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    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, Cevat
    Objective: 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.
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    Relationship between SYNTAX score and myocardial viability in ischemic cardiomyopathy
    (Turkish Soc Cardiology, 2019) Ozturk, Semi; Gurbuz, Ahmet Seyfeddin; Kirma, Cevat
    Objective: 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.
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    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, Cevat
    Objective: 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.