Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Could Plasma Asymmetric Dimethylarginine Level Be A Novel Predictor Beyond The Classic Predictors of Stent Restenosis?(2014) Bal, Ugur Abbas; Yildirir, Aylin; Aydinalp, Alp; Kaynar, Gamze; Kanyilmaz, Suleyman; Murat, Koza; Muderrisoglu, Ibrahim Haldun; https://orcid.org/0000-0002-9446-2518; https://orcid.org/0000-0001-8750-5287; https://orcid.org/0000-0002-3761-8782; 25233494; AAK-4322-2021; A-4947-2018; AAD-5841-2021Objective: The aim of this study was to investigate the factors associated with coronary stent restenosis and if there is an association between plasma asymmetric dimethylarginine (ADMA) levels and stent restenosis. Methods: Ninety-one patients, who had a history of coronary bare metal stent implantation due to any cause in the last one year period, were admitted to this observational cross-sectional study. Coronary angiography was performed to all patients and quantitative angiography was used to determine the presence of stent restenosis. Laboratory parameters and angiographic features that contribute to stent restenosis were evaluated. Plasma ADMA levels were measured by using high performance liquid chromatography. Logistic regression analysis was used to determine the independent factors of stent restenosis. Results: Angiographic restenosis was found in 35 patients (38.5%). Stent diameter (p=0.038) and left ventricular ejection fraction (p=0.023) were lower and stent implantation history due to acute coronary syndrome (p=0.029), plasma ADMA level (5.0 +/- 1.8x10(-4) mmol/L vs. 3.9 +/- 1.0x10(-4) mmol/L, p=0.001), C-reactive protein concentration (p=0.016), white blood cell count (p=0.044) and stent length (p=0.005) were higher in patients with restenosis. Plasma ADMA level (beta=0.536; OR: 1.710; CI: 1.022-2.861; p=0.041), C-reactive protein concentration (beta=0.062; OR: 1.064; CI: 1.003-1.129; p=0.041), stent diameter (beta=-3.047; OR: 0.048; CI: 0.007-0.313; p=0.002) and length (beta=0.165; OR: 1.179; CI: 1.036-1.343; p=0.013) were found to be the independent predictors of stent restenosis in logistic regression analysis. Conclusion: We conclude that plasma ADMA levels may be used as a novel marker for stent restenosis beyond the classic stent restenosis markers.Item Predictors of Obstructive Coronary Artery Disease vs Non-obstructive Lesions on Coronary Angiography in Patients with Non-ST Elevation Myocardial Infarction. A Retrospective Analysis from a University Hospital(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Karacaglar, Emir; Yilmaz, Kerem Can; Muderrisoglu, Ibrahim Haldun; 0000-0001-8926-9142; 0000-0002-2538-1642; AAC-2597-2020; AAJ-1331-2021; W-5233-2018; ABI-6723-2020Item Neutrophil/Lymphocyte Ratio in Coronary Bare Metal Stent Restenosis(2017) Yilmaz, Kerem Can; Ciftci, Orcun; Karacaglar, Emir; Bal, Ugur Abbas; Okyay, Kaan; Aydinalp, Alp; Yildirir, Aylin; Muderrisoglu, Ibrahim Haldun; 0000-0002-9446-2518; 0000-0002-2538-1642; 0000-0002-3761-8782; 0000-0001-8926-9142; 0000-0001-8750-5287; 0000-0001-6134-8826; 0000-0003-3320-9508; AAK-4322-2021; ABI-6723-2020; AAJ-1331-2021; AAD-5841-2021; W-5233-2018; A-4947-2018; AAK-7355-2020Item Assessment of Mental Workload and Academic Motivation in Medical Students(2016) Atalay, Kumru Didem; Can, Gulin Feryal; Erdem, Saban Remzi; Muderrisoglu, Ibrahim Haldun; https://orcid.org/0000-0002-7537-2170; 27183939; AAJ-2370-2021Objectives: To investigate the level of correlation and direction of linearity between academic motivation and subjective workload. Method: The study was conducted at Baskent University School of Medicine, Ankara, Turkey, from December 2013 to February 2014, and comprised Phase 5 Phase 6 medical students. Subjective workload level was determined by using National Aeronautics and Space Administration Task Load Index scale that was adapted to Turkish. Academic motivation values were obtained with the help of Academic Motivation Scale university form. SPSS 17 was used for statistical analysis. Results: Of the total 105 subjects, 65(62%) students were in Phase 5 and 40(38%) were in Phase 6. Of the Phase 5 students, 18(27.7%) were boys and 47(72.3%) were girls, while of the Phase 6 students, 16(40%) were boys and 24(60%) were girls. There were significant differences in Phase 5 and Phase 6 students for mental effort (p= 0.00) and physical effort (p= 0.00). The highest correlation in Phase 5 was between mental effort and intrinsic motivation (r= 0.343). For Phase 6, highest correlation was between effort and amotivation (r= -0.375). Conclusion: Subjective workload affected academic motivation in medical students.Item Neutrophil to Lymphocyte Ratio As A Predictor of Severe Coronary Artery Disease and Left Ventricular Systolic Dysfunction of Any Degree in Geriatric Patients Presenting to Emergency Department with Acute Coronary Syndrome(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Aydos, Tolga Resat; Muderrisoglu, Ibrahim Haldun; 0000-0002-1832-9336; 0000-0001-8926-9142; AAJ-7279-2020; AAC-2597-2020; W-5233-2018Introduction: We examined the role of the neutrophil-to-lymphocyte ratio (NLR) for predicting severe coronary artery disease and left ventricular systolic dysfunction of any degree in geriatric patients presenting to emergency department with non-ST-elevation acute coronary syndrome. Materials and Method: We retrospectively reviewed data for patients aged >= 65 years with non-ST-elevation acute coronary syndrome who underwent coronary angiography between April 2011 and January 2016. Patients were divided into Group 1 (101 patients; severe [>50%] lesions in one or more epicardial artery or branch) and Group 2 (65 patients; no severe lesions). The key clinical parameters, including NLR were compared among the groups and the power of NLR as a predictor of severe coronary artery disease and left ventricular systolic dysfunction of any degree was determined. Results: Group 1 included more patients who were male, older, or smoked; these had higher troponin I, mass CK-MB, NLR, but a lower left-ventricular ejection fraction. NLR was an independent predictor of severe coronary disease and left ventricular systolic dysfunction of any degree with good sensitivity and moderate specificity. Conclusion: Neutrophil-to-lymphocyte ratio is a simple, rapid, and cheap parameter that can predict severe coronary artery disease and left ventricular systolic dysfunction of any degree in geriatric patients with non-ST-elevation acute coronary syndrome.Item The Effects of Steroids on Endothelial Function Reply(2017) Caldir, Mehmet Vedat; Celik, Guner Koyuncu; Ciftci, Ozgur; Muderrisoglu, Ibrahim Haldun; GOE-6067-2022Item Experience With Cardiac Implantable Electrical Device Explantation After Cardiac Transplantation: A Report of 16 Cases From a Single Center in a Period of 5 Years(2018) Ciftci, Orcun; Yilmaz, Kerem Can; Sezgin, Atilla; Ozin, Mehmet Bulent; Muderrisoglu, Ibrahim Haldun; Haberal, Mehmet; 0000-0001-8926-9142; 0000-0002-3462-7632; 29528003; W-5233-2018; AAJ-1331-2021; AAJ-8097-2021Objectives: Cardiac implantable electrical devices are widely used for patients with advanced heart failure and are usually explanted during orthotopic heart transplant. However, lead fragments and the pulse generator are sometimes left after the procedure. Given the concerns of infectious and thromboembolic complications, their removal is recommended. Herein, we report our experience with cardiac implantable electrical device explantation after orthotopic heart transplant. Materials and Methods: We included recipients of heart transplants performed at Baskent University Faculty of Medicine, Department of Cardiovascular Surgery, who underwent lead and pulse generator explantation by manual traction between January 2012 and June 2017. We analyzed patient demographic, clinical, biochemical, and treatment properties. Results: Sixteen patients (11 males, 5 females) with a median age of 45 years (range, 18-52 y) were included. Two patients (12.5%) died during follow-up but not secondary to device explantation. All patients were using immunosuppressives and 50% were receiving antiplatelet/anticoagulant agents. All pulse generators were located at the left prepectoral area, with tips of lead fragments in the superior vena cava or left subclavian vein. No procedural complications were observed. Aspirin was continued uninterrupted perioperatively, warfarin was stopped 2 days before the procedure, and low-molecular-weight heparins were skipped on the morning and evening of the procedure. One patient (6.3%) complained of postoperative pain, and another (6.3%) developed a pocket hematoma, which was treated conservatively. No patient developed fever, clinical infection, or major bleeding. Preoperative and postoperative levels of hemoglobin, white blood cells, and C-reactive protein were similar. No demographic, procedural, or biochemical variable was significantly correlated with postprocedural complications. Conclusions: In our cohort, explantation of lead fragments and pulse generators of cardiac implantable electrical devices was safe after heart transplant. It appears that neither antiplatelet/anticoagulant agents nor immunosuppressives seem to put patients at increased risk of postoperative complications.Item Fragmented QRS on 12-Lead Electrocardiogram Is Correlated With Severe Coronary Artery Disease and Abnormal Myocardial Perfusion Scintigraphy Results in Renal Transplant Candidates(2018) Ciftci, Orgun; Keskin, Suzan; Karacaglar, Emir; Yilmaz, Kerem Can; Aktas, Ayse; Sezer, Siren; Moray, Gokhan; Muderrisoglu, Ibrahim Haldun; Haberal, Mehmet; 0000-0001-8926-9142; 0000-0002-2538-1642; 0000-0003-2498-7287; 0000-0002-3462-7632; 30066622; W-5233-2018; ABI-6723-2020; AAJ-1331-2021; AAE-1041-2021; AAJ-8097-2021Objectives: Coronary artery disease is a major cause of mortality and morbidity after renal transplant. Fragmented QRS on standard 12-lead electrocardiograms has been proposed as a marker of myocardial scar, mainly due to coronary artery disease. Here, we aimed to investigate fragmented QRS to detect severe coronary artery disease in renal transplant candidates. Materials and Methods: We retrospectively reviewed the medical records of 534 patients with end-stage renal failure who were on the deceased-donor renal transplant wait list at Baskent University Faculty of Medicine due to having no living kidney donor available. We evaluated patients with standard 12-lead electrocardiograms, myocardial perfusion scintigraphy, and coronary angiography. We compared fragmented QRS prevalence versus myocardial perfusion scintigraphy abnormalities and severe coronary artery disease. Correlations among these were analyzed. Results: Of 92 renal transplant candidates (median age of 56.5 y; range, 24-80 y), 87 patients (94.6%) had myocardial perfusion defects and 72 (78.3%) had myocardial wall motion abnormalities on myocardial perfusion scintigraphy. Forty-four patients (47.8%) had severe coronary artery disease on coronary angiography, and 51 patients (55.4%) had fragmented QRS. Fragmented QRS was significantly more common among patients with myocardial scar. Coronary artery disease was significantly more common in patients with fragmented QRS (P = .042) and in those with fragmented QRS combined with myocardial perfusion defects (P < .01). Fragmented QRS was significantly correlated with presence of myocardial scar and any perfusion defects. When combined with myocardial perfusion defects, fragmented QRS was significantly correlated with severe coronary artery disease (P < .05). Conclusions: Fragmented QRS was significantly correlated with abnormal myocardial perfusion scintigraphy and severe coronary artery disease in renal transplant candidates.This simple parameter can provide valuable information on severe coronary artery disease and help to prevent excess patient morbidity and mortality from this disease after renal transplant.Item Heart Rate Variability And Heart Rate Turbulence In Patients With Vasovagal Syncope(2021) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Muderrisoglu, Ibrahim Haldun; 0000-0002-9146-0621; 0000-0001-5250-5404; 0000-0002-5711-8873; 34549694; AAD-5479-2021; AAD-5564-2021; ABD-7321-2021Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope. Material and methods Patients who underwent head-up tilt test (HUTT) due to unexplained syncope and who had a 24-hr Holter ECG recording in the same period were retrospectively analyzed. Patients with diabetes, a history of myocardial infarction, heart failure, orthostatic hypotension, atrial fibrillation, or use of vasoactive drugs, such as beta blockers, were excluded from the study. 161 patients who met these criteria were included in the study. Time domain HRV parameters from Holter ECG recordings and HRT parameters from patients with sufficient number of ventricular premature contractions were measured. Results The age of the patients varied from 16 to 75 yrs (mean: 44.8 +/- 18.5 yrs). HUTT results of 60 (37.2%) patients were evaluated as positive. There were no significant differences in the basal demographic, clinical, or laboratory findings of the tilt-positive and tilt-negative patient groups. Likewise, there were no significant differences between the time domain HRV parameters and HRT parameters of both groups. Conclusion HRV and HRT parameters reflecting basal autonomic function were not different between HUTT positive and HUTT negative patient groups. These findings suggest that basal autonomic functions have no effect on vasovagal syncope pathogenesis.Item Platelet Membrane Gamma-Glutamyl Transferase-Specific Activity and the Clinical Course of Acute Coronary Syndrome(2019) Demirtas, Koray; Yayla, Cagri; Sade, Leyla Elif; Yildirir, Aylin; Ozin, Mehmet Bulent; Haberal, Aysegul; Muderrisoglu, Ibrahim Haldun; 0000-0001-8750-5287; 29996664; A-4947-2018gamma-Glutamyl transferase (GGT) participates in oxidative and inflammatory reactions inside the atheroma plaque and platelets. We evaluated whether platelet membrane gamma-glutamyl transferase (Plt-GGT) activity is a predictor of major adverse cardiac events (MACEs) during 3 months follow-up of patients with acute coronary syndrome (ACS; MACE-3M). We included 105 patients who were hospitalized consecutively with the diagnosis of ACS. Patients with an MACE-3M were older, more likely to have hypertension, hyperlipidemia, family history of coronary artery disease(CAD), thrombolysis in myocardial infarction (TIMI) risk score >4, higher Plt-GGT and serum GGT activities, serum C-reactive protein level, and lower left ventricular ejection fraction (LVEF) when compared to those without MACE-3M (all P values <=.05). By receiver-operator characteristic (ROC) curve analysis, 265 mU/mg for Plt-GGT, 30 U/L for serum GGT, and 45% for LVEF were determined as cutoff values to discriminate MACEs. Platelet GGT activity >265 mU/mg, TIMI risk score >4, and family history of CAD were independent predictors of MACE-3M (all P values <.05). Platelet GGT activity was as an independent predictor for MACEs in patients with ACS during the 3 months follow-up.