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Öğe 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, MehdiAim: 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.Öğe Gender-Related Differences in Patients with Acute Heart Failure: Observation from the Journey Heart Failure-Turkish Population Study(Kare Publ, 2023) Akcay, Filiz Akyildiz; Sinan, Umit Yasar; Gurbuz, Dogac Caglar; Safak, Ozgen; Kaya, Hakki; Yuksek, Umit; Zoghi, MehdiBackground: Gender-related clinical variations in patients with acute heart failure have been described in previous studies. However, there is still a lack of research on gender differences in patients hospitalized for acute heart failure in Turkiye. The aim of this study is to compare the clinical features, in-hospital approaches, and outcomes of male and female patients hospitalized for acute heart failure. Methods: Differences in clinical characteristics, medication prescription, hospital management, and outcomes between males and females with acute heart failure were investigated from the Journey Heart Failure-Turkish Population study. Results: Nine hundred eighteen patients (57.2%) were men and 688 (42.8%) were women. Women were older than men (70.48 +/- 13.20 years vs. 65.87 +/- 12.82 years; P <.001). The frequency of comorbidities such as hypertension (72.7% vs. 62.4%, P <.001), diabetes (46.5% vs. 38.5%, P =.001), atrial fibrillation (46.5% vs. 33.4%, P <.001), New York Heart Association class III-IV symptoms (80.6% vs. 71.2%, P =.001), and dyspnea in the rest (73.8% vs. 68.3%, P =.044) were more common in women on admission. Male patients were more frequently hospitalized with reduced left ventricular ejection fraction (51.0% vs. 72.4%, P <.001). In-hospital mortality was higher among female patients (9.3% vs. 6.4%, P =.022). Higher New York Heart Association class, lower estimated glomerular filtration rate, higher N-terminal pro-B type natriuretic peptide on admission, and mechanical ventilation usage were the independent parameters of in-hospital mortality, whereas the female gender was not. Conclusion: Our study clearly demonstrated the diversity in presentation, management, and in-hospital outcomes of acute heart failure between male and female patients. Although left ventricular systolic functions were better in female patients, in-hospital mortality was higher. Recognizing these differences in the management of heart failure in different sexes will serve better results in clinical practice.Öğe Marital status and outcomes in chronic heart failure: Does it make a difference of being married, widow or widower?(Istanbul Provincial Directorate of Health, 2021) Şentürk, Bihter; Kaya, Hakkı; Çelik, Ahmet; Bekar, Lütfü; Güngör, Hasan; Zoghi, Mehdi; Ural, Dilek; Çavuşoğlu, Yüksel; Temizhan, Ahmet; Yılmaz, Mehmet BirhanOBJECTIVE: We aimed to compare the outcomes of chronic heart failure (HF) patients with reduced ejection fraction (CHFrEF) in the Turkish Research Team in HF (TREAT-HF) registry according to marital status with a specific focus on being the widowed (widow/widower) versus the married. METHODS: TREAT-HF is a network, enrolling CHFrEF with a follow up for HF-related hospitalization (HFrH) and all-cause mortality (ACM). In this cohort, the widowed patients were compared with patients who were married before and after propensity score (PS) matching analysis. RESULTS: There were 723 cHFrEF patients with a complete dataset, including reported marital status at baseline for this analysis. Out of 723 patients with HF, 37 “never-married” and “divorced” patients were excluded from the analysis. Then, out of 686 remaining patients with HF, who had at least one reported marriage in the database, widowed patients with HF (n=124) were compared with married patients (n=562). The mean follow up period was 21±12 months up to 48 months. The widowed patients had a higher risk of HFrH (p=0.047), although ACM remained similar compared to married patients (p=0.054). After PS matching, HFrH remained more frequent among the widowed compared with the married (p=0.039) although ACM yielded similar rates. Of note, it was shown that being a widower (p=0.419) was not linked to increased risk of HFrH during follow up contrary to being a widow (p=0.037) despite similar age, ejection fraction, creatinine, NYHA functional class distribution and a similar rate of life-saving medications. CONCLUSION: PS matching analysis yielded that the widowed had increased the risk for HFrH. Of note, widowers did not seem to have an increased risk for HFrH, contrary to widows.Öğe Noncompliance with Dietary Salt Restriction and Outcomes in Chronic Heart Failure: A Propensity Score Matching Analysis from TREAT-HF Registry(University of Health Sciences Turkey, Istanbul Haseki Training and Research Hospital, 2021) Şentürk, Bihter; Kaya, Hakkı; Çelik, Ahmet; Bekar, Lütfü; Güngör, Hasan; Zoghi, Mehdi; Ural, Dilek; Çavusoglu, Yüksel; Temizhan, Ahmet; Yılmaz, Mehmet BirhanAim: To compare chronic heart failure patients with reduced ejection fraction (cHFrEF) who stated to comply with salt restriction in their diets versus those who did not. Methods: Patients without salt restriction were compared to those with salt restriction regarding HF-related hospitalization (HFrH) and all-cause mortality (ACM) before and after propensity score (PS) matching analysis. Results: The study included a total of 723 patients. 136 of them stated not to comply with salt restriction, 587 of them stated to comply with salt restriction. More frequent HFrH were observed in patients without salt restriction compared to those with salt restriction (75% vs. 62.9%, p=0.007), though, ACM was similar in both groups (29.4% vs 27.6%, p=0.672). After PS matching, HFrH during follow-up remained more frequent in those without salt restriction compared to those with salt restriction (73.7% vs 59.3%, p=0.019) but ACM was not different in both groups (30.5% vs 29.7%, p=0.887). Noncompliance to dietary salt restriction was found as one of the independent predictors of HFrH. Conclusion: In cHFrEF outpatients, noncompliance to dietary salt restriction does not seem to increase the risk for ACM but it poses an increased risk for HFrH.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).
