Browsing by Author "Sahin, Durmus Yildiray"

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Antithrombotic treatment patterns and stroke prevention in patients with atrial fibrillation in Turkey: Inferences from GARFIELD-AF registry
(2019) Sayin, Begum Yetis; Okutucu, Sercan; Yilmaz, Mehmet Bircan; Ozdemir, Kurtulus; Aydinlar, Ali; Sahin, Durmus Yildiray; Altun, Armagan; Acikel, Sadik; Okuyan, Ertugrul; Sucu, Murat; Ongen, Zeki; Ersanli, Murat Kazim; Yilmaz, Ozcan; Demir, Mesta; Pekdemir, Hasan; Topsakal, Ramazan; Sahiner, Mehmet Levent; Aras, Dursun; Oto, Ali; 31062761; ABB-5844-2020
Objective: The corner stone of atrial fibrillation therapy includes the prevention of stroke with less adverse effects. The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) study provided data to compare treatment strategies in Turkey with other populations and every-day practice of stroke prevention management with complications. Methods: GARFIELD-AF is a large-scale registry that enrolled 52,014 patients in five sequential cohorts at > 1.000 centers in 35 countries. This study was initiated to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF. A total of 756 patients from 17 enrolling sites in Turkey were in cohort 4 and 5. Treatment strategies at diagnosis initiated by CHA(2)DS(2)-VASc score, baseline characteristics of patients, treatment according to stroke and bleeding risk profiles, and INR values were analyzed in cohorts. Additionally, event rates during the first year follow up were evaluated. Results: AF patients in Turkey were mostly seen in young women. Stroke risk according to the CHADS(2) score and CHA(2)DS(2)-VASc score compared with world data. The mean of risk score values, including HAS-BLED score were lower in Turkey than in the world data. The percentage of patients receiving FXa inhibitor with or without an antiplatelet usage was more than the other drug groups. All-cause mortality was higher in Turkey. Different form world data when HAS-BLED score was above 3, the therapy was mostly changed to antiplatelet drugs in Turkey. Conclusion: In addition to deficiencies in available treatment options, patient care and clinical outcomes of patients with AF, the data of GARFIELD-AF provide data from Turkey about therapeutic strategies and best practices.
The Association between Aortic Distensibility and Coronary Flow Reserve in Newly Diagnosed Diabetic Patients
(2015) Kalkan, Gulhan Yuksel; Gur, Mustafa; Haydardedeoglu, Filiz Eksi; Kirim, Sinan; Baykan, Ahmet Oytun; Kuloglu, Osman; Ucar, Hakan; Sahin, Durmus Yildiray; Elbasan, Zafer; Seker, Taner; Turkoglu, Caner; Yildirim, Arafat; Cayli, Murat; 0000-0002-0179-9673; 24815036; AAK-5003-2021
IntroductionAortic distensibility (AD) is an important parameter affecting coronary hemodynamics. Coronary flow velocity reserve (CFVR) is a reliable marker of coronary endothelial function in diabetic patients. The aim of this study was to investigate the association between AD and CFVR in newly diagnosed diabetic patients. MethodWe studied 77 patients with newly diagnosed diabetes mellitus (DM) and 30 age- and sex-matched healthy control subjects. CFVR was calculated as the hyperemic to resting coronary diastolic velocities ratio by using transthoracic echocardiography. Pulse pressure (PP) and AD were calculated. ResultsFasting blood glucose, HbA1c and PP were significantly higher in patients with diabetes (P<0.001, P<0.001 and P=0.009, respectively). Other clinical and demographical characteristics, laboratory findings and echocardiographic findings were similar in both groups (P>0.05, for all). The measurement of CFVR and AD in patients with diabetes were significantly lower compared with the controls (P<0.001 and P=0.001, respectively). CFVR was significantly negatively correlated with age, body mass index, HbA1c, systolic blood pressure, and PP, while significantly positively correlated with AD (P<0.05, for all). Multivariate regression analysis showed that only AD (=0.485, P<0.0001) and HbA1c (=-0.362, P<0.0001) were independently associated with CFVR. The cutoff value of AD obtained by the receiver operator characteristic (ROC) curve analysis was 2.44 for the prediction of impaired CFVR. ConclusionAortic distensibility and HbA1c were independently associated with CFVR. The decrease in AD may be used as a marker of impaired coronary microcirculation in asymptomatic diabetic patients.
Left Ventricle Geometry Affects Coronary Flow Reserve in Diabetic Patients
(2015) Kalkan, Gulhan Yuksel; Gur, Mustafa; Elbasan, Zafer; Baykan, Ahmet Oytun; Kuloglu, Osman; Sahin, Durmus Yildiray; Seker, Taner; Haydardedeoglu, Filiz Eksi; Sen, Omer; Ucar, Hakan; Kirim, Sinan; Cayli, Murat; 0000-0002-0179-9673; 25655851; AAK-5003-2021
Objectives: The aim of this study was to investigate the association between coronary flow reserve (CFR) and left ventricle (LV) geometric patterns in patients with newly-diagnosed diabetes mellitus (DM). Study design: We studied 116 patients with newly-diagnosed DM and 31 healthy control subjects. Echocardiographic examination was performed on all subjects. Four different geometric patterns were identified in diabetic patients, according to LV mass index (LVMI) and relative wall thickness (RWT) [NG: Normal geometry; CR: Concentric remodeling; EH: Eccentric hypertrophy; CH: Concentric hypertrophy]. CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio. Results: Compared with controls, CFR was decreased in diabetic patients (p<0.05). The lowest CFR values were observed in the CH group compared with control and other groups (p<0.05, for all). Also, CFR values of the CR and EH groups were lower than NG and the control group (p<0.05, for all). CFR was associated with LV geometry (r=-0.449, p=0.001), LVMI (r=-0.401, p<0.001), RWT (r=-0.247, p=0.008), HbA1c (r=-0.576, p<0.001) and mitral valve E/A ratio (r=0.239, p=0.01) in bivariate analysis. CFR was independently associated with LV geometry (beta=-0.449, p<0.001), LVMI (beta=-0.192, p=0.016), and HbA1c (beta=-0.576, p<0.001) in multivariate analysis. Conclusion: CFR was impaired in newly-diagnosed DM. The degree of this deformation increases from normal geometry towards to concentric hypertrophy. This condition suggests that myocardial structural remodeling due to diabetes might be effective on CFR.