Browsing by Author "Buturak, Ali"

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Arrhythmias following Revascularization Procedures in the Course of Acute Myocardial Infarction: Are They Indicators of Reperfusion or Ongoing Ischemia?
(HINDAWI LTD, 2013-01-01) Tatli, Ersan; Alicik, Guray; Buturak, Ali; Yilmaztepe, Mustafa; Aktoz, Meryem
Objective. The most important step in the treatment of ST elevation myocardial infarction is to sustain myocardial blood supply as soon as possible. The two main treatment methods used today to provide myocardial reperfusion are thrombolytic therapy and percutaneous coronary intervention. In our study, reperfusion arrhythmias were investigated as if they are indicators of coronary artery patency or ongoing ischemia after revascularization. Methods. 151 patients with a diagnosis of acute ST elevation myocardial infarction were investigated. 54 patients underwent primary percutaneous coronary intervention and 97 patients were treated with thrombolytic therapy. The frequency of reperfusion arrythmias following revascularization procedures in the first 48 hours after admission was examined. The relation between reperfusion arrhythmias, ST segment regression, coronary artery patency, and infarct related artery documented by angiography were analyzed. Results. There was no statistically significant difference between the two groups in the frequency of reperfusion arrhythmias (P = 0.355). Although angiographic vessel patency was higher in patients undergoing percutaneous coronary intervention, there was no significant difference between the patency rates of each group with and without reperfusion arrythmias. Conclusion. Our study suggests that recorded arrhythmias following different revascularization procedures in acute ST elevation myocardial infarction may not always indicate vessel patency and reperfusion. Ongoing vascular occlusion and ischemia may lead to various arrhythmias which may not be distinguished from reperfusion arrhythmias.
Assessment of Mean Platelet Volume in Patients with Resistant Hypertension, Controlled Hypertension and Normotensives
(AVES, 2015-01-01) Surgit, Ozgur; Pusuroglu, Hamdi; Erturk, Mehmet; Akgul, Ozgur; Buturak, Ali; Akkaya, Emre; Gul, Mehmet; Uygur, Begum; Yazan, Serkan; Eksik, Abdurrahman
Objective: Patients with resistant hypertension are at increased risk for cardiovascular events. Mean platelet volume (MPV) is an accepted biomarker of platelet activation and considered as a risk factor for cardiovascular disease. The aim of this study was to determine whether MPV levels are higher in resistant hypertensive (RHTN) patients than in controlled hypertensive (CHTN) patients and healthy normotensive controls. Materials and Methods: 279 consecutive patients were included in this study. Patients were divided into three groups: Resistant hypertension patient group {[}n=78
Assessment of Subclinical Left and Right Ventricular Dysfunction by Using Isovolumic Acceleration in Patients with Dipper and Non-dipper Hypertensives
(2013-01-01) Erturk, Mehmet; Buturak, Ali; Pusuroglu, Hamdi; Kalkan, Ali Kemal; Gurdogan, Muhammet; Uzun, Fatih; Akgul, Ozgur; Aksu, Hale Unal; Akturk, Faruk; Uslu, Nevzat
Comparison of Anti- Embolic Protection with Proximal Balloon Occlusion and Filter Devices During Carotid Artery Stenting: Clinical and Procedural Outcomes
(2013-01-01) Tatli, Ersan; Buturak, Ali; Dogan, Emir; Alkan, Mustafa; Sayin, Murat; Yilmaztepe, Mustafa; Atakay, Selcuk
Comparison of anti-embolic protection with proximal balloon occlusion and filter devices during carotid artery stenting: clinical and procedural outcomes
(TERMEDIA PUBLISHING HOUSE LTD, 2013-01-01) Tatli, Ersan; Buturak, Ali; Grunduz, Yasemin; Dogan, Emir; Alkan, Mustafa; Sayin, Murat; Yilmaztepe, Mustafa; Atakay, Selcuk
Aim: The objective of this study was to compare the periprocedural and clinical outcomes after carotid artery stenting (CAS) with proximal protection devices versus with distal protection devices. Material and methods: Patients with internal carotid artery (ICA) stenosis undergoing CAS with cerebral embolic protection were randomly assigned to proximal balloon occlusion or distal filter protection. Adverse events were defined as death, major stroke, minor stroke, transient ischemic attack (TIA) and myocardial infarction (MI). Periprocedural and 30-day adverse events and ICA vasospasm rates were compared between the two embolic protection groups. Results: Eighty-eight consecutive patients were randomized: 48 patients with proximal protection (mean age 68.8 +/- 13.6, 66\% male) and 40 patients with a distal protection device (mean age 65.4 +/- 12.3
Elective percutaneous coronary intervention leads to significant changes in serum resistin, leptin, and adiponectin levels regardless of periprocedural myocardial injury: an observational study
(AVES, 2016-01-01) Buturak, Ali; Degirmencioglu, Aleks; Bayrak, Fatih; Kiris, Tuncay; Karakurt, Huseyin; Demir, Ali Riza; Surgit, Ozgur; Erturk, Mehmet
Objective: Bioactive roles of adipokines in coronary atherosclerosis and acute coronary syndromes have been demonstrated previously. Ho-wever, there is a lack of data regarding the relationship between serum adipokines and periprocedural myocardial injury (PMI) following elective percutaneous coronary intervention (PCI). Therefore, we aimed to investigate the association between serum adipokines and PMI related to elective PCI. Methods: In total, 153 consecutive patients (aged 60.6 +/- 8.2 years, 98 men) with stable angina pectoris undergoing elective PCI were enrolled in this observational cross-sectional study. Serum resistin, leptin, adiponectin, and high-sensitive Troponin T (hscTnT) levels were measured immediately before PCI and after 12-h PCI. The no-injury, PMI, and type 4a myocardial infarction (type 4a MI) groups were defined as groups consisting patients with post-procedural hscTnT concentrations < 14 ng/L, between 14-70 ng/L, and > 70 ng/L, respectively. Results: Serum hscTnT, resistin, and leptin concentrations significantly (p<0.001) increased while serum adiponectin levels decreased (p<0.001) after 12-h elective PCI. However, no correlation was found between post-procedural hscTnT concentrations and resistin, leptin, and adiponectin levels. The no-injury group consisted of 65 patients (42.4\%), whereas PMI and type 4a MI were observed in 70 (45.8\%) and 18 (11.8\%) patients, respectively. The average pre-procedural and post-procedural resistin, leptin, and adiponectin levels did not show any significant difference in the no-injury, PMI, and type 4a MI groups. Conclusion: There is no correlation between serum adipokine levels and post-procedural troponin elevations reflecting PMI or type 4a MI. However, serum resistin and leptin levels increase, whereas adiponectin levels decrease significantly after elective PCI.
Evaluation of the effects of chronic biomass fuel smoke exposure on peripheral endothelial functions: an observational study
(TURKISH SOC CARDIOLOGY, 2011-01-01) Buturak, Ali; Genc, Ahmet; Ulus, Ozden Sila; Duygu, Egemen; Okmen, Arda Sanli; Uyarel, Huseyin
Objective: To evaluate the effect of chronic biomass fuel (BMF) smoke exposure on peripheral endothelial functions. Methods: Forty-seven healthy subjects who have been exposed to BMF smoke since birth (mean age 31.6 +/- 6.8 years, 21 male) were enrolled in the present cross-sectional observational study. The control group consisted of 32 healthy subjects (mean age 27.9 +/- 4.4 years, 11 male). The carotid intima media thickness (CIMT), flow associated dilatation (FAD \%) and endothelium independent vasodilatation (GTN \%) were assessed in all subjects. The carotid CIMT was defined as the distance between the leading edge of the lumen intima and the media adventitia interfaces. FAD \% was defined as the percentage change in the internal diameter of the brachial artery during reactive hyperemia related to the baseline. GTN \% was defined as the change in diameter in response to the application of 400 mu g of glyceril trinitrate relative to the baseline scan at the end of the fourth minute. Statistical analysis was performed using Student's t-test, Chi-square test and Spearman rank order correlation analysis. Results: The average exposure time of the subjects to biomass fuel smoke was 31.7 +/- 6.6 years. They have been exposed to dung inhalation products meanly 8.3 +/- 1.8 months in a year seasonally. The average daily exposure time was 15.7 +/- 3.3 hours. CIMT values of the two groups were not statistically different from each other (0.47 +/- 0.09 vs. 0.49 +/- 0.06 mm, p=0.138). However, a markedly reduced FAD \% was determined in the study group (5.06 +/- 4.95 vs. 10.7 +/- 4.64, p < 0.001). And GTN \% of the BMF exposed group was significantly lower than the control group (14.41 +/- 8.47 vs. 21.85 +/- 7.87, p < 0.001). Conclusion: FAD \% and GTN \% are markedly reduced in the individuals who have been exposed to BMF smoke inhalation products. Therefore, chronic BMF smoke exposure may be a risk factor for the development of endothelial dysfunction. (Anadolu Kardiyol Derg 2011
Miyokard İnfarktüsü Sonrası Hemodinamik Bozukluk Oluşturmayan Kronikleşmiş Sol Ventrikül Psödoanevrizması: Olgu Sunumu
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2012-04-01) Buturak, Ali; Duygu, Egemen
ÖZET Sol ventrikül psödoanevrizması, miyokard enfarktüsünün genellikle akut döneminde hemodinamik bozuklukla birlikte seyreden ciddi bir mekanik komplikasyonudur. Bu yazıda eski anterolateral miyokard infarktüsü son rasında kronik sol ventrikül psödoanevrizması tanısı alan ve hemodinamik bozukluk bulguları olmayan bir olgu sunulmaktadır.
Rise of serum troponin levels following uncomplicated elective percutaneous coronary interventions in patients without clinical and procedural signs suggestive of myocardial necrosis
(TERMEDIA PUBLISHING HOUSE LTD, 2016-01-01) Buturak, Ali; Degirmencioglu, Aleks; Surgit, Ozgur; Demir, Ali Riza; Karakurt, Huseyin; Erturk, Mehmet; Yazici, Selcuk; Serteser, Mustafa; Norgaz, Tugrul; Gorgulu, Sevket
Introduction: The new definition of periprocedural myocardial infarction (type 4a MI) excludes patients without angina and electrocardiographic or echocardiographic changes suggestive of myocardial ischemia even though significant serum troponin elevations occur following percutaneous coronary intervention (PCI). Aim: To evaluate the incidence and predictors of serum troponin rise following elective PCI in patients without clinical and procedural signs suggestive of myocardial necrosis by using a high-sensitivite troponin assay (hsTnT). Material and methods: Three hundred and four patients (mean age: 60.8 +/- 8.8 years, 204 male) undergoing elective PCI were enrolled. Patients with periprocedural angina, electrocardiographic or echocardiographic signs indicating myocardial ischemia or a visible procedural complication such as dissection or side branch occlusion were excluded. Mild-moderate periprocedural myocardial injury (PMI) and severe PMI were defined as post-PCI (12 h later) elevation of serum hsTnT concentrations to the range of 14-70 ng/l and > 70 ng/l, respectively. Results: The median pre-procedural hsTnT level was 9.7 ng/l (interquartile range: 7.1-12.2 ng/l). Serum hsTnT concentration elevated (p < 0.001) to 19.4 ng/l (IQR: 12.0-38.8 ng/l) 12 h after PCI. Mild-moderate PMI and severe PMI were detected in 49.3\% and 12.2\% of patients, respectively. Post-procedural hsTnT levels were significantly higher in multivessel PCI, overlapping stenting, predilatation and postdilatation subgroups. In addition, post-procedural hsTnT levels were correlated (r = 0.340
Subintimal angioplasty and stenting in chronic total femoropopliteal artery occlusions: Early- and mid-term outcomes
(VIA MEDICA, 2015-01-01) Tatli, Ersan; Buturak, Ali; Kayapinar, Osman; Dogan, Emir; Alkan, Mustafa; Gunduz, Yasemin
Background: This study was conducted to evaluate the initial and mid-term patency rates of chronic total femoropopliteal artery (FPA) occlusions treated by subintimal angioplasty (SIA) and stenting. Methods: From March 2010 to February 2013, 74 patients were included in the study. Seventy two patients with total occlusion of the FPA and good distal runoff (2 or 3 patent vessels) were treated with percutaneous SIA and stenting. All patients had severe claudication or critical limb ischemia. In all cases, the procedure was performed with a contralateral approach. Follow-up was done at 6 months with clinical evaluation and color-Doppler. If it was necessary, peripheric angiography was performed. Results: Immediate technical success was achieved in 72 (97\%) patients. Two (3\%) distal embolizations, 2 (3\%) groin hematomas, 1 (1\%) femoral pseudoaneurysm and 1 (1\%) rupture of the junction-external iliac-superficial femoral artery occurred. All of the complications were treated successfully. Total occlusion in 1 patient and critical occlusion in 3 patients were showed at the 6th month. Patency rate at the sixth month was 94\% with a stent length of 13.4 +/- 8.2 cm. Conclusions: Percutaneous SIA and stenting for chronic total of the FPA occlusion showed good initial and mid-term patency rates, with few periprocedural complications.
The Effect of Mild Left Ventricular Diastolic Dysfunction on Outcome After Isolated Coronary Bypass Surgery
(2020-01-01) Degirmencioglu, Aleks; Senay, Sahin; Gullu, Umit; Karakus, Gultekin; Zencirci, Ertugrul; Buturak, Ali; Ugur, Murat; Gemici, Gokmen; Akyol, Ahmet; Celik, Seden Erten; Alhan, Cem
The Long Term Incidence and Predictors of Radial Artery Occlusion Following a Transradial Coronary Procedure
(2013-01-01) Buturak, Ali; Gorgulu, Sevket; Norgaz, Tugrul; Voyvoda, Nuray; Sahingoz, Yusuf; Degirmencioglu, Alex; Demirci, Yasemin; Dagdelen, Sinan
The long-term incidence and predictors of radial artery occlusion following a transradial coronary procedure
(VIA MEDICA, 2014-01-01) Buturak, Ali; Gorgulu, Sevket; Norgaz, Tugrul; Voyvoda, Nuray; Sahingoz, Yusuf; Degirmencioglu, Aleks; Dagdelen, Sinan
Background: Radial artery occlusion (RAO) is an infrequent complication of transradial coronary procedures (TRA). To our knowledge, there is no satisfactory data regarding the late term incidence and predictors of RAO in the literature. Our aim was to establish the long-term incidence of radial artery occlusion and investigate its predictors. Methods: This was a single center prospective study. A total number of 409 consecutive patients undergoing their first TRA were recruited. Clinical and procedural data were all recorded. Doppler ultrasound examination was performed at 6-15 months following the intervention. Results: RAO was detected in 67 patients and 342 patients maintained radial artery patency. The overall RAO incidence was 16.4\% at late term. Patients with RAO were younger than the patients with patent radial arteries (55.9 +/- 9.7 vs. 59.1 +/- 9.4 years, p = 0.014). The incidence of RAO in hypertensive patients (9.8\%) was lower (p < 0.001) than the observed incidence (23\%) in non-hypertensive patients. RAO group had higher rate (28\%, p = 0.027) of post-procedural access site pain. Regression analysis revealed that hypertension was negative while post-procedural access site pain was positive independent predictors for RAO. In addition, the relative risk for RAO also increased significantly (p < 0.001) when the ratio of sheath/artery diameter (S/A) was > 1. Conclusions: The present study reveals that the long-term incidence of RAO is 16.4\%. Hypertension, post-procedural access site pain and S/A ratio > 1 are independent predictors of RAO at late term.