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    A Case of Acute Coronary Syndrome Under Immunosuppression Who is the Criminal Neutrophils or T Cells?
    (Emergency Medicine Physicians Assoc Turkey, 2022) Oktay, Irem; Sertdemir, Ahmet Lutfu; Icli, Abdullah
    Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent, life-threatening bacterial and fungal infections of the skin, airways, lymph nodes, liver, brain, and bones. These infections most commonly occur in organs in contact with the outside world (lungs, gastrointestinal tract, and skin), as well as in lymph nodes that drain these structures. While involvement can be seen in many organs, there is no known cardiovascular involvement. Our case is an ACS case that has a different place in the literature because acute coronary syndrome (ACS) was seen in a twenty years old male patient with a diagnosis of chronic granulomatous disease.
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    Is Computed Tomography the Gold Standard in Aortic Dissection?
    (Emergency Medicine Physicians Assoc Turkey, 2020) Tatar, Sefa; Icli, Abdullah; Akilli, Hakan; Gormus, Niyazi; Sertdemir, Ahmet Lutfu
    Introduction: Aortic dissection is a disease with high mortality, which is characterized by a tear in the aortic wall. Thanks to early diagnosis and treatment, patients' survival rates are high. Chest pain is the most common symptom. Imaging methods help in diagnosis. Its treatment is surgery. Case Report: A 47-year-old male patient was admitted to the emergency department with chest pain. The diagnosis of aortic dissection in computed tomography was evaluated as motion artifact and valve motion, and he was asked to be discharged from the emergency service after his diagnosis was missed. However, transesophageal echocardiography was performed because of the patient's clinical symptom and echocardiographic findings supported the aortic dissection. When a dissection flap was seen in transesophageal echocardiography, the patient was transferred to surgery. In surgery, a dacron graft was placed in the patient's aorta and a prosthetic valve was placed on the aortic valve, and left main coronary repair and right coronary is bypass were performed. The patient was discharged without any problem. Conclusion: Aortic dissection is a clinical diagnosis, it is a disease with high mortality. Imaging methods are helpful in diagnosis, but the fact that imaging methods rule out dissection does not always rule out the disease. The important thing is to suspect the disease and to consider the patient's current clinical symptoms and signs.
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    Liver-Spleen Ratio: Can It Be Used for the Prediction of Coronary Artery Disease?
    (Aves, 2022) Poyraz, Necdet; Ozer, Hakan; Baloglu, Ismail; Kadiyoran, Cengiz; Yilmaz, Pinar Diydem; Sertdemir, Ahmet Lutfu; Turkmen, Kultigin
    Background: Considering that ectopic fat accumulation in various organs, especially the heart and liver, is a cardiometabolic risk factor, the need for easily accessible markers of ectopic fat accumulation is inevitable. The main starting point of the study is based on the hypothesis of predicting cardiovascular disease risk through the link that can be established between the liver-spleen ratio, which is one of the strong indicators of hepatosteatosis, and epicardial adipose tissue volume. Methods: This was a retrospective study. The records of 283 consecutive patients who underwent coronary computed tomography angiography in our Radiology Department were reviewed retrospectively from our hospital's system. All patients' epicardial adipose tissue volume and liver-spleen ratio were calculated using appropriate criteria on non-contrast computed tomography images. Additionally, the Coronary Artery Disease-Reporting and Data System was calculated on contrast computed tomography images. The participating patients were divided into groups according to the liver-spleen ratio and Coronary Artery Disease-Reporting and Data System score. Results: We found that while there was a negative correlation between the liver-spleen ratio and epicardial adipose tissue volume in the hepatosteatosis group, this relationship was not observed in the non-steatosis group. In addition, we observed that the family history of cardiovascular disease and the frequency of cardiovascular disease were higher in the hepatosteatosis group than in the other group, and there was a correlation between cardiovascular disease and the liver-spleen ratio. Also, we found that age and liver- spleen ratio values were found to be independent predictors of coronary artery disease. Conclusion: In our study, we found that the frequency of cardiovascular disease was lower in patients with a high liver-spleen ratio. We also demonstrated in the study that the liver-spleen ratio, which indicates a low level of epicardial adipose tissue volume accumulation, is an independent predictor of cardiovascular disease. In addition, the use of liver-spleen ratio, which is more valuable than liver attenuation in predicting hepatic steatosis, may be more useful in evaluating the risk of hepatosteatosis-related cardiovascular disease.
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    Prognostic nutritional index and the risk of acute kidney injury in patients with acute coronary syndrome
    (Assoc Medica Brasileira, 2021) Sertdemir, Ahmet Lutfu; Icli, Abdullah; Aribas, Alpay; Tatar, Sefa; Akilli, Nazire Belgin; Alsancak, Yakup; Akilli, Hakan
    OBJECTIVE: Recent studies have linked malnutrition with undesirable outcomes in cardiovascular diseases. However, the underlying mechanism is unknown. Contrast-induced acute kidney injury (CI-AKI) increased cardiovascular mortality after percutaneous coronary intervention (PCI). This study hypothesizes that prognostic nutritional index (PNI) plays a role in the development of CI-AKI in patients with acute coronary syndrome undergoing emergency PCI. METHODS: This study enrolled 551 patients. PNI was determined as 10x serum albumin (g/dL)+0.005xtotal lymphocyte count (mm(3)). CI-AKI was characterized as the increase in serum creatinine >= 0.3 mg/dL level within 48 h after PCI. Patients were classified as either CI-AKI (+) or CI-AKI (-). RESULTS: CI-AKI has occurred in 72 of 551 patients (13.1%). PNI was significantly lower in the CI-AKI (+) group than in the CI-AKI (-) group (44.4 +/- 6.6 versus 47.2 +/- 5.8, p<0.001, respectively). Multivariate logistic regression analysis showed that PNI [odds ratio, OR: 1.631, 95% confidence interval (CI): 1.168-2.308, p=0.02] and estimated glomerular filtration rate (OR: 3.26, 95%CI 1.733-6.143, p<0.001) were independent risk factors for CI-AKI. CONCLUSIONS: PNI is an independent risk factor for CI-AKI. The development of CI-AKI may be the mechanism responsible for the relationship between poor nutritional status and adverse cardiac events.
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    Prognostic nutritional index and the risk of acute kidney injury in patients with acute coronary syndrome
    (Assoc Medica Brasileira, 2021) Sertdemir, Ahmet Lutfu; Icli, Abdullah; Aribas, Alpay; Tatar, Sefa; Akilli, Nazire Belgin; Alsancak, Yakup; Akilli, Hakan
    OBJECTIVE: Recent studies have linked malnutrition with undesirable outcomes in cardiovascular diseases. However, the underlying mechanism is unknown. Contrast-induced acute kidney injury (CI-AKI) increased cardiovascular mortality after percutaneous coronary intervention (PCI). This study hypothesizes that prognostic nutritional index (PNI) plays a role in the development of CI-AKI in patients with acute coronary syndrome undergoing emergency PCI. METHODS: This study enrolled 551 patients. PNI was determined as 10x serum albumin (g/dL)+0.005xtotal lymphocyte count (mm(3)). CI-AKI was characterized as the increase in serum creatinine >= 0.3 mg/dL level within 48 h after PCI. Patients were classified as either CI-AKI (+) or CI-AKI (-). RESULTS: CI-AKI has occurred in 72 of 551 patients (13.1%). PNI was significantly lower in the CI-AKI (+) group than in the CI-AKI (-) group (44.4 +/- 6.6 versus 47.2 +/- 5.8, p<0.001, respectively). Multivariate logistic regression analysis showed that PNI [odds ratio, OR: 1.631, 95% confidence interval (CI): 1.168-2.308, p=0.02] and estimated glomerular filtration rate (OR: 3.26, 95%CI 1.733-6.143, p<0.001) were independent risk factors for CI-AKI. CONCLUSIONS: PNI is an independent risk factor for CI-AKI. The development of CI-AKI may be the mechanism responsible for the relationship between poor nutritional status and adverse cardiac events.
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    A Rare Cause of Pulmonary Embolism: Lead Fracture in an Unexpected Area
    (Erciyes Univ Sch Medicine, 2024) Sahin, Ahmet Taha; Alsancak, Yakup; Sertdemir, Ahmet Lutfu; Gezer, Mertcan
    Background: Cardiac pacemakers are increasingly used in clinical cardiology practice for various indications. Lead fractures, though undesirable, are potential complications in patients with pacemakers.Case Report: We present a case of a patient with a cardiac pacemaker, in whom a lead fracture was discovered during an investigation for the etiology of pulmonary embolism.Conclusion: Cardiac pacemakers are invaluable in clinical practice. However, complications related to lead fractures can lead to additional clinical challenges in patients. Vigilance for such scenarios is crucial in the management of patients with pacemakers.
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    A Rare Cause of Pulmonary Embolism: Lead Fracture in an Unexpected Area
    (Erciyes Univ Sch Medicine, 2024) Sahin, Ahmet Taha; Alsancak, Yakup; Sertdemir, Ahmet Lutfu; Gezer, Mertcan
    Background: Cardiac pacemakers are increasingly used in clinical cardiology practice for various indications. Lead fractures, though undesirable, are potential complications in patients with pacemakers.Case Report: We present a case of a patient with a cardiac pacemaker, in whom a lead fracture was discovered during an investigation for the etiology of pulmonary embolism.Conclusion: Cardiac pacemakers are invaluable in clinical practice. However, complications related to lead fractures can lead to additional clinical challenges in patients. Vigilance for such scenarios is crucial in the management of patients with pacemakers.
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    Telltale termination of an A-on-V tachycardia with two blocked atrial activations: What is the mechanism?
    (Wiley, 2021) Deveci, Bulent; Kara, Meryem; Sertdemir, Ahmet Lutfu; Bastug, Serdal; Korkmaz, Ahmet; Ozeke, Ozcan; Cay, Serkan
    The termination of tachycardia may provide important clues toward the mechanism of the tachycardia and that close vigilance may clinch the diagnosis before proceeding to other pacing maneuvers.