PubMed İndeksli Açık & Kapalı Erişimli Yayınlar

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    The Novel CHA(2)DS(2)-VASC-FSH Score is Predictive of Severe Coronary Artery Disease on Coronary Angiography in Patients with Atrial Fibrillation and Unstable Symptoms
    (2019) Ciftci, Orcun; Yilmaz, Kerem Can; Karacaglar, Emir; Yilmaz, Mustafa; Ozin, Bulent; Muderrisoglu, Ibrahim Haldun; 31258358
    Objective: AF may create confusion about the presence of severe or unstable coronary artery disease in cases with unstable symptoms. Novel scores and markers are needed to determine severe coronary artery disease in such patients. We aimed to test the newly developed CHA(2)DS(2)-VASc-FSH score, developed by adding family history for coronary artery disease, hyperlipidemia, and smoking to the original CHA(2)DS(2)-VASc score, in the prediction of severe CAD in patients with AF and unstable symptoms. Materials and Methods: We retrospectively analyzed 72 patients presenting to Baskent Universtiy School of Medicine Hospital between April 2011 and January 2016. The CHA(2)DS(2)-VASc-FSH score was assessed for the prediction of severe CAD. Results: Seventy-two patients aged 65.7 +/- 11.2 years were enrolled. Thirty-five (48.6%) patients had severe CAD and 11 (15.3%) had unstable CAD. patients with severe coronary artery disease had a significantly greater CHA(2)DS(2)-VASC-FSH score (5 (1-8) vs 3(0-7); p< 0.05). The CHA(2)DS(2)-VASC-FSH score independently predicted severe CAD, with a CHA(2)DS(2)-VASc-FSH score of 3 or greater having a sensitivity of 77.1% and a specificity of 56.8% for severe CAD. Conclusion: Among patients with AF and unstable symptoms, the CHA(2)DS(2)-VASc-FSH score independently predicts severe CAD.
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    Clinical practices of the management of nonvalvular atrial fibrillation and outcome of treatment: A representative prospective survey in tertiary healthcare centers across Turkey
    (2018) Ozin, Bulent; Aytemir, Kudret; Aslan, Ozgur; Ozcan, Turkay; Kanadasi, Mehmet; Demir, Mesut; Gokce, Mustafa; Sucu, Mehmet Murat; Ozdemir, Murat; Yiğit, Zerrin; Yavuzkir, Mustafa Ferzeyn; Oto, Ali; 0000-0003-3821-412X; 29512625; AAD-9938-2021
    Objective: The goal of this study was to define clinical practice patterns for assessing stroke and bleeding risks and thromboprophylaxis in nonvalvular atrial fibrillation (NVAF) and to evaluate treatment outcomes and patient quality of life. Methods: A clinical surveillance study was conducted in 10 tertiary healthcare centers across Turkey. Therapeutic approaches and persistence with initial treatment were recorded at baseline, the 6th month, and the 12th month in NVAF patients. Results: Of 210 patients (57.1% male; mean age: 64.86 +/- 12.87 years), follow-up data were collected for 146 patients through phone interviews at the 6th month and 140 patients at the 12th month. At baseline, most patients had high CHADS(2) score (>= 2: 48.3%) and CHA(2)DS(2)-VASc (>= 2: 78.7%) risk scores but a low HAS-BLED (0-2: 83.1%) score. Approximately two-thirds of the patients surveyed were using oral anticoagulants as an antithrombotic and one-third were using antiplatelet agents. The rate of persistence with initial treatment was approximately 86%. Bleeding was reported by 22.6% and 25.0% of patients at the 6th and 12th month, respectively. The proportion of patients with an INR of 2.0-3.0 was 41.8% at baseline, 65.7% at the 6th month, and 65.9% at the 12th month. The time in therapeutic range was 61.0% during 1 year of follow-up. The median EuroQol 5-dimensional health questionnaire (EQ-5D) score of the patients at baseline and the 12th month was 0.827 and 0.778, respectively (p<0.001). The results indicated that patient quality of life declined over time. Conclusion: In atrial fibrillation, despite a high rate of persistence with initial treatment, the outcomes of stroke prevention and patient quality of life are not at the desired level. National health policies should be developed and implemented to better integrate international guidelines for the management of NVAF into clinical practice.