Browsing by Author "Vural, Mustafa Gokhan"

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    Left-Sided Atrial Septal Pouch and Risk of Cryptogenic Stroke
    (2016) Yilmaz, Murat; Vural, Mustafa Gokhan; Karcaaltincaba, Musturay; Yoldas, Tahir Kurtulus; Yilmaz, Muhittin Serkan; Kavalci, Cemil; https://orcid.org/0000-0003-2529-2946; AGG-1308-2022
    Introduction: Stroke is the second most cause of death worldwide after coronary artery disease. Left-sided atrial septal pouch (LASP) is associated with potential cardioembolic stroke. This study determines the association between LASP and cryptogenic stroke (CS) using cardiac multi-detector computed tomography (cMDCT) angiograms. Materials and methods: This study included 40 patients with CS (23 males, mean age: 403 +/- 10.4 years) and 40 age- and sex matched healthy controls. cMDCT examinations by dual-source 64-slice MDCT with 0.6-mm slice thickness were performed for all patients and controls. The association between LASP and risk of CS was assessed after adjustment for other stroke risk factors. Results: Patients with LASP were younger than control subjects (41.3 +/- 7.2 years vs 44.2 +/- 5.7 years; p = 0.066), with a comparable prevalence of hypertension (42.5% vs 35%; p = 0.491) and other risk factors. There were no differences in the prevalence of LASP between patients and controls (32.5% vs 25%; p = 0.621). LASP was observed in 43.5% (n = 10) of normotensive stroke patients compared to 15.4% (n = 4) of normotensive controls (Odds Ratio (OR): 4.23, 95% CI: 1.09-16.27, p = 0.063). On the other hand, LASP was detected in 17.6% (n = 3) of hypertensive CS patients compared to 42.9% (n = 6) of hypertensive controls (OR: 028, 95% CI: 0.05-4.23, p = 0.253). The presence of LASP was not associated with an increased risk of CS. Conclusion: This study suggests that LASP is associated with CS. However, in normotensive individuals, LASP may be a minor risk factor for CS.
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    Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality
    (2020) Yilmaz, Mehmet Birhan; Aksakal, Emrah; Aksu, Ugur; Altay, Hakan; Nesligul, Yildirim; Celik, Ahmet; Akil, Mehmet Ata; Bekar, Lutfu; Vural, Mustafa Gokhan; Guvenc, Rengin Cetin; Ozer, Savas; Ural, Dilek; Cavusoglu, Yuksel; Tokgozoglu, Lale; 32120368; AAE-1392-2021
    Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: There were 1054 patients with a mean age of 63.3 +/- 13.3 years and with a median follow-up period of 16 (7-17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores <= 1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year. Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 year.