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Öğe Assessment of the relationship between preprocedural C-reactive protein/albumin ratio and stent restenosis in patients with ST-segment elevation myocardial infarction(Elsevier Espana Slu, 2019) Rencuzogullari, Ibrahim; Karabag, Yavuz; Cagdas, Metin; Karakoyun, Suleyman; Seyis, Sabri; Gursoy, Mustafa Ozan; Yesin, Mahmut; Artac, Inanc; Ilis, Dogan; Tanboga, Ibrahim HalilIntroduction: Rent restenosis remains a clinical challenge for patients with ischemic heart disease, since it is associated with repeated coronary interventions as well as higher hospitalization rates and medical costs. Inflammation plays a significant role. Although an association between stent restenosis, increased C-reactive protein (CRP) and decreased albumin levels has been previously reported, no studies have investigated the ability of the CRP/albumin ratio to predict stent restenosis. Methods: This retrospective study included 448 patients who had previously undergone primary percutaneous coronary intervention and who were referred for subsequent reintervention due to recurrence of anginal symptoms. The study population was divided into two groups based on whether the patient had developed stent restenosis. They were then stratified into three groups according to their CRP/albumin ratio. Results: Out of 448 patients, stent restenosis was observed in 24.5% (n=110), as determined by coronary angiography. Patients with stent restenosis had a higher CRP/albumin ratio, greater platelet distribution width (POW), higher CRP levels, and lower levels of both high-density lipoprotein (HDL) cholesterol and serum albumin. The CRP/albumin ratio (OR: 2.289, 95% CI: 1.056-4.959; p=0.036), stent diameter, PDW and HDL cholesterol levels were found to be independent predictors of stent restenosis. A ROC curve comparison demonstrated that the CRP/albumin ratio was a better predictor of restenosis than either albumin and CRP individually, but it was not better than POW and HDL cholesterol. Conclusion: As a novel inflammation-based risk score, the CRP/albumin ratio may be an easily accessible marker for assessment of stent restenosis risk. (C) 2019 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. AU rights reserved.Öğe Association of the SYNTAX Score II with cardiac rupture in patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention(Lippincott Williams and Wilkins, 2018) Rencuzogullari I.; Çağdaş M.; Karaba? Y.; Karakoyun S.; Yesin M.; Gürsoy M.O.; Seyis, Sabri; Artaç, I; Iliş, D; Efe, S.C; Tanboğa I.H.Background Despite advances in reperfusion strategies, medical therapy, and emergent surgery, cardiac rupture (CR) is still a major lethal complication. Numerous parameters have been found to be associated with CR development after a primary percutaneous coronary intervention (pPCI). SYNTAX Score (SS) and SYNTAX Score II (SSII) have been studied in ST-segment elevation myocardial infarction (STEMI) patients, and higher scores have been associated with higher mortality. However, the relationship between CR and SSII is unclear. This study investigates the possible relationship between CR and SS, SSII in STEMI patients treated with pPCI. Patients and methods We enrolled 1663 consecutive STEMI patients treated with pPCI, who were divided into two groups according to CR development and compared with each other. Patients were further stratified into the three groups according to their SSII values. Results In this study, 33 (1.98%) patients developed CR. Both SS and SSII of those with CR were significantly higher than those without (19.27±4.0 vs. 16.40±4.55; P<0.001 and 49.40±16.54 vs. 30.92±11.80; P<0.001, respectively). It was also observed that CR increased gradually according to increasing SSII tertiles. SSII was found to be an independent predictor for CR (odds ratio=1.043, 95% confidence interval: 1.012-1.074; P=0.006). In the long-term follow-up, all-cause mortality was significantly higher in patients with CR than those without (60.6 vs. 8.8%; P<0.001). Conclusion This study shows that SSII is an independent predictor for CR. Furthermore, patients with CR were associated with a poor prognosis. Closer follow-up of patients with high SSII may be useful in the early detection and treatment of this fatal complication. © 2018 Wolters Kluwer Health, Inc. All rights reserved.Öğe CHA2DS2-VASc score predicts intracoronary thrombus burden in patients with ST-elevation myocardial infarction(Allied Acad, 2017) Seyis, Sabri; Kurmus, Ozge; Kilic, Salih; Uzunget, Sezen Baglan; Ercan, Ebru AkgulObjective: To evaluate the role of CHA2DS2-VASc score in predicting the intracoronary thrombus burden in patients with ST-Elevation Myocardial Infarction (STEMI). Background: High intracoronary thrombus burden is associated with reduced procedural success, larger infarct size, and mortality after Primary Percutaneous Coronary Intervention (PPCI). Prediction of thrombus burden before PPCI might be useful by enabling the detection of patients at risk for these complications. Methods: We retrospectively evaluated 164 consecutive patients who presented with STEMI within 12 h after the onset of chest pain between January 2015 and June 2016. PPCI was performed within 1 h after admission. Thrombus burden was graded according to Thrombolysis in Myocardial Infarction (TIMI) thrombus score. The patients were stratified into low (grades 1, 2 and 3) and high thrombus burden groups (grades 4 and 5). CHA2DS2-VASc score was calculated for each patient. Results: Thrombus burden was low in 94 (57%) patients and high in 70 (43%) patients. CHA2DS2-VASc score was higher in patients with high thrombus burden compared to patients with low thrombus burden (4.41 +/- 1.7 vs. 1.47 +/- 1.1, p<0.001). Logistic regression analysis revealed that one-point increment in CHA2DS2VASc score was associated with three times higher risk of having high thrombus burden (odds ratio 3.28, 95% CI: 2.57-5.70). The area under the ROC curve for a cut-off value of CHA2DS2-VASc score>2 to predict high thrombus burden was 0.925, with a sensitivity of 91% and a specificity of 82%. Conclusion: CHA2DS2-VASc score is a simple tool that predicts thrombus burden in STEMI patients undergoing PPCI.Öğe Effect of coronary slow flow on intrinsicoid deflection of QRS complex(Hindawi Ltd, 2018) Seyis, SabriCoronary slow flow is a rare, clinically important entity observed in acute coronary syndrome. The pathophysiological mechanism is not fully elucidated. We investigated patients with chest pain who had angiographic features consistent with the coronary slow flow. One hundred ten patients were included. Electrocardiography, echocardiography, and angiography results were retrospectively noted. The mean age was 56.4. Fifty-eight were male, and fifty-two were female. The control group consisted of patients with normal angiography. Patients had higher diastolic blood pressure, lower mean ejection fraction, higher average left ventricular end-diastolic diameter, and higher mean left atrial size than the control group (p = 0.009, p = 0.017, p = 0.041, and p < 0.001, resp.). Patients had higher average V1 I D, V6 I D, P wave dispersion, `ITC LA I), TFC Cx, ITC RCA, and 'ITC levels than the control group. A significant linear positive relationship was found between the Vi ID and the TFC LAD, TFC Cx, TFC RCA, and TFC; also between the V6 ID and the ITC LAD, TFC Cx, 'TFC RCA, and TFC. Angiographic and electrocardiographic features are suggestive and diagnostic for the coronary slow flow syndrome. Although when regarded as a benign condition, corollary slow flow should be diagnosed, followed up, and treated as many of laboratory features suggest ischemic events.Öğe The effects of continuous positive airway pressure on premature ventricular contractions and ventricular wall stress in patients with heart failure and sleep apnea(Hindawi Ltd, 2018) Seyis, Sabri; Usalan, Adnan Kazim; Rencuzoğullari, Ibrahim; Kurmuş, Özge; Güngen, Adil CanBackground. We aimed to investigate the effects of continuous positive airway pressure (CPAP) treatment on electrocardiography (ECG), premature ventricular contraction load on 24-hour Holter recordings, and implantable cardioverter defibrillator (ICD) shocks in patients with obstructive sleep apnea syndrome (OSAS) and heart failure. Methods. Patients with heart failure and ICD and patients with newly diagnosed OSAS were divided into two groups according to CPAP treatment. To compare the impact of CPAP on ECG parameters, both baseline and 6-month ECG, 24-hour Holter ECG, ambulatory blood pressure monitoring, echocardiography, polysomnography, and laboratory parameters were collected. Results. CPAP treatment significantly reduced the frequency of premature ventricular contractions, T-peak to T-end, corrected QT, corrected QT dispersion, and T-peak to T-end/corrected QT ratio in the study group (p < 0.001 for all). Although the baseline NT-pro-BNP levels were similar between study and control groups, after six months, the NT-pro-BNP levels of the study group were significantly lower than that of the control group (39.18 +/- 7.57 versus 46.11 +/- 7.65; p < 0.001). Conclusions. CPAP treatment in patients with heart failure and ICD and in patients with newly diagnosed OSAS may have beneficial effects on premature ventricular contractions and electrocardiographic arrhythmia indices and NT-pro-BNP levels. However, these results are needed to be clarified with further studies.Öğe Relationship between platelet to lymphocyte ratio and coronary angiography timing in patients with NSTEMI(Scientific Publishers of India, 2017) Seyis, Sabri; Günay, Şeyda; Rencuzoğlu, İbrahimObjective: To investigate the usefulness of PLR in predicting severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with Non ST elevation myocardial infarction NSTEMI who underwent nonurgent coronary angiography (CA). Background: In NSTEMI patients, there is a debate whether early angiography and revascularization is beneficial compared with a more conservative approach. Platelet to lymphocyte ratio (PLR) is a new prognostic marker that gives idea about inflammation and aggregation pathways and may predict coronary atherosclerotic burden. PLR can be used to select patients who should go under angiography earlier due to excessive ischemic load. Methods: We retrospectively evaluated 111 consecutive patients who presented with NSTEMI and underwent non-urgent coronary angiography between July 2016 and March 2017. The PLR was calculated as the ratio of the platelet count to the lymphocyte count. The Syntax scores SX of all patients were calculated. A low SX score was defined as ? 22, an intermediate score as 23 to 32, and a high score as ? 33. Results: 92 patients (82.8%) had low SX scores (? 22), 19 patients (17.1%) had intermediate to high SX scores (? 23). Patients in the intermediate to high SX score group had significantly higher PLR 263 (219-366) vs. 117 (82-144.5) p<0.001. In ROC analysis PLR of 178 or lower predicted a low SX score defined as ? 22 with a sensitivity of 91.3% and specificity of 100%. Conclusion: In patients with NSTEMI, PLR has significant association with syntax score and may be used for risk stratification and assessing optimal timing for coronary angiography. © 2017, Scientific Publishers of India, All rights reserved.Öğe Resynchronization in the left superior vena cava.(Allied Acad, 2017) Seyis, Sabri; Kurmus, OzgeBackground: Persistent Left Superior Vena Cava (PLSVC) is a rare congenital anomaly which is typically asymptomatic and discovered incidentally during device implantation. Methods: In this case, we present challenges and techniques of Cardiac Resynchronization Therapy (CRT) in a patient with PLSVC. Results: After evaluating the exact anatomy of PLSVC and Coronary Sinus (CS), we chose the appropriate approach and equipment's. By using a J shaped stylet, a guide wire and inner sub-selection catheter, we performed implantation successfully. Conclusion: In most cases of PLSVC, successful cardiac device implantation is possible with increasing operator experience, cardiac imaging and appropriate tools.Öğe The value of the tei index in predicting implantable cardioverter defibrillator shocks(Yerkure Tanitim Yayincilik Hizmetleri As, 2018) Seyis, SabriAmaç: İmplante edilen kardiyoverter defibrilatörler (İKD) uygun hastalarda ani ölüm riskini azaltmaktadır. Ancak İKD şokları ile artmış morbidite ve mortalite arasında ilişki olduğu düşünülmektedir. Çalışmamızda son zamanlarda kardiyak olayları öngörmede sıklıkla kullanılan ekokardiyografik bir ölçüm olan Tei indeksinin İKD şokları ile ilişkisini inceledik. Yöntem: Uygun endikasyonla İKD implante edilen hastaların retrospektif olarak bazal özellikleri ve iki yıllık cihaz takipleri incelendi. İKD şoku alanlar ve İKD şoku almayanlar olarak iki grup oluşturuldu. Bu gruplar bazal özellikleri ve Tei indeksi açısından karşılaştırıldı. Bulgular: Çalışma popülasyonumuzdaki kalp yetersizliği hastalarının İKD implantasyonunu takip eden iki yıl içerisinde hiç şok almayanlara göre ortalama Tei indeksleri anlamlı şekilde daha yüksek saptandı (0.70±0.10 vs 0.56±0.10, p<0.001). Primer koruma amaçlı İKD takılan hastalarda uygun veya uygunsuz şok alanların oranı %28,9 iken, sekonder koruma amaçlı İKD takılan i hastalarda şok alma oranı %71.1 olarak bulundu (p<0.001). İKD şoku alan hastalar İKD şoku almayan hastalara göre daha yaşlı, daha fazla sigara içiyor ve hipertansiyon sıklığı daha fazlaydı (p<0.001). Sonuç: Sonuç olarak; bu çalışmada Tei indeksi ile İKD uygun ve uygunsuz şokları arasında bir ilişki tespit gösterilmiştir. Tei indeksi İKD şoklarını predikte edebilecek basit bir yöntemdir. Anahtar sözcükler: Uygunsuz şok; implante edilen kardiyoverter defibrilatör; Tei indeksi.
