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Author: search.filters.author.Karabulut, Ahmet

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Now showing 1 - 7 of 7
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    Impact of coronary collateral circulation and severity of coronary artery disease in the development of postoperative atrial fibrillation
    (OXFORD UNIV PRESS, 2014-01-01) Sahin, Irfan; Ozkaynak, Berk; Karabulut, Ahmet; Avci, Ilhan Ilker; Okuyan, Ertugrul; Mert, Bulent; Avsar, Murat; Turna, Fahrettin; Kayalar, Nihan; Erentug, Vedat; Dinckal, Mustafa Hakan
    OBJECTIVES: Atrial fibrillation (AF) after cardiac surgery has been reported to be approximately 30\%, making it one of the most important causes of morbidity and mortality post surgery. Although various clinical and laboratory predictors and underlying mechanisms progressing to postoperative AF have been proposed, the role of ischaemia in pathogenesis is doubtful. In this study, the association of coronary collateral circulation (CCC) and severity of coronary artery disease (CAD) with the development of postoperative AF was investigated. METHODS: A total of 597 patients who underwent on-pump coronary artery bypass surgery were included in the study. Pre-, peri-and postoperative variables were recorded in a computerized database. CCC and severity of CAD were documented for each patient according to Rentrop classification and Gensini score. RESULTS: Postoperative AF was observed in 96 patients (16.1\%). Advanced age, female gender, presence of hypertension and low haematocrit level were significantly associated with postoperative AF. By contrast, CCC and severity of CAD were not associated with postoperative AF (P = 0.22 and 0.5, respectively). Older age and lower preoperative haematocrit levels were the major predictors of postoperative AF development in the multivariate regression analysis. CONCLUSIONS: CCC and severity of CAD did not have a significant effect on the occurrence of postoperative AF, suggesting an ineffective role of myocardial ischaemia in the development of this condition.
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    Association Between History of Polymerase Chain Reaction-verified COVID-19 Infection and Outcomes of Subsequent ST-Elevation Myocardial Infarction
    (SAGE PUBLICATIONS INC, 2023-01-01) Dogan, Zeki; Erden, Ismail; Bektasoglu, Gokhan; Karabulut, Ahmet
    While the acute phase of coronavirus disease 2019 (COVID-19) is associated with worsening cardiac outcomes, it is unclear whether it affects the outcome of patients with ST-segment elevation myocardial infarction (STEMI) after the acute phase. In addition, while many studies compared the course of STEMI during the COVID-19 pandemic with the years before the outbreak, we evaluated the course of STEMI during the pandemic according to whether or not patients had history of COVID-19. Patients diagnosed with STEMI during the ongoing COVID-19 pandemic were included in the study. The Ministry of Health database was analyzed retrospectively, and patients with (n = 191) and without (n = 127) a history of polymerase chain reaction (PCR) confirmed COVID-19 infection were divided into groups. Clinical and angiographic characteristics were assessed. The rates of in-hospital major adverse cardiac events (MACE) were higher in those who had a history of PCR-verified COVID-19 infection. Angiographic and procedural findings indicating successful reperfusion were better in patients without a history of COVID-19. A history of COVID-19 infection (odds ratio 1.40, 95\% confidence interval 1.25-1.60, P < .01) independently predicted MACE. A history of COVID-19 infection is a predictor of worse outcomes following coronary intervention and in-hospital MACE among patients with STEMI.
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    Rational guidewire use in the coronary chronic total occlusion interventions
    (SPRINGER, 2020-01-01) Karabulut, Ahmet; Gorgulu, Sevket; Kocagoz, Tanil
    Background: Procedures for coronary chronic total occlusion (CTO) are still a clinical challenge with relatively lower success rates. Recent advances in the biotechnology and introduction of CTO-dedicated guidewires have increased the procedural success rate of CTO interventions. Herein, we aimed to reveal the clinical and angiographic predictors of the crossability of the initial guidewire choice and rational guidewire usage in CTO interventions. A total of 177 patients with an indication for a coronary CTO procedure were included in this study. The use of 1-3 guidewires and crossing of the CTO lesion with the initial guidewire choice was defined as rational guidewire usage. The CTO lesions were classified according to the Japanese chronic total occlusion registry (J-CTO) and EuroCTO scores for evaluating the difficulty of the procedures. Then, a statistical analysis was performed to assess the initial guidewire choice, crossability, and contributors to rational guidewire usage. Results: The mean J-CTO score was 1.42 +/- 1.16, and the mean EuroCTO score was 1.44 +/- 1.18. The success rate of the procedures was 90.4\%. The initial guidewire choice crossed the lesion in 44.1\% of the cases, in which 1-3 guidewires were used (82.1\%). The crossability of the polymeric and moderate stiff tip guidewires was higher (82.1\% and 64.1\%, respectively), and the Pilot series was the most successful brand (36.2\%). Logistic regression analysis confirmed that J-CTO score, procedural technique, guidewire type, and stiffness of the tip were the major predictors of rational guidewire usage. Conclusion: Our analysis showed that the use of polymeric and moderate stiff tip guidewires, particularly the Pilot brand, were associated with rational guidewire usage in easy and intermediate difficulty CTO cases.
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    Cutting balloon use may ease the optimal apposition of bioresorbable vascular scaffold in in-stent stenosis
    (TERMEDIA PUBLISHING HOUSE LTD, 2015-01-01) Karabulut, Ahmet; Demirci, Yasemin
    Bioresorbable vascular scaffolds (BVS) have different mechanical properties as compared to metallic stents. Therefore, the standard procedural technique to achieve appropriate deployment may differ. Utilisation of debulking techniques, including cutting balloon and directional atherectomy prior to BVS deployment, is still questionable. Herein, we discuss a case of coronary in-stent restenosis and reveal the advantage of predilatation of the lesion with cutting balloon prior to BVS deployment.
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    Treatment strategies in the left main coronary artery disease associated with acute coronary syndromes
    (ELSEVIER SCIENCE BV, 2015-01-01) Karabulut, Ahmet; Cakmak, Mahmut
    Significant left main coronary artery (LMCA) stenosis is not rare and reported 3 to 10\% of patients undergoing coronary angiography. Unprotected LMCA intervention is a still clinical challenge and surgery is still going to be a traditional management method in many cardiac centers. With a presentation of drug eluting stent (DES), extensive use of IVUS and skilled operators, number of such interventions increased rapidly which lead to change in recommendation in the guidelines regarding LMCA procedures in the stable angina (Class 2a recommendation for ostial and shaft lesion and class 2b recommendation for distal bifurcation lesion). However, there was not clear consensus about the management of unprotected LMCA lesion associated with acute myocardial infarction (MI) with a LMCA culprit lesion itself or distinct culprit lesion of other major coronary arteries. Surgery could be preferred as an obligatory management strategy even in the high risk patients. With this review, we aimed to demonstrate treatment strategies of LMCA disease associated with acute coronary syndrome, particularly acute myocardial infarction (MI). In addition, we presented a short case series with LMCA lesion and ST elevated acute MI in which culprit lesion placed either in the left anterior descending artery or circumflex artery. We reviewed the current medical literature and propose simple algorithm for management. (C) 2015 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.
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    The Role of Microbiologic Agents in the Progression of the Atherosclerosis: a Comprehensive Review
    (DIGITAL COMMONS BEPRESS, 2020-01-01) Karabulut, Ahmet
    Atherosclerosis is a leading cause of disability, morbidity and mortality in the world. Atherosclerosis is accepted as a chronic progressive inflammatory disease. The inflammatory cascade in the vascular wall is well-defined. However, the predictors and contributors of the inflammatory response in atherosclerosis are not completely understood. Systemic and local inflammation, which enhance the burden of inflammation in the vascular wall, have been proposed as risk factors for the progression of atherosclerosis. Infectious micro-organisms are one of the major triggering factors for local and systemic inflammation. In this review, we aimed to emphasize the linkage between micro-organisms and the progression of atherosclerosis. We briefly summarize the current medical literature and discuss the future perspectives of the linkage between microbial agents and atherosclerosis representing cause and effect.