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   2018| October-December  | Volume 4 | Issue 4  
    Online since November 27, 2018

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Predictive values of inflammatory cell ratios for complexity of coronary artery disease in patients with acute coronary syndrome
Ahmet Karakurt, Cennet Yildiz
October-December 2018, 4(4):70-76
Background: The aim of this study was to investigate the relationship between neutrophil to lymphocyte ratio (NLR) platelet to lymphocyte ratio (PLR), mean platelet volume to lymphocyte ratio (MPVLR), MPV to platelet ratio (MPVPR) and the complexity of coronary artery disease (CCAD) in patients with acute coronary syndrome (ACS) using the SYNTAX score (SS) algorithm. Materials and Methods: A total of 599 patients with ACS undergoing coronary arteriography were enrolled and divided into three groups according to their SS: low SS group ≤22 (low-SSG,); intermediate SSG ≥23 and ≤32 (in-SSG,); and high- SSG ≥33 (high-SSG). Routine complete blood count parameters were analyzed at hospital admission. Results: There were significant differences between three groups in terms of PLR and MPVLR values (P = 0.007 and P = 0.029). Correlation analysis showed that PLR and MPVLR were positively correlated with CCAD (r = 0.095, P = 0.018 and r = 0.112, P = 0.005, respectively). In multivariate logistic regression analysis, MPVLR was not an independent predictor of CCAD, whereas PLR was found to be a weak independent predictor of CCAD (odds ratio = 1.003 [1.001–1.006], P = 0.021). Receiver operating characteristics analysis showed that PRL had low sensitivity (56.2%) and specificity (51.6%) for prediction of CCAD. Conclusion: Our study showed that NLR, MPVPR, and MPVLR were not independent predictors of CCAD in patients with ACS. PLR had such a weak relationship with CCAD that it could not be used for prediction of CCAD in these patients.
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Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
Salih Kilic, Ahmet Çelik, Ali Sabri Seyis, Ozge Kurmus, Kamil Tülüce, Zeynep Yapan Emren, Ali Kemal Kalkan, Mehdi Zoghi
October-December 2018, 4(4):86-89
Background: In the present study, we aimed to evaluate the factors that might be caused by adequate anticoagulation control in patients treated with warfarin for any reason. Methods: The WARFARIN-TR (The Awareness, Efficacy, Safety, and Time in Therapeutic Range of Warfarin in Turkish Population) study included 4987 patients using warfarin between January 1, 2014 and December 31, 2014. Time in therapeutic range (TTR) was calculated according to F. R. Roosendaal's algorithm with linear interpolation. The study population divided into two groups; adequate international normalized ratio (INR) control when TTR ≥70% (Group 1, n = 1068, 21.4%) and inadequate INR control when TTR <70% (Group 2, n = 3919, 78.6%). All demographic and clinic characteristics of the patients were compared to determine possible factors that might be cause adequate warfarin use. Results: The mean age of the study population was 60.7 ± 13.5 years, and there was no significant difference between groups. The mean TTR value of Group 1 was significantly higher than Group 2 (80 ± 8.5 vs. 40.9 ± 17.2; P < 0.001). The traditional cardiovascular risk factors were similar between groups except hypertension (Group 1 51.4% and Group 2 56.4%; P = 0.004) and chronic kidney disease (Group 1 8.3% and Group 2 5.5%; P = 0.001). There were no significant differences between groups regarding bleeding. The awareness of warfarin use was significantly higher in Group 1 patients than Group 2 patients. Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.007; P = 0.014), hypertension (OR, 0.821; P = 0.01), atrial fibrillation (OR, 1.180; P = 0.033), chronic kidney disease (OR, 1.697; P < 0.001), to know warfarin use reason (OR, 1.699; P < 0.001), and know to food-drug interaction with warfarin (OR, 1.583; P < 0.001) were independent predictors of adequate coagulation. Conclusion: Our study demonstrated that a low proportion of patients taking warfarin achieve an adequate TTR in daily practice. Furthermore, the patients with adequate TTR are more aware of warfarin use.
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The predictors of long-term hospitalization in Turkish heart failure population: A subgroup analysis of journey heart failure-TR study: On behalf of journey heart failure-TR investigators
Umit Yasar Sinan, Mehmet Erturk, Erkan Yıldırım, Duygu Koçyiğit, Ilgın Karaca, Faruk Ertas, Ahmet Celik, Fatih Aksoy, Hasan Ali Gumrukcuoglu, Umit Yuksek, Mahir Cengiz, Mehdi Zoghi
October-December 2018, 4(4):82-85
Background: Heart failure (HF) is an important public health problem. We aimed to investigate the predictors of long-term hospitalization in Turkish HF population. Materials and Methods: Journey-HF-TR study is a multicenter, cross-sectional, noninvasive, and observational study that was conducted in intensive care unit (ICU), coronary care unit (CCU), and cardiology wards in seven geographical regions of Turkey. In this subgroup analysis, patients were classified as two groups according to inhospital stay called the patient with the shorter length of stay (S-LOS) (inhospital stay <5 days; S-LOS) and patients with longer LOS (L-LOS) (inhospital stay ≥5 days; L LOS). Results: The study group was consisted of 1606 patients (57.2% male, mean age: 67. 8 ± 13.0 years old). One thousand and thirty seven patients, whom in-hospital stay duration were recorded in case report form, were included in this analysis. There were 487 patients (32.1%) in S LOS group and 1030 patients (67.9%) in L LOS group. In multivariate analysis, correlation was present for NYHA functional capacity, CKD, ACS related HF, right HF, cardiogenic shock, invasive and noninvasive ventilation, and hemodynamic monetarization. The longer inhospital stay increases the probability of morbidity and mortality. Conclusion: We demonstrated that there was positive correlation between longer hospital stay and HF severity (NYHA III-IV), CKD, cardiogenic shock, right ventricular HF, and HF related to ACS. HFpEF patients have less in-hospital stay than HFrEF and HFmrEF patients.
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Comparison of anthropometric indices in predicting the risk of hypertension, Iran - 2014
Hossein Lashkardoost, Fateme Hoseyni, Elham Rabbani, Farzane Qorbani Moqadam, Leila Hosseini, Salimeh Azizi, Andishe Hamedi
October-December 2018, 4(4):77-81
Purpose: The best anthropometric index has not been established to investigate the relationship between hypertension and obesity. Since a similar study was not conducted in Bojnurd, we began to investigate the comparison of anthropometric indices (body mass index, waist circumference, and waist-to-hip and waist-to-height ratios) in predicting the risk of hypertension. Materials and Methods: The present cross-sectional study was conducted on women referring to Bojnurd health centers. For analyzing the data, we used t-test, Chi-square, logistic regression, and the receiver operating characteristic curve in SPSS 19 software. Results: The prevalence of blood pressure was 53.4% (confidence interval = 46.8–60). All four anthropometric indicators were used as a screening tool for hypertension diagnosis; however, body mass index (BMI) had a higher sub-curved surface than other anthropometric indices (area under curve = 0.717). The cutoff point of BMI for predicting the risk of hypertension was 25.6. Conclusions: This study suggested that BMI as an anthropometric indicator to evaluate the risk of hypertension. Since a significant percentage of people are unaware of the existence of hypertension, continuing education is needed to encourage people to pay more attention to this problem.
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Is there a correlation between systolic heart failure and levels of toll-like receptor-5 and N-terminal pro-B-type natriuretic peptide?
Cetin Mirzaoglu, Tarik Kivrak, Mehmet Balin, Mehmet Ali Kobat, Orhan Dogdu, Ilgin Karaca
October-December 2018, 4(4):65-69
Objective: Specific biomarkers are essential in the diagnosis of heart failure. Our trial aim is determined that relationship between toll-like receptor-5 (TLR-5) and N-terminal pro-B-type natriuretic peptide (NT-ProBNP) in patients with reduced ejection fraction. Methods: Two groups were formed in our study (normal and patient group). Among the two groups were investigated that relationship between TLR-5 and NT-ProBNP. Results: The plasma levels of both NT-ProBNP and TLR-5 are significantly higher in patients with congestive heart failure than healthy individuals. However, there is no definite correlation between plasma levels of NT-ProBNP and TLR-5 in patients with congestive heart failure. The high-level plasma TLR-5 is of prognostic value independent from the plasma NT-ProBNP levels, in these patients. Conclusion: As a conclusion, according to recent studies, the high plasma levels of NT-ProBNP and TLR-5 are mainly associated with high mortality and longer hospitalization rate in individuals with heart failure. Therefore, the higher is plasma levels of markers such as TLR-5 and NT-ProBNP, the worse is the overall prognosis in these patients. NT- ProBNP and TLR-5 are thought to be the cheapest and the most appropriate marker to be determined.
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Association of neutrophil to lymphocyte ratio with lower patency rates among patients with infrapopliteal arterial disease undergoing balloon angioplasty
Abdulkadir Uslu, Regayip Zehır, Elnur Alızade, Ayhan Küp, Zubeyde Bayram, Ahmet Guner, Süleyman Barutcu
October-December 2018, 4(4):90-95
Introduction: Percutaneous endovascular methods have emerged to the contemporary revascularization choice in patients with infrapopliteal (IP) arterial disease. However, restenosis remains to be the Achilles' heel of this minimally invasive revascularization techniques. We aimed to analyze the association between preprocedural (neutrophil to lymphocyte ratio) Neutrophil-to-Lymphocyte ratio (NLR) and subsequent patency in a cohort of patients with symptomatic IP disease undergoing balloon angioplasty. Methods: All patients primarily treated with angioplasty of at least one IP artery causing severe symptoms or critical limb ischemia (CLI) (Rutherford category 1–6) between January 2014 and August 2015 were analyzed. The baseline demographic, clinical, and angiographic features admission laboratory test results were obtained from hospital files and computer records. NLR was calculated as the preprocedural ratio of neutrophils to lymphocytes. Results: The study population involved 42 (43.8%) CLI patients and 52 (54.2%) claudicants. The most frequent target vessel was the posterior tibial artery. Primary patency at 1 month was 81.9% and 62.7% at 6 months. NLR (odds ratio: 0.04, P = 0.03) independently predicted patency at 1 month but did not have a role on arterial patency after 1 month. Only smoking (odds ratio: 4.8, P = 0.01) associated with patency at 6 months. Conclusion: Preprocedural NLR was an independent risk factor for IP arterial patency at short-term. It may be used as a risk factor for subsequent amputation or recurrent interventions.
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