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Öğe Decreased circulatory erythropoietin in hyperacute phase of myocardial ischemia(Elsevier Ireland Ltd, 2011) Alioglu, Emin; Ercan, Ertugrul; Tamer, Gulden Sonmez; Duman, Can; Turk, Ugur; Tengiz, Istemihan; Tuzun, NurullahPurpose: Erythropoietin provides cellular protection by inhibiting apoptosis. Myocardial damage related to the cardiac ischemia is more prominent especially in the first 6 h. In the present study, circulatory erythropoietin levels in response to cardiac ischemia were evaluated. Materials and methods: Patients with stable angina who underwent balloon angioplasty (study group, n = 55) and hospitalized for coronary angiography (as control group, n = 23) were enrolled into the study. Serum erythropoietin levels were measured in both groups in baseline, 6 and 18 h after the procedure. Results: Coronary balloon inflation time was accepted as duration of myocardial ischemia. Study group showed significant erythropoietin reduction at sixth hour compared to control group. Erythropoietin reduction at sixth hour was significantly correlated with duration of myocardial ischemia. Conclusion: Decreased circulatory erythropoietin levels in the early phase of acute cardiac ischemia may accelerate the apoptotic activity. Recombinant erythropoietin replacement to prevent erythropoietin decrease following cardiac ischemia may have negative effect on myocyte loss. (C) 2008 Elsevier Ireland Ltd. All rights reserved.Öğe High Inflammatory Activity Related to the Number of Metabolic Syndrome Components(Wiley, 2010) Kirilmaz, Bahadir; Asgun, Fatih; Alioglu, Emin; Ercan, Ertugrul; Tengiz, Istemihan; Turk, Ugur; Saygi, SerkanIt has been known that each component of the metabolic syndrome (MS) has an atherogenic potential and increases the risk of cardiovascular events. Therefore, patients who have MS are candidates for the development of atherosclerosis and accompanying complications. In this study, the authors assessed the levels of acute phase reactants as an indicator of inflammation in patients with MS. Twenty-five patients with recently diagnosed MS and not treated before who had at least 3 of 5 diagnostic criteria of MS listed in the Third Report of the Adult Treatment Panel National Cholesterol Education Program (NCEP-ATP III) guidelines were included in the study. Twenty healthy patients constituted the control group. Inflammatory parameters were compared between the groups. There was no significant difference between the MS and control group with regard to age and sex. White blood cell count (/mm(3)), high-sensitivity C-reactive protein (hs-CRP), uric acid, interleukin (IL) 6, and fibrinogen levels were found to be significantly higher in the MS group. Number of MS components was strongly correlated with serum levels of hs-CRP (r=0.688, P=.0001), IL-6 (r=0.546, P=.0001), fibrinogen (r=0.551, P=.0001), uric acid (r=0.517, P=.0001), and leucocyte count (/mmr3) (r=0.456, P=.002). Inflammation plays an important role in atherosclerotic complications, which is activated in MS. Increased number of MS components are strongly associated with elevated inflammatory and metabolic markers. Measurement of serum inflammatory parameters in patients with MS may be beneficial in detection and management of cardiovascular events and in the assessment of efficacy of treatment. J Clin Hypertens (Greenwich). 2010;12:136-144. (C)2009 Wiley Periodicals, Inc.Öğe N-Acetylcysteine in Preventing Contrast-Induced Nephropathy Assessed by Cystatin C(Wiley-Hindawi, 2013) Alioglu, Emin; Saygi, Serkan; Turk, Ugur; Kirilmaz, Bahadir; Tuzun, Nurullah; Duman, Can; Tengiz, IstemihanAims: Prophylactic oral N-acetylcysteine (NAC) has been widely used for prevention of contrast-induced nephropathy (CIN). However, clinical studies have not been demonstrating this effect consistently because of evidence that NAC can alter serum creatinine levels without affecting glomerular filtration rate (GFR). We investigated NAC for the prevention of CIN by monitoring creatinine and cystatin C. Methods: We enrolled 113 patients (49 patients in NAC group and 64 patients in control group) with normal to subnormal GFR who were scheduled for cardiovascular procedures. Patients in NAC group receive acetylcysteine 600 mg twice a day, on the day before and on the day of cardiovascular procedure. All patients received a periprocedural intravenous infusion (volume expansion) of 1 ml/kg/h with 0.45% saline for 24 h (12 h before and 12 h after exposure to contrast medium). Serum cystatin C and creatinine levels were measured before and at 12, 24, and 48 h after procedure. Results: The incidence of cystatin C-based CIN was 28.5% (n = 14) in NAC and 23.4% (n = 15) in control group (p = 0.663) and serum creatinine-based CIN was 12.2% (n = 6) in NAC and 17.2% (n = 11) in control group (P= 0.468). In this study, oral NAC had no effect on the prevention of CIN in patients undergoing cardiovascular procedures. Conclusion: In this study, oral NAC administration does not reduce neither the incidence of cystatin C-based CIN nor serum creatinine-based CIN in patients undergoing cardiovascular procedures.Öğe Non ST-segment elevation myocardial infarction in patient with essential thrombocythemia(BMC, 2009) Alioglu, Emin; Tuzun, Nurullah; Sahin, Fahri; Kosova, Buket; Saygi, Serkan; Tengiz, Istemihan; Turk, UgurA 68-year-old woman presented with acute chest pain and a greatly increased platelet count. Cardiac catheterization revealed subtotal occlusion and a thrombus-like filling defect in the right coronary artery. The patient was successfully treated with intravenous tirofiban. Essential thrombocythemia was diagnosed based on bone marrow findings, clinical presentation and laboratory analysis. The relationship between intracoronary thrombus and essential thrombocythemia is discussed.Öğe Prediction of Head-Up Tilt Test Result: Is it Possible?(Wiley-Blackwell Publishing, Inc, 2010) Turk, Ugur; Alioglu, Emin; Kirilmaz, Bahadir; Duygu, Hamza; Tuzun, Nurullah; Tengiz, Istemihan; Zoghi, MehdiBackground: The determination of early, accurate, predictive criteria for a positive result would permit a reduction in the duration of the head-up tilt testing (HUTT). Previous studies propounded that existence of early sympathetic overreactivity (rapid and sustained increase in heart rate) during HUTT predicts positive result. However, the exact value of this variable is unknown. We analyzed the early heart rate (HR) responses to HUTT and evaluated their ability to predict HUTT result. Methods: Consecutive patients referred to the syncope unit of our center for recurrent unexplained syncope were studied. Results: We studied 189 consecutive patients and 67 (35%) patients had a negative HUTT; 122 (65%) patients had a positive HUTT. The early HR increase was defined as the maximum HR during the first 10 minutes of tilting minus the resting HR before tilting. The receiver-operator curves (ROCs) show the overall performance of the HR changes for predicting the HUTT result. For all variables, area under the ROC curve (AUC) was nearly equivalent to 0.50 and early HR increase was not a predictor of the negative result of HUTT (AUC = 0.546). Also there was no any significant correlation between the magnitude of early HR increase and patient age (r = -0.03, P = 0.76). Conclusions: The results suggest that the early increase in HR during the first 10 minutes of the HUTT may not be a useful parameter for predicting the test result. Many factors, such as late exaggeration in sympathetic activity during HUTT and age-dependent reduction in baroreflex sensitivity, may attenuate the predictive value of early HR increase. (PACE 2010; 33:153-158).Öğe Thrombotic occlusion of a left main coronary artery in a patient with prosthetic mitral valve(Turkish Soc Cardiology, 2010) Saygi, Serkan; Alioglu, Emin; Turk, Ugur; Tuzun, Nurullah; Kirilmaz, Bahadir; Tengiz, Istemihan; Ercan, Ertugrul[Anstract Not Available]
