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Öğe Angiographic characteristics of coronary artery fistulas(Turkish Soc Cardiology, 2014) Tuncer, Cemal; Eryonucu, Beyhan; Batyraliev, Talantbek; Gokce, Mustafa; Yilmaz, Remzi; Akkoyun, Murat; Acar, GurkanObjectives: Coronary artery fistula (CAF) in adults is a rare form of coronary artery anomaly. It is often diagnosed incidentally during coronary angiography. The aim of this study was to evaluate the clinical and angiographic characteristics of adult patients with CAF. Study design: We retrospectively reviewed the database of 70,850 patients who had undergone coronary angiography in five different invasive cardiology centers in the southeastern region of Turkey. Among them, 56 patients had CAF (39 males, 17 females, mean age: 63.7 +/- 10.4 years). Demographic data, clinical evaluation and cardiac catheterization reports were reviewed from the medical records. Results: A total of 58 fistulas were detected in 56 patients; two patients (3.6%) had bilateral fistulas originating from both the left and right coronary artery. In our angiographic series, CAF prevalence was 0.08%. Dyspnea on exertion and/or angina pectoris was the most common symptom (69%). Fifteen patients (26.8%) had concomitant obstructive coronary artery disease. Coronary artery fistulas originated mainly from the left anterior descending artery (n=30, 51.7%). Others originated from the right coronary artery (n=15, 25.9%), circumflex artery (n=6, 10.3%), and right sinus of Valsalva (n=3, 5.2%). In four patients (n=4, 7.1%), multiple micro fistula were draining into the left ventricle. Conclusion: In our angiographic series, the prevalence of CAF was 0.08%, and the most common site of origin was the left anterior descending artery.Öğe Angiographic Characteristics of Coronary Artery Fistulas: A Retrospective Database Study(Elsevier Science Inc, 2013) Tuncer, Cemal; Eryonucu, Beyhan; Batyraliev, Talantbek; Gokce, Mustafa; Yilmaz, Remzi; Akkoyun, Murat; Acar, Gurkan[Abstract Not Available]Öğe Association between Platelet-to-Lymphocyte Ratio and Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome(Karger, 2015) Demircelik, Muhammed Bora; Kurtul, Alparslan; Ocek, Hakan; Cakmak, Muzaffer; Ureyen, Cagin; Eryonucu, BeyhanObjective: Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk of CIN. The platelet-to-lymphocyte ratio (PLR) is closely linked to inflammatory conditions. We hypothesized that PLR levels on admission can predict the development of CIN after PCI for ACS. Subjects and Methods: A total of 426 patients (mean age 63.17 +/- 13.01 years, 61.2% males) with ACS undergoing PCI were enrolled in this study. Admission PLR levels were measured before PCI. Serum creatinine values were measured before and within 72 h after the administration of contrast agents. Patients were divided into 2 groups: the CIN group and the no-CIN group. CIN was defined as an increase in serum creatinine level of >= 0.5 mg/dl or 25% above baseline within 72 h after contrast administration. Results: CIN developed in 53 patients (15.9%). Baseline PLR was significantly higher in patients who developed CIN compared to those who did not (160.8 +/- 29.7 and 135.1 +/- 26.1, respectively; p < 0.001). Multivariate analyses found that PLR [odds ratio (OR) 3.453 +/-, 95% confidence interval (CI) 1.453-8.543; p = 0.004] and admission creatinine (OR 6.511, 95% CI 1.759-11.095; p = 0.002) were independent predictors of CIN. Conclusions: The admission PLR level is an independent predictor of the development of CIN after PCI in ACS. (C) 2015 S. Karger AG, BaselÖğe Association between Red Blood Cell Distribution Width and Coronary Artery Calcification in Patients Undergoing 64-Multidetector Computed Tomography(Korean Soc Cardiology, 2015) Gurel, Ozgul Malcok; Demircelik, Muhammed Bora; Bilgic, Mukadder Ayse; Yilmaz, Hakki; Yilmaz, Omer Caglar; Cakmak, Muzaffer; Eryonucu, BeyhanBackground and Objectives: The red blood cell distribution width (RDW) has been found to be associated with cardiovascular morbidity and mortality. The objective of this study was to determine whether the RDW measures are associated with the coronary artery calcification score (CACS) in patients who did not present with obvious coronary heart disease (CHD). Subjects and Methods: A total of 527 consecutive patients with a low to intermediate risk for CHD but without obvious disease were enrolled in this study. The study subjects underwent coronary computerized tomography angiography and CACS was calculated. The patients were divided into two groups based on CACS: Group I (CACS <= 100) and Group II (CACS>100). The two groups were compared in terms of classic CHD risk factors and haematological parameters, particularly the RDW. Results: Group I patients were younger than Group II patients. The Framingham risk score (FRS) in patients of Group II was significantly higher than that in patients of Group I. Group II patients had significantly elevated levels of haemoglobin, RDW, neutrophil count, and neutrophil/lymphocyte ratio compared with Group I patients. CACS was correlated with age, RDW, and ejection fraction. In the multivariate analysis, age, RDW, and FRS were independent predictors of CACS. Using the receiver-operating characteristic curve analysis, a RDW value of 13.05% was identified as the best cut-off for predicting the severity of CACS (>100) (area under the curve=0.706). Conclusion: We found that the RDW is an independent predictor of the CACS, suggesting that it might be a useful marker for predicting CAD.Öğe Öğe Öğe Coronary intervention for acute coronary syndrome in a 51-year-old man with immune thrombocytopenic purpura: A case report(BioMed Central Ltd. info@biomedcentral.com, 2014) Bora Demirçelik, Muhammed; Altinsoy, Meltem; Bozduman, Fadime; Güneş, Mahmut Fatih; Çakmak, Muzaffer; Eryonucu, BeyhanIntroduction. Treatment of the rare cases of patients with chronic idiopathic thrombocytopenic purpura with acute coronary syndrome can be a significant problem. The patient in our case report was treated successfully with percutaneous coronary intervention. Case presentation. A 51-year-old man of Turkish origin who had idiopathic thrombocytopenic purpura was admitted to our hospital with severe chest pain. His electrocardiography was normal on admission but dynamic ischemic changes were observed during follow-up. He underwent immediate coronary angiography. In his angiography, left anterior descending artery stenosis was 90% together with the diagonal ostium. Percutaneous coronary intervention was performed successfully. Bleeding complications were not observed after the procedure. Conclusions: We report the presence of a rare case of chronic idiopathic thrombocytopenic purpura in a patient with acute coronary syndrome. In this situation a serious multidisciplinary approach is required before coronary intervention. © 2014 Demircelik et al.; licensee BioMed Central Ltd. © 2014 Elsevier B.V., All rights reserved.Öğe Hand and heart, hand in hand: is radiological hand osteoarthritis associated with atherosclerosis?(Wiley, 2014) Cemeroglu, Ozlem; Aydin, Halil I.; Yasar, Zeynep S.; Bozduman, Fadime; Saglam, Mustafa; Selcoki, Yusuf; Eryonucu, BeyhanAimIncreasing evidence suggests that atherosclerosis contributes to the initiation or progression of osteoarthritis (OA). It has been suggested that atherosclerosis may cause vascular insufficiency which may lead to or progress OA. In this study, the association between the severity of radiologic hand OA and atherosclerosis was analyzed in women. MethodsSixty-one women, 50years of age, free of hand symptoms were enrolled in the study. Postero-anterior views of both hands were obtained using digital radiography. A total of 14 joints were assessed for radiographic OA according to Kellgren/Lawrence (K/L) score. An OA-affected joint was defined as K/L score of 2. Hand OA was defined as 3 joints of both hands affected with OA and severity of hand OA was defined as total K/L scores of all 14 joints of both hands. Gensini scoring was used to evaluate the patients for atherosclerosis severity. ResultsThe patient characteristics such as presence of diabetes, smoking, hypertension, dyslipidemia and medications used were similar for patients with and without hand OA (P>0.05) and did not correlate with Gensini or hand OA scores. The mean Gensini scores of patients with hand OA was 21.517.1 and without hand OA was 11.8 +/- 9.2 (P=0.017). The degree of osteoarthritic joint involvement and Gensini scores showed a positive correlation (r=0.332, P=0.009). ConclusionHand OA may be a benign clinical finding that may suggest a possible serious underlying atherosclerosis. Patients with significant hand OA should be screened for atherosclerosis to prevent serious coronary artery disease and related comorbidities.Öğe Recurrent Acute Coronary Syndromes With Normal Homocystein Level: A Mutation of MTHFR Gene(Gazi Univ, Fac Med, 2014) Gurel, Ozgul Malcok; Demircelik, Muhammed Bora; Gunes, Mahmut; Eryonucu, BeyhanA 29-year-old female patient, complaining of squeezing retrosternal chest pain, was admitted to our emergency department. Her angina pectoris had started fifteen days ago and accentuated during the last two days. In her medical history, it was determined that during the last four years she had been admitted to hospitals with the same complaint twice, troponins were found to be elevated, she was hospitalized and coronary angiography (CAG) was totally normal. The young woman with recurrent acute coronary syndrome had a mutation in the MTHFR gene. On the determination of normal coronary arteries, we have demonstrated the localization of myocardial infarction via magnetic resonance imaging. In our case we have found no other risk factors except MTHFR 1298 gene mutation for coronary artery disease. MTHFR 1298 gene mutation may cause this state of hypercoagulopathy.Öğe Red Cell Distribution Width and Coronary Artery Calcification Reply(Korean Soc Cardiology, 2016) Gurel, Ozgul Malcok; Demircelik, Muhammed Bora; Eryonucu, Beyhan[Abstract Not Available]Öğe The Effectiveness of Multimedia Nursing Education on Reducing Illness-Related Anxiety and Depression in Coronary Care Unit's Patients(Elsevier Science Inc, 2013) Demircelik, Muhammed Bora; Yigit, Derya; Sentepe, Esra; Keklik, Mevlude; Cetin, Mustafa; Cetin, Zehra; Eryonucu, Beyhan[Abstract Not Available]Öğe The Relationship Between Adropin Levels and the Slow Coronary Flow Phenomenon(Springer India, 2015) Demircelik, Bora; Kurtul, Alparslan; Ocek, Hakan; Cakmak, Muzaffer; Cetin, Mustafa; Ureyen, Cagin; Eryonucu, BeyhanThere is accumulating evidence that inflammation plays a major role in the development of the slow coronary flow (CSF) phenomenon. In this study, we aimed to study the new biomarker adroin levels as it relates to CSF. Patients who underwent coronary angiography before and had no significant epicardial coronary disease were included in the study. Patients who had thrombolysis in myocardial infarction frame counts (TFCs) above the normal cutoffs were considered to have CSF and those within normal limits were considered to have normal coronary flow (NCF). NCF group over the age of 30 were selected from patients with normal coronary arteries. The adropin levels and biochemical profiles of all patients were studied and analyzed with coronary flow parameters. There were 58 patients in the CSF group and 50 patients in the NCF group. The mean adropin level was significantly lower in CSF group than in NCF group (3.2 +/- 0.71 vs. 4.9 +/- 1.51 ng/mL, p < 0.001). There was a significant correlation between the adropin levels and TFC (r = -0.676, p < 0.001). Multivariable regression analysis showed that the adropin levels were an independent predictor of the CSF phenomenon (odds ratio = 1.041, 95 % confidence interval: 1.004-1.114, p = 0.014). In this study, we show that patients with CSF have decreased levels of adropin. We further show a strong correlation between the adropin levels and coronary blood flow. We conclude that decreased adropin levels might be a useful tool in predicting CSF in patients who undergo coronary angiography.
