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Author: search.filters.author.Altin, CihanSubject: search.filters.subject.Atrial fibrillation

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    Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Bariatric Surgery by P Wave/QT Interval Dispersion
    (2018) Yilmaz, Mustafa; Altin, Cihan; Tekin, Abdullah; Erol, Tansel; Arer, Ilker; Nursal, Tarik Zafer; Torer, Nurkan; Erol, Varlik; Muderrisoglu, Haldun; 0000-0002-3628-4661; 0000-0002-5658-870X; 0000-0002-2557-9579; 0000-0002-9635-6313; 28900850; AAN-5153-2021; ABD-7304-2021; IQV-1169-2023; S-6973-2016; AAG-8233-2020
    The association of obesity with atrial fibrillation (AF) and with ventricular arrhythmias is well documented. The aim of this study was to investigate whether weight reduction by a laparoscopic sleeve gastrectomy has any effect on P wave dispersion (PWD), a predictor of AF, and corrected QT interval dispersion (CQTD), a marker of ventricular arrhythmias, in obese individuals. In a prospective study, a total of 114 patients (79 females, 35 males) who underwent laparoscopic sleeve gastrectomy were examined. The patients were followed 1 year. PWD and CQTD values before and 3rd, 6th, and 12th months after the surgery were calculated and compared. There was a statistically significant decline in body mass index (BMI), PWD, and CQTD values among baseline, 3rd, 6th, and 12th months (p < 0.001 for all comparisons). Correlation analysis showed a statistically significant correlation between Delta PWD and Delta BMI (r = 0.719, p < 0.001), Delta PWD and Delta left ventricular end-diastolic diameter (LVEDD) (r = 0.291, p = 0.002), Delta PWD and Delta left atrial diameter (LAD) (r = 0.65, p < 0.001), Delta CQTD and Delta BMI (r = 0.266, p = 0.004), Delta CQTD and Delta LVEDD (r = 0.35, p < 0.001), Delta CQTD and Delta LAD (r = 0.289, p = 0.002). In multiple linear regression analysis, there was a statistically significant relationship between Delta PWD and Delta BMI (beta = 0.713, p < 0.001), Delta PWD and Delta LVEDD (beta = 0.174, p = 0.016), Delta PWD and Delta LAD (beta = 0.619, p < 0.001), Delta CQTD and Delta BMI (beta = 0.247, p = 0.011), Delta CQTD and Delta LVEDD (beta = 0.304, p < 0.001), Delta CQTD and Delta LAD (beta = 0.235, p = 0.009). PWD and CQTD values of patients were shown to be attenuated after bariatric surgery. These results indirectly offer that there may be a reduction in risk of AF, ventricular arrhythmia, and sudden cardiac death after obesity surgery.
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    Dabigatran for Stroke Prevention in Real Life in a Sample of Population from Turkey: D-SPIRIT Registry
    (2021) Altin, Cihan; 34881702
    Objective: The D-SPIRIT registry is designed to investigate the safety and effectiveness of dabigatran etexilate in patients with atrial fibrillation in routine clinical practice. Methods: D-SPIRIT is the first national, multicenter, prospective, observational, postmarketing registry that investigates the usage of dabigatran in real life. A total of 326 noveloral anticoagulant-eligible patients with atrial fibrillation who have been taking dabigatran etexilate therapy for stroke prevention at least 6 months from 9 different centers were enrolled into the registry. Patients were followed up for 2 years to evaluate the effectiveness and safety of the treatment. All adverse clinical events including bleeding, thromboembolic events, stroke, systemic embolism, transient ischemic attack, myocardial infarction, and all-cause death were recorded. Results: The mean age was 71.1 +/- 9.6 years, and 57.4% of the study participants were female. The mean CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age >= 75 years, diabetes mellitus, stroke or transient ischemic attack [TIA], vascular disease, age 65-74 years, sex category) score was 3.4 +/- 1.6. The cumulative adverse clinical events rate was 6.30% per year. The rate for embolic events including TIA, ischemic stroke, and peripheral embolism was 1.26% per year. The rate for major bleeding was 2.20% per year, and the mortality rate was 0.94% per year. Conclusion: This registry obtained an important overview of the current safety and effectiveness of the dabigatran etexilate in Turkey. Our results indicate similar rates of thromboembolic and bleeding events with pivotal phase 3 trial and other real-life registries. However, rate of undertreatment usage of dabigatran etexilate in real life was found to be considerable.
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    Design and rationale of dabigatran's stroke prevention in real life in Turkey (D-SPIRIT)
    (2016) Turk, Ugur Onsel; Alioglu, Emin; Tuncer, Esref; Ozpelit, Mehmet Emre; Pekel, Nihat; Tengiz, Istemihan; Cetin, Nurullah; Dalgic, Onur; Topaloglu, Caner; Bilgin, Nazile; Altin, Cihan; Ozdemirkiran, Tolga; Tuluce, Kamil; Turkoglu, Ebru Ipek; Ozpelit, Ebru; 27138311
    Objective: The D-SPIRIT registry is designed to investigate the safety and efficacy of dabigatran etexilate in patients with nonvalvular atrial fibrillation (NVAF) and to collect data on outcomes in clinical practice. Methods: The D-SPIRIT is a national, prospective, observational, post-marketing registry involving patients with NVAF who have been taking dabigatran etexilate therapy for stroke prevention for a minimum of 6 months prior to enrollment. The registry will collect and analyze data from routine care, enrolling up to 600 patients in 9 centers. Patients will be followed up for 2 years to evaluate effectiveness and safety. A sample size of 600 subjects is proposed based on the following assumptions; Two-sided significance level of 0.05 (1-sided significance level of 0.025), ischemic stroke incidence rate of 0.768%-1.111%, hemorrhagic stroke incidence rate of 0.109%-0.130%, transient ischemic attack incidence rate of 0.722%-0.623%, therapy discontinuation incidence rate of 40% at day 730, and duration of enrollment period of 12 months with non-uniformed enrollment rate. Ethics approval was given by Dokuz Eyll University Ethics Committee of Clinical Research (2014/54) and approved by the Turkish Ministry of Health. Conclusion: Potential results of D-SPIRIT registry will add data from clinical practice to those from the RE-LY trial to expand knowledge of dabigatran etexilate treatment in patients with NVAF.