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Item Correlation of changes in the red blood cell distribution width with the response to continuous positive airway pressure in patients with obstructive sleep apnea(2019) Lakadamyali, Huseyin; Kivanc, Tulay; Avci, Aynur YilmazIt is recently found that the red blood cell distribution width (RDW) is independently associated with cardiovascular disease in patients with obstructive sleep apnea (OSA).The goal of this study is to investigate the correlation of RDW with the severity of OSA and whether RDW could be used to monitor the response to continuous positive airway pressure (CPAP) therapy in OSA patients. The study enrolled 70 participants. Control group (n=24) consisted of patients with normal polysomnography and OSA group (n=46) comprised patients with OSA of varying severity. RDW was measured before polysomnography in both groups. In addition, RDW was measured in the OSA group following 3months of CPAP therapy. The RDW was significantly higher in the OSA group (p<0.001), and this difference remained after adjusting for age and body mass index (p=0.001). The RDW was approximately twofold greater in the OSA group (OR 2.126, 95% confidence interval 1.32-3.41; p=0.002). On univariate analysis, the RDW was significantly correlated with hypoxia parameters, which was persistent with multivariate analysis. Furthermore, CPAP therapy reduced RDW (p=0.002), and the change in the severity of 3% ODI by CPAP was correlated with the change in the RDW (r=0.416, p=0.013). The high RDW may be related to the pathophysiology of OSA. The high RDW in OSA may be associated with hypoxia. Therefore, treating OSA with CPAP could improve the RDW.Item Carotid intima-media thickness in chronic obstructive pulmonary disease and survival: A multicenter prospective study(2019) Lakadamyali, Huseyin; Kivanc, Tulay; 30942958Introduction Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima-media thickness (CIMT) is a noninvasive method assessing atherosclerosis. Objective It was aimed to determine relationship and survival between COPD and CIMT. Methods CIMT was measured using Doppler ultrasound (USG) in 668 stable COPD patients at 24 centers. Patients were followed-up for 2 years. Results There were 610 patients who completed the study. There were 200 patients CIMT with <0.78 mm (group 1), and 410 with CIMT >= 0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between groups 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack-years), biomass exposure (years), exacerbation rate (last year), duration of hypertension (years) and cholesterol level; negative correlations between CIMT and FEV1 (P < 0.05). According to logistic regression model, compared with group A, risk of CIMT increase was 2.2-fold in group B, 9.7-fold in group C and 4.4-fold in group D (P < 0.05). Risk of CIMT increase was also related with cholesterol level (P < 0.05). Compared with infrequent exacerbation, it was 2.8-fold in the patients with frequent exacerbation (P < 0.05). The mean survival time was slightly higher in group 1, but not significant (23.9 vs 21.8 months) (P > 0.05). Conclusion This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages.