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    Association Between Resistin Level and Renal Function in Patients Undergoing Coronary Artery Bypass Graft Surgery
    (Bmj Publishing Group, 2012) Gungor, Hasan; Kirilmaz, Bahadir; Zorlu, Ali; Oguz, Emrah; Ayik, Mehmet Fatih; Kumak, Ferhat; Zoghi, Mehdi
    Aim: The purpose of this study was to evaluate the association between resistin levels and renal function in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: Thirty-seven consecutive patients (mean +/- SD, age 60 +/- 10 years, 29 (78%) male) undergoing CABG surgery at our department were enrolled into our study. Blood samples were taken to examine quantities of resistin level and other blood parameters the day before surgery. The patients were categorized into 2 groups: lower resistin level (group 1) or higher resistin level (group 2) according to the median value of 9 ng/mL. Results: Mean + SD resistin level, glomerular filtration rate (GFR), and urea and creatinine levels were 9.5 +/- 4.2 ng/mL, 78 +/- 25 mL/min per 1.73 m(2), 42 +/- 14 mg/dL, and 1.08 +/- 0.2 mg/dL, respectively. Resistin showed significant correlation with serum levels of urea (r = 0.448l P = 0.005), creatinine (r = 0.367; P = 0.026), inverse correlation with GFR (r = -0.398; P = 0.015), statin usage (r = -0.393; P = 0.016), and A-blocker usage (r = -0.365; P = 0.026). In the multivariate logistic regression model, only GFR (odds ratio, 0.960; 95 confidence interval, 0.928-0.993; P = 0.018) remained independently associated with higher resistin levels after adjustment of other potential confounders in patients undergoing CABG surgery. According to the receiver operating characteristics curve analysis, the optimal cutoff value of GFR to predict higher resistin levels was found as 91 mL/min or less per 1.73 m(2), with 100% sensitivity and 61.1% specificity. Conclusion: The present study demonstrated that a lower glomerular filtration rate was associated with higher circulating resistin levels, independent of coronary heart disease risk factors in patients undergoing CABG surgery.
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    Digoxin intoxication: An old enemy in modern era
    (Science Press, 2012) Kirilmaz, Bahadir; Saygi, Serkan; Gungor, Hasan; Turk, Ugur Onsel; Alioglu, Emin; Akyuz, Serdar; Asgun, Fatih
    Objectives Although development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issue which could be easily overlooked. In this report, we analyzed a case series definitively diagnosed as digoxin intoxication in the modern era. Methods We analyzed 71 patients hospitalized with digoxin intoxication confirmed by history, complaints, clinical and electrocardiograph (ECG) findings, and serum digoxin levels > 2.0 ng/mL, during a five year period. The demographic and clinical data, indications for digoxin use, digoxin dosage, concurrent medications, laboratory data, hospital monitoring, and ECG findings were obtained from all patients. Results Thirty-eight of 71 patients (53.5%) had symptoms of heart failure during admission or later. Sixty-four percent of patients were older than 75 years. The percentage of females was 67%. Atrial fibrillation, hypertension and gastrointestinal complaints were more frequent in the females (64% in females, 30% in males, P = 0.007; 81% in female, 52% in males, P = 0.01; 50% in female, 17.3% in males, P = 0.008, respectively). The mortality rate during the hospital course was 7%. Conclusions This report demonstrated the reduced mortality rates in patients with digoxin intoxication over the study period. Gastrointestinal complaints are the most common symptoms in this population.
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    Serum resistin level: as a predictor of atrial fibrillation after coronary artery bypass graft surgery
    (Lippincott Williams & Wilkins, 2011) Gungor, Hasan; Ayik, Mehmet Fatih; Kirilmaz, Bahadir; Ertugay, Serkan; Gul, Ilker; Yildiz, Bekir Serhat; Nalbantgil, Sanem
    Aim Atrial fibrillation (AF) is the most common arrhythmia with an incidence of 25-40%, after coronary artery bypass grafting (CABG). Resistin is a newly identified adipocyte-secreted hormone belonging to a cysteine-rich protein family. This study examined the relation of preoperative and postoperative early serum resistin level, which can play an important role as an inflammatory marker to predict AF after CABG. Methods We prospectively analyzed 40 consecutive patients (mean age, 59.2+10.3 years; 31 men and nine women) who were undergoing CABG between September and November 2009 at our department. Blood samples were taken to examine quantities of resistin level, the day before surgery and on the 24th hour in the intensive care unit. Results The incidence of AF was 25% (n=10, 2.2+1.1 days, 1.2+0.4 episodes). Preoperative resistin level was higher in the AF group (10.6+3.3 vs. 9.1+4.5 ng/ml, P=0.33), but it was not statistically significant. Postoperative resistin level was significantly higher in the AF group (27.4+8.4 vs. 17.9+9.1 ng/ml, P=0.012) compared with the sinus rhythm group. Resistin levels significantly increased after the surgery in both groups [9.1+4.5 vs. 17.9+9.1 ng/ml, P<0.001 (sinus rhythm group) and 10.6+3.3 vs. 27.4+8.4 ng/ml, P<0.001 (AF group)]. Conclusion Patients with an elevated postoperative resistin level may have high risk for AF after CABG. This intervention targeting inflammation might help reduce the incidence of AF. Coron Artery Dis 22:484-490 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.