Yazar "Yilmaz, Mustafa" seçeneğine göre listele

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    Could elevated platelet-lymphocyte ratio predict left ventricular systolic dysfunction in patients with non-ST elevated acute coronary syndrome?
    (Turkish Soc Cardiology, 2015) Bekler, Adem; Gazi, Emine; Yilmaz, Mustafa; Temiz, Ahmet; Altun, Burak; Barutcu, Ahmet; Peker, Tezcan
    Objective: The prognostic value of a high platelet-lymphocyte ratio (PLR) has been reported in patients with non-ST elevated myocardial infarction (NSTEMI) and different oncologic disorders. We aimed to evaluate the predictive value of the PLR for left ventricular systolic dysfunction (LVSD) in patients with non-ST elevated acute coronary syndrome (NST-ACS). Methods: A total of 220 patients with NST-ACS were included in the study. The study population was divided into tertiles based on admission PLR values. High (n=73) and low PLR (n=147) groups were defined as patients having values in the third tertile (>135.6) and lower 2 tertiles (<= 135.6), respectively. Left ventricular dysfunction was defined as ejection fraction <= 40%, and related variables were evaluated by backward conditional binary logistic regression analysis. Results: The patients in the high PLR group were older (p<0.001) and had a higher rate of previous myocardial infarction and NSTEMI (p=0.046, p=0.013, respectively). There were significantly more coronary arteries narrowed (p=0.001) and lower left ventricular ejection fraction (p<0.001) in the high PLR group. Baseline platelet levels were significantly higher (p<0.001) and triglyceride and lymphocyte levels were significantly lower (p=0.009 and p<0.001, respectively) in the high PLR group. PLR >135.6 was found to be an independent predictor of systolic dysfunction in the multivariate analyses (beta: 0.306, 95% confidence interval: 0.151-0.619; p=0.001). Conclusion: A high PLR is a strong and independent predictor for LVSD in patients with NST-ACS.
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    Eosinophil count is related with coronary thrombus in non ST-elevated acute coronary syndrome
    (Palacky Univ, Medical Fac, 2015) Tenekecioglu, Erhan; Yilmaz, Mustafa; Bekler, Adem; Demir, Serafettin
    Background. White blood cells are reported as important not only in plaque vulnerability but also in thrombus formation and thrombus growth in acute coronary syndromes. Eosinophils contain granules that promote thrombus formation and thrombus growth in some heart diseases. In this study we aimed to investigate the relation of eosinophil count with coronary thrombus formation in patients with non ST-elevated acute coronary syndrome (NST-ACS). Method. A total of 251 consecutive patients were hospitalized in our hospital with a diagnosis of NST-ACS. Venous blood is collected for measurement of hematologic indices in all patients undergoing the coronary angiography. Coronary angiographies were performed in our clinic using the standard Judkins technique and angiographic assessment of the presence of thrombus was made. Results. During coronary angiography, coronary thrombus was not detected in 82 patients (Group 1). In the coronary angiography of 169 patients, coronary thrombus was detected at various grades (Group 2). While the neutrophil count (6.84 +/- 1.94 vs. 5.53 +/- 1.37; P<0.001) and eosinophil count (0.257 +/- 0.125 vs. 0.163 +/- 0.114; P<0.005) was significnatly increased in the group with coronary thrombus, the lymphocyte count (1.87 +/- 0.66 vs. 2.00 +/- 0.70; P<0.001) was significantly decreased in the group with coronary thrombus as compared to the patient group without coronary thrombus. In the correlation analyzes; presence of coronary thrombus is correlated with total cholesterol, LDL-C, total CK, CK-MB, troponin, total number of diseased coronary, platelet count, neutrophil count, lymphocyte count and eosinophil count. On multivariate linear regression analysis, total leukocyte count, neutrophil count, lymphocyte count, eosinophil count, troponin and total cholesterol was found to be independent predictor of coronary thrombus in patients with NST-ACS. Conclusion. Beside the increased neutrophil count, increased eosinophil count in CBC should alert the clinician about coronary thrombus development in patients with NST-ACS in order to make early medical interventions at acute phase of the disease.
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    Evaluation of Brucella pericarditis cases by pooled analysis method
    (Refik Saydam National Public Health Agency (RSNPHA), 2023) Evlice, Oğuz; Yilmaz, Mustafa; Çeviker, Sevil Alkan; Küçük, Uğur
    Objective: Brucellosis is one of the most frequent zoonotic infectious diseases and is a global public health concern, particularly in developing countries. Brucellosis causes systemic symptoms and can affect different parts of the body. Brucellar pericarditis is a rare involvement of the cardiovascular system. This study aimed to investigate the clinical outcomes of Brucella pericarditis cases. Methods: A pooled analysis study was conducted by searching four international online databases with the terms “Brucella” and “pericarditis” and their synonyms. The full texts or abstracts were screened using these keywords. The publications were examined in terms of the age and gender of cases, publication year and country, additional diagnosis, diagnostic methods, treatments, and outcomes. Results: The study included 25 cases (14 males, 56%), with a mean age of 38.84 ± 9.7 (12-79) years. Systemic findings were present in 17 (68%) patients, and 17 (68%) had a cardiac presentation. 10 (40%) patients had retrosternal pain/ chest pain, 10 (40%) patients had pericardial frontman, and five (%10) cases had tachycardia. The most commonly used diagnostic method was a serological test (96%), and a positive blood culture result was determined in 64%. The Rose Bengal test was performed in seven cases, of which six had positive results. Complete recovery was reported for 22 cases, and death in two patients. Conclusion: Although brucellosis is less common in many developed countries, it should be keep in mind differential diagnosis in endemic areas. Brucellosis is a rare cause of pericarditis and requires specific treatment. Standard tube agglutination tests are highly sensitive and specific in the diagnosis of brucellosis. This non-invasive, practical test should be used in the differential diagnosis of pericarditis. © (2023), (Refik Saydam National Public Health Agency (RSNPHA)). All Rights Reserved.
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    Methyltetrahydrofolate reductase C677T gene mutation and hyperhomocysteinemia as a novel risk factor for diabetic nephropathy
    (Springer, 2009) Ukinc, Kubilay; Ersoz, Halil Onder; Karahan, Caner; Erem, Cihangir; Eminagaoglu, Selcuk; Hacihasanoglu, Arif Bayram; Yilmaz, Mustafa
    Hyperhomocysteinemia is a well-defined risk factor for endothelial dysfunction and atherosclerosis. A point mutation (677 C-T) of MTHFR gene results in a significant increase at plasma homocysteine levels. In this study we aimed to evaluate the effects of MTHFR gene mutation and consequent hyperhomocysteinemia on the development of diabetic microvascular complications in comparison with the other defined risk factors. Diabetic patients without a history of macrovascular complication or overt nephropathy enrolled into the study. The presence of MTHFR 677 C-T point mutation was evaluated by Real-Time PCR technique by using a LightCycler. MTHFR heterozygous mutation was present in 24 patients over 52. Patients with diabetes were divided into two groups according to the presence of MTHFR gene mutation. Both groups were well matched regarding age and diabetes duration. Metabolic parameters, plasma homocysteine, microalbuminuria, folic acid, and vitamin B12 levels were also studied. Presence of neuropathy and retinopathy were evaluated by specific tests. Duration of diabetes, BMI, systolic and diastolic blood pressure, plasma CRP, HbA1c, and lipid levels were not different between the two groups. Plasma homocysteine (12.89 +/- A 1.74 and 8.98 +/- A 1.91 mu mol/l; P < 0.0001) and microalbuminuria levels (73.40 +/- A 98.15 and 29.53 +/- A 5.08 mg/day; P = 0.021) were significantly higher in the group with MTHFR gene mutation while creatinine clearance levels (101.1 +/- A 42.6 and 136.21 +/- A 51.50 ml/min; P = 0.008) were significantly lower. Sixteen over 22 (73%) of the patients with diabetic nephropathy had MTHFR gene mutation, while this was only 27% (8 over 30) in normoalbuminuric patients (P = 0.017). There was a significant correlation of plasma homocysteine level with microalbuminuria (r = 0.54; P = 0.031) in the patients with diabetic nephropathy who had C677T polymorphism. We did not find any specific association of MTHFR gene mutation and hyperhomocysteinemia with retinopathy or neuropathy.
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    Microalbuminuria in untreated prehypertension and hypertension without diabetes
    (E-Century Publishing Corp, 2014) Tenekecioglu, Erhan; Yilmaz, Mustafa; Yontar, Osman Can; Karaagac, Kemal; Agca, Fahriye Vatansever; Tutuncu, Ahmet; Kuzeytemiz, Mustafa
    Objective: Hypertension (HT) and prehypertension (preHT) were independent predictors of cardiovascular diseases. Urinary albumin leakage is a manifestation of generalized vascular damage. B-type natriuretic peptide (BNP) is a vasoactive peptide secreted by left ventricle in response to myocytic stretch. We aimed to investigate relationship between microalbuminuria (MA) and BNP in untreated elevated blood pressures. Methods: Of 105 untreated prehypertensive subjects (53 men, 52 women), 100 hypertensive subjects (51 men, 49 women) and 57 normotensive subjects (32 men, 25 women) none had history of diabetes. Urine albumin excretion was measured by immunoradiometric assay in morning urine sample. Results: The prevalence of MA was higher in hypertensive group than in prehypertensive group and in normotensive group (Hypertensive group; 33.9%, prehypertensive; 25.9%, normotensive; 10%). Subjects with HT had higher prevalence of microalbminuria; larger body mass index, higher levels of triglycerides, blood glucose and creatinin were more common in subjects with HT than in those with preHT. In hypertensive group; patients with microalbuminuria had higher systolic blood pressure (SBP), BNP, LVMI and lower eGFR as compared to those without MA. MA was significantly correlated with LVMI, BNP and SBP. In multivariate regression analysis, SBP (beta: 0.361; P < 0.001), LVMII (beta: 0.267; P = 0.011) and BNP (beta: 0.284; P = 0.005) were independent variables associated with MA in hypertensives. In prehypertensive group; patients with microalbuminuria had higher SBP, BNP, LVMI and lower eGFR as compared to those without MA. MA was significantly correlated with LVMI, BNP and SBP. In multivariate regression analysis, SBP (beta: 0.264; P = 0.002), LVMI (beta: 0.293; P = 0.001) and BNP (beta: 0.168; P = 0.045) were associated with MA in prehypertensives. Conclusions: In preHT and HT, SBP, BNP and LVMI are associated with MA. In the evaluation of increased blood pressures, in case of increased BNP and LVMI, MA should be investigated even in prehypertensive stages. The subjects with increased blood pressures should get medical treatment to prevent the effects on vascular structure and myocardium even in prehypertensive phase.
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    Predictors of coronary collaterals in patients with non ST-ellevated acute coronary syndrome: the paradox of the leukocytes
    (Termedia Publishing House Ltd, 2014) Tenekecioglu, Erhan; Yilmaz, Mustafa; Karaagac, Kemal; Bekler, Adem; Aslan, Burhan; Demir, Serafettin; Kuzeytemiz, Mustafa
    Aim of the study: Atherosclerosis represents active inflammation in which leukocytes play significant role. Coronary collateral development is a response to myocardial ischaemia. In this study we aimed to investigate the association of the leukocytes with coronary collateral development in patients with non ST-elevated acute coronary syndromes (NST-ACS). Material and methods: A total of 251 consecutive patients were hospitalized in our hospital with a diagnosis of NST-ACS. The blood samples were collected 1-hour after admission to the hospital and peripheral leukocytes (neutrophils, monocytes and lymphocytes) were examined. All patients underwent coronary angiography. The coronary collateral vessels (CCV) are graded according to the Rentrop scoring system. Results: Group 1 consisted of 146 patients with Rentrop 0 and Group 2 consisted of 105 patients with Rentrop I, 2 and 3. The presence of CCV was significantly associated with neutrophil count, lymphocyte count, monocyte count and neutrophil-lymphocyte ratio (NLR). In subgroup analyses, higher NLR was significantly associated with good CCV development in patients with NST-ACS. Conclusions: Higher neutrophil count, monocyte count and NLR and lower lymphocyte count on admission, were associated with the presence of CCV in patients with NST-ACS. High NLR may predict good collateral development in patients with NST-ACS.
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    Red blood cell distribution width is associated with myocardial injury in non-ST-elevation acute coronary syndrome
    (Hospital Clinicas, Univ Sao Paulo, 2015) Tenekecioglu, Erhan; Yilmaz, Mustafa; Yontar, Osman Can; Bekler, Adem; Peker, Tezcan; Karaagac, Kemal; Ozluk, Ozlem Arican
    OBJECTIVES: The red blood cell distribution width has been associated with an increased risk of cardiovascular events. In the present study, we assessed the relationship between red cell distribution width values and cardiac troponin I levels in patients admitted with non-ST-elevation acute coronary syndrome. METHODS: We analyzed blood parameters in 251 adult patients who were consecutively admitted to the intensive coronary care unit with non-ST-elevation acute coronary syndrome over a 1-year period. For all patients, a baseline blood sample was collected for routine hematological testing. Cardiac troponin I was measured at baseline and after 6 h. The patients were diagnosed with non-ST-elevation myocardial infarction or unstable angina based on the elevation of cardiac troponin I levels. RESULTS: The red cell distribution width was higher in the group with non-ST-elevation myocardial infarction compared with the patient group with unstable angina (14.6 +/- 1.0 vs 13.06 +/- 1.7, respectively; p=0.006). Coronary thrombus was detected more frequently in the group of patients with non-ST-elevation myocardial infarction than in the patients with unstable angina (72% vs 51%, respectively; p=0.007). Using receiver operating characteristic curve analysis for the prediction of non-ST-elevation myocardial infarction based on the red cell distribution width, the area under the curve was 0.649 (95% confidence interval: 0.546-0.753; p=0.006), suggesting a modest model for the prediction of non-ST-elevation myocardial infarction using the red cell distribution width. At a cut-off value of 14%, the sensitivity and specificity of the red cell distribution width were 73% and 59%, respectively. Additionally, the red cell distribution width was positively correlated with cardiac troponin I (r=0.19; p=0.006). CONCLUSION: A greater baseline red cell distribution width value was associated with myocardial injury and elevated cardiac troponin I levels in non-ST-elevation acute coronary syndrome. Therefore, the red cell distribution width could be considered for risk stratification of acute coronary syndrome patients admitted to emergency departments.