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Öğe Association between depression and anxiety scores and inflammation in patients wain isolated coronary artery ectasia(Turkish Soc Cardiology, 2019) Gurbuz, Ahmet Seyfeddin; Alsancak, Yakup; Sakli, Beyza; Duzenli, Mehmet AkifObjective: Depression and anxiety disorders are frequently found in combination with obstructive coronary artery disease. Coronary artery ectasia (CAE) is an atypical form of coronary artery disease, the etiology of which has not yet been clearly defined. The aim of this study was to assess the existence of a relationship between anxiety/depression and CAE. Methods: A CAE group (n=41; mean age: 58.9 +/- 9.0 years) and a control group (n=42; mean age: 58.0 +/- 9.6 years) were compared. The anxiety and depression status of patients was evaluated using the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results: Age, sex, ejection fraction, and cardiovascular risk factor data were similar in both groups. The serum C-reactive protein (CRP) and uric acid levels as well as the leukocyte count were significantly higher in the CAE group (p<0.05). The HADS anxiety score was higher in the CAE group, but without statistical significance (p=0.23). The HADS depression score and total HADS score was significantly higher in the CAE group (p<0.001 and p<0.001). The total HADS score and the HADS depression score were correlated with the serum CRP level (r=0.489; p<0.001 and r=0.543; p<0.001, respectively), whereas the anxiety score was not correlated with CRP (r=0.85; p=0.23). Conclusion: The depression score, CRP, and uric acid levels were greater in patients with isolated CAE compared with those of patients with normal coronaries. The anxiety score did not demonstrate a relationship to CAE; however, there was an association between the depression score and CRP, which is an inflammatory marker.Öğe Breastfeeding does not protect against the development of carditis in children with acute rheumatic fever(Cambridge Univ Press, 2022) Gurbuz, Funda; Sahiner, Nejla Canbulat; Unal, Emin; Gurbuz, Ahmet Seyfeddin; Baysal, TamerIntroduction: Acute rheumatic fever is an autoimmune disease that develops due to streptococcal infection. The positive effect of breastfeeding on the development of the child's immune system is well documented. In this study, we aimed to investigate the effect of breast milk intake period on the development of carditis. Materials and methods: Patients (n: 182) who were diagnosed with acute rheumatic fever between 2010 and 2019 were enrolled in the study. The patients were divided into groups according to carditis development. The demographic, socio-economic, and breastfeeding data were compared between groups. Results: The mean age of the patients was 10.5 +/- 3.4, and 43.4 % (n: 79) of them were female. Independent predictors of the development of carditis in the first acute rheumatic fever episode were the number of children at home (OR: 1.773, CI 95%: 1.105, 2.845; p: 0.018) and breast milk intake less than 6 months (OR: 0.404, CI 95%: 0.174, 0.934; p: 0.034). Independent predictors of the development of carditis in any of the acute rheumatic fever episodes were the number of children at home (OR: 1.858, CI 95%: 1.100, 3.137; p: 0.021) and female gender (OR: 3.504, CI 95%: 1.227, 10.008; p: 0.019). The only independently predictor of the development of chorea during acute rheumatic fever was female gender (OR: 3.801, CI 95%: 1.463, 9.874; p: 0.006). Conclusion: Although the occurrence of carditis is less common during the first acute rheumatic fever attack in patients with breast milk intake less than six months, this advantage is lost in recurrent attacks. This study showed that breast milk does not have a negative effect on acute rheumatic fever carditis.Öğe CHA2DS2-VASc and HAS-BLED scores are not associated with cardiac defibrillators therapies(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Alsancak, Yakup; Sari, Hasan; Gurbuz, Ahmet Seyfeddin; Sertdemir, Ahmet Lutfi; Aribas, Alpay; Soylu, AhmetAim: The CHA(2)DS(2)-VASc (heart failure, hypertension, age >75, diabetes mellitus, stroke history, vascular disease, 65-74 age range, gender) and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history, labile INR, elderly, drugs/alcohol) are scoring system for using to estimate stroke and bleeding development in cases with atrial fibrillation. We aim to evaluate the relationship between the implantable cardioverter defibrillator (ICD) therapies and CHAIDSi-VASc and HAS-BLED scores. Methods: 398 patients were included in this retrospective study after reviewing the data of the patients above the age of 18 who had ICD implantation for any reason between 2014-2019 and who were found to have at least two pacemaker check-ups with 6-month intervals. CHA(2)DS(2)-VASc and HAS-BLED scores were calculated during the device implantation and last control visit date. Results: 148 of the patients received ICD therapy (appropriate shock [n = 1181 and in appropriate therapy In = 301) and 250 of them did not receive any therapy. It was observed that the CHA(2)DS(2)-VASc and HAS-BLED scores were similar in the groups receiving and not receiving therapy (respectively, p = 0.64 and p = 0.60). CHA(2)DS(2)-VASc and HAS-BLED scores were similar in patients with appropriate shock or not (respectively p = 0.89 and p = 0.85) with median follow-up period 5.5 years. Multivariate regression analysis showed that reduced ejection fraction, presence of single-chamber ICD, lapsing of a long time after the implantation were independent risk factors for ICD device therapies (p < 0.05). Conclusions: CHA(2)DS(2)-VASc and HAS-BLED scores are not associated with device-based ICD therapies.Öğe Effect of Coronary Tortuosity on Exercise Stress Test(Istanbul Training & Research Hospital, 2020) Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Ozcelik, Abdullah; Icli, AbdullahIntroduction: Coronary tortuosity (CT) is a common anatomical finding during coronary angiography (CA); however, its aetiology and clinical importance have not been clearly defined. We aimed to evaluate the effect of the presence or severity of CT and effect of the sigma-shaped right coronary artery (RCA) on the exercise stress test (EST). Methods: The study included 175 patients who underwent CA due to cardiac symptoms and positive EST and had no obstructive coronary artery disease in a single centre between 2017 and 2018 June. The patients were divided into two groups: Group 1, patients with CT (n=88), and group 2, patients without CT (n=87). The patients were also categorised as low and moderate-to-high risk based on Duke treadmill score (DTS). Results: The running distance and DTS were lower, and the rate of sigma-shaped RCA was higher in the CT group (p<0.006). The DTS was lower (p=0.024) in the presence of tortuosity in the left anterior descending coronary artery and negatively influenced as the number of coronary arteries affected by tortuosity increased (p<0.001). Based on the DTS score, patients with moderate-to-high risk have a higher number of vessels affected by tortuosity, involvement of left anterior descending coronary artery, and proportion of sigma-shaped RCA (p<0.001). Conclusion: In the presence of CT, the rate of positivity is significantly higher, and the DTS is lower in the stress test.Öğe Effects of atrial electromechanical delay and ventriculoatrial conduction over the atrial functions in patients with frequent extrasystole and preserved ejection fraction(Wiley, 2019) Gurbuz, Ahmet Seyfeddin; Ozturk, Semi; Kilicgedik, Alev; Akgun, Taylan; Kalkan, Mehmet Emin; Demir, Serdar; Efe, Suleyman CaganBackground The deterioration of left atrial and ventricular functions was demonstrated in patients with frequent ventricular extrasystole (fVES). The exact pathophysiology of left atrial dysfunction in patients with fVES is unclear. Retrograde ventriculoatrial conduction (VAC) often accompanies fVES, which may contribute to atrial dysfunction. We investigated whether atrial electromechanical delay and VAC are related to these atrial functions in patients with frequent right ventricular outflow tract (RVOT) VES and preserved ejection fraction (pEF). Methods This study included 21 patients with pEF (eight males, 48 +/- 11 years), who had experienced more than 10 000 RVOT-VES during 24-h Holter monitoring and had undergone electrophysiological study/ablation. The study also included 20 healthy age- and sex-matched control subjects. Transthoracic echocardiography was performed on all of the subjects. Atrial conduction time was obtained by using tissue Doppler imaging. Strain analysis was performed with two-dimensional speckle tracking echocardiography. Results The peak atrial longitudinal strain was significantly impaired in patients with fVES (P = 0.01). In addition, although the interatrial and left atrial conduction delay times were significantly different between each group (P < 0.001, P < 0.001), the right atrial conduction delay times were similar. When patients with fVES were divided into groups depending on the existence of retrograde VAC, atrial deformation parameters and conduction delay time did not significantly differ between either group. Conclusion Frequent RVOT-VES causes left atrial dysfunction. This information is obtained through strain analyses and recordings of left atrial conduction times in patients with pEF. Regardless, retrograde VAC is not related to atrial dysfunction.Öğe Hematological indices in renovascular hypertension: A propensity score matching analysis(Turkish Soc Cardiology, 2019) Gurbuz, Ahmet Seyfeddin; Ozturk, SemiObjective: Various hematological blood count parameters, including the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), were analyzed to assess differences in patients with renovascular (RVH) and essential hypertension (EH). Methods: A propensity score analysis was performed to match 51 patients with RVH and 173 patients with EH. After matching, 49 pairs of patients were compared. Results: Before matching, patients with RVH had significantly higher NLR values [1.35 (range: 1.14-1.76) vs. 1.05 (range: 0.81-1.3); p<0.001] and MPV [8.7 fL (range: 8.3-9.5 fL) vs. 8.4 fL (range: 7.3-9.2 fL; p=0.002]. After propensity score matching was performed (49 vs 49 patients), age, sex, atherosclerosis risk factors, frequency of atherosclerosis, and the medications used were similar between groups. The NLR was significantly greater in patients with RVH [1.00 (range: 0.76-1.40) vs 1.35 (range: 1.15-1.75; p<0.001]. The MPV did not differ significantly between groups. The NLR was the only parameter independently associated with RVH in a multivariate logistic regression [odds ratio: 5.563, 95% confidence interval (CI): 2.089-14.814; p=0.001]. Receiver operating characteristic curve analysis results indicated that NLR >1.16 predicted RVH with a sensitivity of 72% and a specificity of 60% [area under curve: 0.724, 95% CI: 0.624-0.823; p <= 0.001]. Conclusion: The results of the present study demonstrated that NLR, which is a simple, clinical parameter of inflammation, was elevated in patients with RVH.Öğe Heparanase is a predictive marker for high thrombus burden in patients with ST-segment elevation myocardial infarction(Taylor & Francis Ltd, 2019) Gurbuz, Ahmet Seyfeddin; Ozturk, Semi; Efe, Suleyman Cagan; Yilmaz, Mehmet Fatih; Yanik, Raziye Ecem; Yaman, Ali; Kirma, CevatObjective: Heparanase (HPA) is an endo-beta-D-glucuronidase capable of degrading heparin sulphate (HS) and heparin side chains. HPA plays a role in tumour growth, angiogenesis, cell invasion and in activation of the coagulation system. We aimed to investigate the relationship between HPA and thrombus burden (TB) in patients with ST-Segment Elevation Myocardial Infarction (STEMI). Methods: This prospective study enrolled 187 patients with STEMI who were treated with primary percutaneous coronary intervention (pPCI). Blood samples were taken to determine serum HPA levels prior to coronary angiography and heparin administration. Serum HPA analysis was performed with a commercially available Human Elisa kit. Results: Patients were divided into two groups: high TB (n:58) and low TB (n:129) group. Serum HPA levels were significantly higher in patients with high TB than low TB [250.1 (188.5-338.1) vs. 173.6 (134.3-219.8) pg/mL] (p < 0.001). Serum HPA levels were higher in patients with no-reflow phenomenon compared with others [(409.3 (375.6-512.5) pg/mL vs. 186.2 (144.2-247.4) pg/mL, p < 0.001]. In multiple logistic regression analysis HPA was a predictor of high TB. Conclusion: Elevated HPA level in patients with STEMI is related to high TB. Furthermore, increased HPA level may be associated with thrombotic complications such as no-reflow phenomenon in patients with STEMI.Öğe An impressive image of unilateral pulmonary artery agenesis associated with coronary collateralization in an adult(Turkish Soc Cardiology, 2020) Alsancak, Yakup; Tatar, Sefa; Gurbuz, Ahmet Seyfeddin; Korkmaz, Celalettin; Duzenli, Mehmet Akif[Abstract Not Availabe]Öğe An impressive image of unilateral pulmonary artery agenesis associated with coronary collateralization in an adult(Turkish Soc Cardiology, 2020) Alsancak, Yakup; Tatar, Sefa; Gurbuz, Ahmet Seyfeddin; Korkmaz, Celalettin; Duzenli, Mehmet Akif[Abstract Not Availabe]Öğe Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism(Assoc Medica Brasileira, 2020) Alsancak, Yakup; Sahin, Ahmet Taha; Gurbuz, Ahmet Seyfeddin; Sertdemir, Ahmet Lutfi; Icli, Abdullah; Akilli, Hakan; Duzenli, Mehmet AkifOBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT First, the high-risk APE patients' ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups' ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group (P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group (P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio (P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P-value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT (P-value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period.Öğe Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism(Assoc Medica Brasileira, 2020) Alsancak, Yakup; Sahin, Ahmet Taha; Gurbuz, Ahmet Seyfeddin; Sertdemir, Ahmet Lutfi; Icli, Abdullah; Akilli, Hakan; Duzenli, Mehmet AkifOBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT First, the high-risk APE patients' ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups' ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group (P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group (P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio (P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P-value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT (P-value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period.Öğe Paradoxical Embolism After a Traffic Accident: A Rare Case of Thrombus Entrapped in a Patent Foramen Ovale(Istanbul Training & Research Hospital, 2021) Kandemir, Serif Ahmet; Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Duzenli, Mehmet AkifParadoxical embolism is the passage of a thrombus formed in the venous system through shunts in the lung or heart into the systemic circulation. The most common intracardiac shunt is a patent foramen ovale (PFO). Since the transition of a thrombus formed in the right heart to the left heart and systemic circulation through the PFO is a temporary situation, the entrapped thrombus in the PFO is extremely rare. Herein, we present a case, including the diagnosis and treatment, of a paradoxical embolism in a 53-year-old female with a non-vehicle traffic accident who developed a pulmonary embolism and acute cerebral infarction.Öğe Predictive value of transmitral A-wave acceleration time for paroxysmal atrial fibrillation(Wiley, 2019) Akilli, Hakan; Aribas, Alpay; Icli, Abdullah; Tatar, Sefa; Gurbuz, Ahmet SeyfeddinBackground It has been shown that transmitral A-wave (TMAW) is affected in paroxysmal atrial fibrillation (PAF), and decreased left atrial contractions cause a decrease in the TMAW velocity. The relationship between TMAW acceleration time (TMAW-AccT) and PAF is unknown. In this study, the predictive value of TMAW-AccT for PAF was investigated. Methods Seventy PAF patients (mean age: 57.8 +/- 11.0 years) and 70 control patients (mean age: 58.1 +/- 10.5 years) were included in the study. Transthoracic echocardiography was performed in sinus rhythm in all patients. For TMAW-AccT, the time between the basal point of the A-wave and the highest point reached was measured. Results Transmitral A-wave -AccT was significantly longer in the PAF group than the control group (TMAW-AccT; 88.5 +/- 18.1 vs 77.2 +/- 16.4 ms, P = .000, respectively). The left atrial diameter and the left atrial volume index were similar between the groups (P = .07, P = .18, respectively). According to a multivariate logistic regression analysis, the TMAW-AccT (OR: 1.02, 95% confidence interval 1.02-1.07, P < .001) was a predictor of PAF. A receiver operating characteristic curve analysis showed a cutoff value of TMAW-AccT of >82 ms (sensitivity: 65.7%, specificity: 64.3%, positive predictive value: 64.8%, negative predictive value: 65.2%). Conclusion Transmitral A-wave-AccT can be used as an early marker in detecting PAF without dilated left atrium.Öğe QTc nterval is prolonged in Wilson's disease with neurologic nvolvement(Taylor & Francis Ltd, 2018) Ozturk, Semi; Gurbuz, Ahmet Seyfeddin; Efe, Suleyman Cagan; Iliaz, Raim; Banzragch, Mutse; Demir, KadirBackground Neurologic and liver involvement in Wilson's disease (WD) is well-documented, however, few reports demonstrated cardiac involvement. Tpe and Tpe/QT are new measures of ventricular repolarization which were recently suggested as predictor of arrythmogenesis. We aimed to evaluate ventricular depolarization and repolarization parameters including QT, QTc, Tpe intervals, Tpe/QT, Tpe/QTc ratios, and QT dispersion (QTd) in patients with WD.Materials and methods Thirty-five patients with WD and 30 healthy controls were included in the study. Patients were evaluated by a neurologist in addition to MR imaging. Twenty-one of 35 patients were diagnosed as neuroWilson (NW), whereas 14 patients as non-NW. ECG recordings were obtained using a 12-lead commercial device (Cardiac Science, Burdick s500,USA). All patients underwent standard echocardiographic evaluation. These two groups of patients and healthy controls were compared.Results There were no difference between patients with WD and healthy controls in terms of age sex, BMI, liver, and kidney functions where as patients with WD were anemic and thrombocytopenic. Left atrial, ventricular dimensions, left ventricular systolic, and diastolic functions were similar between patients and healthy control. QT interval was prolonged in patient group, however, QTc, Tpe intervals, Tpe/QT, and Tpe/QTc ratios and QTd did not differ between groups. When patients with NW and non-NW were compared, both QT and QTc intervals were significantly longer in patients with NW, however, Tpe interval, Tpe/QT and Tpe/QTc ratios, and QTd did not differ.Conclusion QT and QTc intervals are prolonged in patients with Wilson's disease and neurologic involvement.Öğe A rare echocardiographic image of aortic prosthetic valve endocarditis complicated with paravalvular abscess, pseudoaneurysm and aorto-right atrial fistula(Wiley, 2018) Gurbuz, Ahmet Seyfeddin; Alsancak, Yakup; Ozcelik, Abdullah; Ozer, Sumeyye Fatma; Duzenli, Mehmet AkifEarly infectious endocarditis (IE) occurs in 3% of prosthesis in the first 12months. Early IE is more aggressive than late prosthetic valve endocarditis. Mortality remains high, despite combined medical and surgical treatment. We present a case of early IE in aortic prosthetic valve complicated with paravalvular abscess, pseudoaneurysm and aorto- right atrial fistula.Öğe A Rare Involvement of Left Main Coronary Artery Due to Woven Coronary Artery in a Patient with Behcet's Disease(Aves, 2020) Tatar, Sefa; Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Icli, AbdullahIn general, woven coronary artery (WCA) is a benign congenital pathology; ocassionally, it may result in adverse cardiovascular events owing to myocardial ischemia. Though all coronary arteries may be affected, the right coronary artery is the most affected. This paper presents an extremely rare WCA effecting the left main coronary artery concurrent with Behcet's disease.Öğe Relationship between fragmented QRS complexes and ejection fraction recovery in anterior ST-segment elevation myocardial infarction patients undergoing thrombolytic treatment(Lippincott Williams & Wilkins, 2020) Eren, Hayati; Kaya, Ulker; Ocal, Lutfi; Gurbuz, Ahmet Seyfeddin; Kalcik, Macit; Abaci, AdnanBackground Acute anterior ST-segment elevation myocardial infarction (STEMI) is a life-threatening disease. Adverse cardiac events of acute anterior STEMI include cardiovascular death or worsening congestive heart failure. This study investigated the role of fragmented QRS complex (fQRS) in predicting insufficient ejection fraction (EF) recovery in acute anterior STEMI. Methods Patients with acute anterior STEMI who received thrombolytic therapy were prospectively enrolled in this study. Twelve-lead electrocardiography (ECG) was obtained from all patients during admission and 24 and 48 h after admission. We divided the patients into two groups according to the presence of fQRS appearance within 48 h: absence of fQRS in any lead (fQRS-), and its presence in two or more contiguous leads (fQRS+). All patients were evaluated with transthoracic echocardiography at admission, and at follow-up 6 and 12 months later. Results A total of 138 consecutive patients were included in the study. Seventy-three patients (52.9%) had fQRS in the ECG. EF recovery in the fQRS(+) group was significantly lower than that of the fQRS(-) group (39% vs. 43.9%,P< 0.001). Multiple logistic regression analysis showed that the fQRS (odds ratio: 4.147, 95% confidence interval: 1.607-10.697,P= 0.003) were an independent predictor of poor EF recovery. Conclusion The presence of fQRS is an independent predictor for inadequate EF recovery in acute anterior STEMI patients undergoing thrombolytic treatment. Assessment of fQRS on surface ECG may be used in determining high-risk patients for poor EF recovery after acute anterior STEMI.Öğe Relationship between SYNTAX score and myocardial viability in ischemic cardiomyopathy(Turkish Soc Cardiology, 2019) Ozturk, Semi; Gurbuz, Ahmet Seyfeddin; Kirma, CevatObjective: The SYNTAX score (SS) is not just a measure of the severity of coronary artery disease, but also complexity. The aim of this study was to evaluate the relationship between the SS and myocardial viability/non-viability assessed by positron emission tomography (PET) in patients with ischemic cardiomyopathy (IC). Methods: A total of 107 IC patients who had undergone PET were enrolled in the study. The patients were divided into two groups according to the presence or absence of viable myocardium. SS was analyzed from recorded conventional coronary angiographies. Results: Patients with a non-viable myocardium (n=21; 19.6%) had a significantly higher SS compared to those with a viable myocardium (17.6 +/- 3.7 vs. 14.1 +/- 5.2, respectively; p=0.004). Point-biserial correlation coefficient analysis indicated that the presence of myocardial non-viability was mildly correlated with a higher SS (rpb=-0.28, p=0.004). In multivariate logistic regression analysis, the SS was identified as the sole independent predictor of myocardial non-viability (odds ratio [OR]: 1.164, 95% confidence interval [CI]: 1.044-1.297; p =0.006]. Receiver operating characteristic analysis revealed a cutoff point of 16 for predicting a non-viable myocardium (area under curve: 0.71, 95% CI: 0.61-0.82) with a sensitivity of 76.2% and a specificity of 61.6%. Conclusion: The results of the present study indicates that a high SS is associated with the presence of a non-viable myocardium in IC patients.Öğe Serum Heparanase Level Is Decreased in Stable Coronary Artery Disease(Karger, 2019) Gurbuz, Ahmet Seyfeddin; Ozturk, Semi; Efe, Suleyman Cagan; Yilmaz, Mehmet Fatih; Yanik, Raziye Ecem; Yaman, Ali; Kirma, CevatObjective: Heparanase (HPA), mammalian endo-beta-D-glu-cu-ronidase, separates heparan sulfate chains of proteoglycans and changes the structure of the extracellular matrix. We investigated whether serum levels of HPA differ in patients with stable coronary artery disease (SCAD) and subjects with normal coronary arteries. Methods: This study enrolled 92 patients with SCAD and 34 controls with normal coronary arteries. Levels of HPA were measured by a commercially available human HPA enzyme-linked immunosorbent assay kit. Results: Serum HPA levels were significantly lower in the SCAD group (137.5 [104.1-178.9] vs. 198.8 [178.2-244.9] pg/mL; p < 0.001). Serum HPA levels were significantly higher in subjects with diabetes mellitus (DM) compared to those without DM (p = 0.008). Levels of HPA were lower in the SCAD group, both in the diabetic and nondiabetic subgroups, as compared to controls (p < 0.001 for both subgroups). Levels of HPA positively correlated with fasting blood glucose (FBG) (r: 0.42; p < 0.001). In multiple logistic regression analysis, serum HPA level (odds ratio [OR]: 0.975; 95% confidence interval [CI]: 0.966, 0.985; p < 0.001) and FBG (OR: 1.028; 95% CI: 1.010, 1.047; p = 0.002) were independently associated with SCAD. The receiver operating characteristic curve showed that HPA levels less than 160.6 pg/mL predicted SCAD with 65% sensitivity and 97% specificity (AUC: 0.80; 95% CI: 0.728, 0.878; p < 0.001). Conclusion: Diabetes and FBG levels were closely associated with serum levels of HPA. Low serum levels of HPA may predict SCAD in both diabetic and nondiabetic populations.
