a target INRs of 2.0-2.5 are acceptable for preventing TEs and safe in terms of bleeding complications in patients with mechanical MVR.
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    The Effects of the Radial Coronary Angiography on the Cannulated Arm Strength
    (2017) Ozcalik, Emre; Aydinalp, Alp; 0000-0002-3761-8782; AAD-5841-2021
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    The Effects of the Radial Coronary Angiography on the Flow Mediated Endothelial Functional of the Radial Artery
    (2017) Ozcalik, Emre; Aydinalp, Alp; 0000-0002-3761-8782; AAD-5841-2021
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    The Effects of the Radial Coronary Angiography on the Radial Artery Diameter
    (2017) Ozcalik, Emre; 0000-0002-3761-8782; AAD-5841-2021
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    The Effects of the Radial Coronary Angiography on the Radial Artery Patency
    (2017) Aydinalp, Alp; Ozcalik, Emre; 0000-0002-3761-8782; AAD-5841-2021
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    Implantation of A Cardiac Resynchronization Therapy-Defibrillator Device in A Patient with Persistent Left Superior Vena Cava
    (2015) Atar, Ilyas; Karacaglar, Emir; Ozcalik, Emre; Ozin, Bulent; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0002-2538-1642; 0000-0003-3821-412X; 26142791; AAG-8233-2020; ABI-6723-2020; AAD-9938-2021
    Presence of a persistent left superior vena cava (PLSVC) is generally clinically asymptomatic and discovered incidentally during central venous catheterization. However, PLSVC may cause technical difficulties during cardiac device implantation. An 82-year-old man with heart failure symptoms and an ejection fraction (EF) of 20% was scheduled for resynchronization therapy-defibrillator device (CRT-D) implantation. A PLSVC draining via a dilated coronary sinus into an enlarged right atrium was diagnosed. First, an active-fixation right ventricular lead was inserted into the right atrium through the PLSVC. The stylet was preshaped to facilitate its passage to the right ventricular apex. An atrial lead was positioned on the right atrium free wall, and an overthe- wire coronary sinus lead deployed to a stable position. CRT-D implantation procedure was successfully completed.
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    Is there a relationship between resistin levels and left ventricular end-diastolic pressure?
    (2018) Yildirir, Aylin; Yildirim, Ozge Turgay; Sade, Leyla Elif; Hasirci, Senem Has; Kozan, Hatice; Ozcalik, Emre; Okyay, Kaan; Bal, Ugur Abbas; Aydinalp, Alp; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0002-6731-4958; 29615544; AAK-7355-2020; AAG-8233-2020
    Objective: Resistin, a cysteine-rich peptide, is associated with atherosclerosis and diabetes. Resistin levels increase corresponding to coronary artery disease (CAD) and heart failure severity. Since resistin level tends to elevate with symptomatic heart failure, it is expected to be associated with left ventricular end-diastolic pressure (LVEDP). However, there is no relevant literature on the relationship between resistin levels and LVEDP. We aimed to evaluate the association between resistin levels and LVEDP, severity of CAD, carotid intima-media thickness (CIMT), and echocardiographic diastolic dysfunction parameters. Methods: For this study, 128 euvolemic patients with creatinine clearance >50 mg/dL and without acute coronary syndrome, who had typical chest pain or were stress test positive, were enrolled. Resistin level was measured by Enzyme-linked immunosorbent assays (ELISA) method. Severe CAD is defined as >= 50% stenosis in one of the major coronary arteries. LVEDP was measured during left heart catheterization. Results: After coronary angiography, 60 patients (46.9%) had severe CAD. The mean LVEDPs were similar for patients with and without severe CAD (p=0.480). The resistin levels did not differ between the groups (p=0.154). The resistin levels did not correlate with LVEDP (r=-0.045, p=0.627), ejection fraction (EF; r=0.110, p=0.228), the Gensini score (r=-0.091, p=0.328), and CIMT (r=0.082, p=0.457). No significant correlation was found between the echocardiographic diastolic dysfunction parameters and resistin levels. Conclusion: There was no significant correlation between resistin level and LVEDP, CAD severity, echocardiographic diastolic dysfunction parameters, and CIMT. Further studies are warranted to determine the efficacy of resistin in clinical use.
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    Prognostic Significance of Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction
    (2023) Kocabas, Umut; Ergin, Isil; Kivrak, Tarik; Oztekin, Gulsum Meral Yilmaz; Tanik, Veysel Ozan; Ozdemir, Ibrahim; Demir, Fulya Avci; Dogdus, Mustafa; Sen, Taner; Altinsoy, Meltem; Ustundag, Songul; Urgun, Orsan Deniz; Sinan, Umit Yasar; Uygur, Begum; Yeni, Mehtap; Ozcalik, Emre; 0000-0001-6424-9399; 37804042; GXG-7709-2022
    Aims The use of guideline-directed medical therapy (GDMT) among patients with heart failure (HF) with reduced ejection fraction (HFrEF) remains suboptimal. The SMYRNA study aims to identify the clinical factors for the non-use of GDMT and to determine the prognostic significance of GDMT in patients with HFrEF in a real-life setting.Methods and results The SMYRNA study is a prospective, multicentre, and observational study that included outpatients with HFrEF. Patients were divided into three groups according to the status of GDMT at the time of enrolment: (i) patients receiving all classes of HF medications including renin-angiotensin system (RAS) inhibitors, beta-blockers, and mineralocorticoid receptor antagonists (MRAs); (ii) patients receiving any two classes of HF medications (RAS inhibitors and beta-blockers, or RAS inhibitors and MRAs, or beta-blockers and MRAs); and (iii) either patients receiving class of HF medications (only one therapy) or patients not receiving any class of HF medications. The primary outcome was a composite of hospitalization for HF or cardiovascular death. The study population consisted of 1062 patients with HFrEF, predominantly men (69.1%), with a median age of 68 (range: 20-96) years. RAS inhibitors, beta-blockers, and MRAs were prescribed in 76.0%, 89.4%, and 55.1% of the patients, respectively. The proportions of patients receiving target doses of guideline-directed medications were 24.4% for RAS inhibitors, 11.0% for beta-blockers, and 11.1% for MRAs. Overall, 491 patients (46.2%) were treated with triple therapy, 353 patients (33.2%) were treated with any two classes of HF medications, and 218 patients (20.6%) were receiving only one class of HF medication or not receiving any HF medication. Patient-related factors comprising older age, New York Heart Association functional class, rural living, presence of hypertension, and history of myocardial infarction were independently associated with the use or non-use of GDMT. During the median 24-month period, the primary composite endpoint occurred in 362 patients (34.1%), and 177 of 1062 (16.7%) patients died. Patients treated with two or three classes of HF medications had a decreased risk of hospitalization for HF or cardiovascular death compared with those patients receiving <= 1 class of HF medication [hazard ratio (HR): 0.65; 95% confidence interval (CI): 0.49-0.85; P = 0.002, and HR: 0.61; 95% CI: 0.47-0.79; P < 0.001, respectively].Conclusions The real-life SMYRNA study provided comprehensive data about the clinical factors associated with the non-use of GDMT and showed that suboptimal GDMT is associated with an increased risk of hospitalization for HF or cardiovascular death in patients with HFrEF.
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    Relation Between Carotid Intima-Media Thickness, Serum Paraoxonase Levels and Severity of Obstructive Sleep Apnea Syndrome
    (2023) Akkurt, Esma Sevil; Bozbas, Serife Savas; Eroglu, Serpil; Ozcalik, Emre; Ozer, Eda Ozturan; Ozyurek, Berna Akinci; Eyuboglu, Fusun Oner; 37983282
    INTRODUCTION: Obstructive sleep apnea (OSA) has a significant effect on the development of cardiovascular complications. The aim of this study was to evaluate the relationship between carotid intimamedia thickness (IMT), paraoxonase 1 (PON 1) enzyme levels and severity of OSA. MATERIAL AND METHODS: A total of 120 cases were included in the study with 30 cases in each group, as follows: Group 1 (AHI < 5/h), Group 2 (AHI 5-15/h), Group 3 (AHI 16-30/h) and Group 4 (AHI > 30/h). Blood samples of the patients were taken to measure serum PON1 activity. Carotid IMT of all patients included in the study was measured by means of echocardiography using vascular probe and results were recorded. RESULTS: With regard to carotid IMT, a statistically significant increase was detected as severity of OSA increased (p < 0.001). A positive relationship was detected between IMT level and total oxygen desaturation time, oxygen desaturation index and SpO2 time < 90 % (p < 0.01). When the groups were compared, a statistically significant decline was observed in serum PON 1 level as severity of OSA increased (p < 0.05). CONCLUSIONS: The findings of our study indicate that PON1 and carotid IMT might be used as indicators of vascular damage in patients with OSA. Depending on the severity of OSA, measurement of PON1 enzyme activity in conjunction with carotid IMT may help us in predicting the cardiovascular risk in patients with OSA (Tab. 4, Fig. 2, Ref. 27). Tex t in PDF www.elis.sk
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    Relation Between Carotid Intima-Media Thickness, Serum Paraoxonase Levels and Severity of Obstructive Sleep Apnea Syndrome
    (2015) Akkurt, Esma Sevil; Bozbas, Serife Savas; Eroglu, Serpil; Ozcalik, Emre; Eyuboglu, Fusun Oner; 0000-0002-7230-202X; 0000-0002-5525-8207; AAI-8064-2021; AAR-4338-2020; ABG-1582-2021