Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Effects of Niacin on Inflammation in Patients with Non-ST Elevated Acute Coronary Syndrome(2015) Karacaglar, Emir; Atar, Ilyas; Altin, Cihan; Yetis, Begum; Cakmak, Abdulkadir; Bayraktar, Nilufer; Coner, Ali; Ozin, Bulent; Muderrisoglu, Haldun; 0000-0002-2538-1642; 0000-0002-5711-8873; 0000-0003-3821-412X; 0000-0002-7886-3688; 0000-0002-9635-6313; 27122858; ABI-6723-2020; ABD-7321-2021; AAD-9938-2021; Y-8758-2018; AAG-8233-2020Background: In this study, we aimed to evaluate the effects of niacin on high sensitivity C reactive protein (hs-CRP) and cholesterol levels in non-ST elevated acute coronary syndrome (NSTE-ACS) patients. Methods: In this prospective, open label study, 48 NSTE-ACS were randomized to niacin or control group. Patients continued their optimal medical therapy in the control group. In the niacin group patients were assigned to receive extended-release niacin 500 mg/day. Patients were contacted 1 month later to assess compliance and side effects. Blood samples for hs-CRP were obtained upon admittance to the coronary care unit, in the third day and in the first month of the treatment. Fasting blood samples for cholesterol levels were obtained before and 30 days after the treatment. The primary end point of the study was to evaluate changes in hs-CRP, cholesterol levels, short-term cardiovascular events, and the safety of niacin in NSTE-ACS. Results: Baseline demographic, clinical and laboratory characteristics were similar between the two groups. Logarithmic transformation of baseline and 3rd day hs-CRP levels were similar between the groups; but 1 month later, logarithmic transformation of hs-CRP level was significantly lower in the niacin group (0.43 +/- 0.39 to 0.83 +/- 0.91, p = 0.04). HDL-C level was significantly increased in the niacin group during follow-up. Drug related side effects were seen in 7 patients in the niacin group but no patients discontinued niacin. Conclusions: Our findings demonstrate that lower dose extended release niacin can be used safely and decreases hs-CRP and lipid parameters successfully in NSTE-ACS patients.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 In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors(2022) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Adar, Adem; Muderrisoglu, Haldun; 35860883Objective: In this study, we aimed to determine whether potent agents affect in-hospital bleeding and mortality compared to clopidogrel in patients with the acute coronary syndrome in whom tirofiban and P2Y12 inhibitor are used together. Methods: Patients who were treated interventionally between 2015 and 2020 and were using tirofiban were retrospectively screened. Clinical, laboratory, and angiographic findings were obtained from the hospital database. Patients were analyzed by dividing them into clopidogrel and prasugrel/ticagrelor groups. Results: Acute coronary syndrome patients (n = 227) who were treated interventionally were included in this retrospective study. Clopidogrel was given to 93 (41%), ticagrelor to 112 (49.3%), and prasugrel to 22 of the patients (9.7%). Compared to the ticagrelor/prasugrel group, the clopidogrel group was older and more were women, and the history of hypertension and previous coronary artery disease was higher (P, respectively: <.001; .001; .008; .0045). The creatinine value was higher, the basal hemoglobin was lower, and the GRACE (Global Registry of Acute Coronary Events) and CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) scores were higher (P, respectively:.026; .002;.002; <.001). The in-hospital bleeding rate was significantly higher in the clopidogrel group (P <.001). Although the in-hospital mortality rate was higher, it was not statistically significant (P = .07). Regression analysis showed that GRACE score and gender were associated with in-hospital mortality (P <.001; P = .031, respectively), and only age was associated with in-hospital bleeding (P <.001). No relationship was found with P2Y12 inhibitor. Conclusion: In our study, we found that the combined use of potent P2Y12 inhibitor with tirofiban in acute coronary syndrome patients treated interventionally was not different from the use of clopidogrel in terms of in-hospital bleeding and mortality.Item Acute Coronary Syndrome In Geriatric Patients In An Intensive Care Unit(2021) Keskin, Suzan; Akgun, Arzu Neslihan; Ciftci, Orcun; Muderrisoglu, Ibrahim HaldunObjective: The advancing age of acute coronary syndrome and the ageing population are leading to an increase in the number of elderly patients with acute coronary syndrome in our clinical practice. In our study, we aimed to investigate the effect of acute coronary syndrome in the geriatric patient group. Materials and Method: We retrospectively included geriatric patients who were in intensive care units because of different diagnoses, who also showed an acute coronary syndrome, and who had been diagnosed using the sequential organ failure assessment score. This score is used to describe the condition of a patient with sepsis and the extent of organ damage during treatment in an intensive care unit. We reviewed patients who were at Baskent University Faculty of Medicine between 25 March 2015 and 12 March 2020. Results: We included 63 patients aged 77.27 +/- 7.65 years. There were 40 (63.5%) males and 23 (36.5%) females. A total of 42 (89.4%) patients died in the first 5 months, one (2.1%) died between the 6th and 10th months, two (4.3%) between the 11th and 20th months, and two (4.3%) between the 21st and 30th months. We found a significant relationship between the sequential organ failure assessment score and mortality rate (p<0.05). The sequential organ failure assessment score was reliable in predicting mortality in geriatric patients with acute coronary syndrome, with 57% sensitivity and 75% specificity. Conclusion: Mortality of geriatric patients with acute coronary syndrome can be significantly determined using the sequential organ failure assessment scores.