Çağlar Alp

OBJECTIVE: We aimed to show the differences in flow-mediated dilatation (FMD) measurements between multiple sclerosis (MS) subgroups and normal control participants.MATERIAL AND METHODS: There were 96 participants (mean age: 42.7 ± 14.1 years) in this study. We grouped the participants as follows: 47 MS patients (mean age: 40.2 ± 12.2 years) and 49 normal control participants (mean age: 45.22 ± 15.27). The MS patients were subclassified as follows: Group 1 – relapsing-remitting multiple sclerosis (RRMS): 37 patients (mean age: 36.9 ± 11.2); Group 2 – secondary progressive multiple sclerosis (SPMS): 5 patients (mean age: 49.0 ± 6.0); and Group 3 – primary progressive multiple sclerosis (PPMS): 5 patients (mean age: 55.4 ± 10.6 years). We used FMD methods for an indirect evaluation of the brachial artery’s reaction to shear stress and peripheral vasodilatory nitric oxide (NO) production capability.RESULTS: There were statistically significant differences between the normal control group and the MS subgroups regarding flow-mediated basal, flow-mediated hyperemia, and FMD ratio values (p = 0.001, p = 0.029, and p = 0.020, respectively). No correlation was found between the expanded disability status scale (EDSS) scores and other measurements after statistically controlling for age and gender factors (p > 0.05).CONCLUSIONS: Our data indicate that FMD measurements decreased more in the MS patients compared to the normal controls. The PPMS group exhibited more severe deterioration with regard to FMD measures than the other groups. FMD ratio values decreased more in the progressive MS groups compared to the normal control and RRMS groups.

Background and Objectives: Systemic inflammation is a key driver in the progression and complexity of coronary artery disease (CAD). Serum calprotectin and the C-reactive protein–triglyceride–glucose index (CTI) have emerged as potential inflammatory and metabolic biomarkers; however, their association with angiographic disease severity has not been clearly defined. This study aimed to evaluate the relationship between serum calprotectin, CTI, and the SYNTAX score (SS) in patients with stable CAD. Materials and Methods: A total of 134 patients undergoing coronary angiography were enrolled. The SS was calculated to quantify coronary lesion complexity. Patients were classified into two groups based on the results of the coronary angiogram: low SS (n = 73, SS < 23), and intermediate–high SS (n = 61, SS ≥ 23). Serum calprotectin, and CTI were obtained at baseline. Correlation analyses were performed to evaluate associations between biomarkers and SS. Receiver operating characteristic (ROC) curve analysis assessed the ability of these biomarkers to predict intermediate–high SS. Univariable and multivariable logistic regression analyses were performed to determine independent associations. Results: Patients with intermediate–high SS had significantly higher levels of serum calprotectin (1009.5 vs. 505.7 ng/mL), and CTI (9.9 vs. 9.5) compared with those with low SS (all p < 0.001). Spearman correlation analysis demonstrated significant positive correlations between SS and, serum calprotectin (ρ = 0.488), and CTI (ρ = 0.453) (all p < 0.001). ROC analysis showed moderate association in respect to intermediate–high SS (0.739 for serum calprotectin, and 0.722 for CTI). In multivariable models, CTI showed the strongest independent association with intermediate–high SS (OR: 4.66, 95% CI: 2.00–10.84, p < 0.001). Conclusions: Serum calprotectin and CTI were significantly associated with coronary lesion complexity, as measured by the SS. These biomarkers may serve as valuable tools for identifying patients with greater CAD severity and anatomical complexity.

Hypertension remains one of the leading preventable contributors to cardiovascular morbidity and mortality worldwide, with its clinical significance extending beyond elevated blood pressure values ...

Background and Objectives: Systemic inflammation is a key driver in the progression and complexity of coronary artery disease (CAD). Serum calprotectin and the C-reactive protein–triglyceride–glucose index (CTI) have emerged as potential inflammatory and metabolic biomarkers; however, their association with angiographic disease severity has not been clearly defined. This study aimed to evaluate the relationship between serum calprotectin, CTI, and the SYNTAX score (SS) in patients with stable CAD. Materials and Methods: A total of 134 patients undergoing coronary angiography were enrolled. The SS was calculated to quantify coronary lesion complexity. Patients were classified into two groups based on the results of the coronary angiogram: low SS (n = 73, SS 23). Serum calprotectin, and CTI were obtained at baseline. Correlation analyses were performed to evaluate associations between biomarkers and SS. Receiver operating characteristic (ROC) curve analysis assessed the ability of these biomarkers to predict intermediate–high SS. Univariable and multivariable logistic regression analyses were performed to determine independent associations. Results: Patients with intermediate–high SS had significantly higher levels of serum calprotectin (1009.5 vs. 505.7 ng/mL), and CTI (9.9 vs. 9.5) compared with those with low SS (all pConclusions: Serum calprotectin and CTI were significantly associated with coronary lesion complexity, as measured by the SS. These biomarkers may serve as valuable tools for identifying patients with greater CAD severity and anatomical complexity.

Chronic total occlusions (CTOs) represent one of the most technically challenging subsets in coronary artery disease interventions, frequently complicated by severe calcification and difficult vessel anatomy. Microcatheters play a crucial role in CTO percutaneous coronary intervention (PCI), but their use can lead to rare complications such as tip entrapment and fracture, especially in calcified lesions. We present a case of microcatheter tip fracture during complex right coronary artery CTO PCI, managed successfully by employing a parallel-wire technique to bypass the fractured segment followed by stent deployment to crush and trap the fragment against the vessel wall. This approach resulted in complete revascularization without adverse events. The case highlights the importance of understanding device limitations, preparing for procedural complications, and utilizing alternative strategies such as the balloon-assisted sliding technique. As coronary calcification prevalence rises, awareness and effective management of such complications are increasingly critical for optimal patient outcomes.

Background: Erectile dysfunction (ED) and acute coronary events are closely linked, yet the trajectory of ED following percutaneous coronary intervention (PCI) remains incompletely understood. The residual SYNTAX score (RSS) quantifies incomplete revascularization and is an established prognostic tool in cardiology; however, its role in erectile function recovery after myocardial infarction (MI) is unclear. Objectives: To evaluate whether RSS predicts recovery of erectile function after MI treated with PCI. Materials and Methods: In this prospective cohort study, 82 men aged 40–70 years who underwent PCI for MI were evaluated. ED was assessed using the International Index of Erectile Function‐5 (IIEF‐5) at baseline (after recovery from PCI, reflecting erectile functions before MI), and at 3 and 6 months. ED was defined as an IIEF‐5 score ≤21. Patients were stratified according to RSS (p < 0.001), but not in those with RSS ≥8 (from 17.2 to 16.3; p = 0.314). While severe ED remained largely unchanged over time, mild‐to‐moderate ED demonstrated the greatest improvement. Anxiety independently predicted ED at 3 months (OR 1.223, p = 0.049). At 6 months, RSS ≥8 independently predicted persistent ED (OR 3.22, p = 0.033), with moderate discriminatory accuracy (AUC 0.72). Conclusion: RSS ≥8 may identify men at increased risk for persistent ED after MI. The differential recovery patterns suggest that reversible functional impairment may predominate in milder forms of ED, whereas persistent severe ED may reflect more extensive systemic and penile vascular disease. Early recognition of anxiety and targeted sexual counseling may support erectile recovery following PCI.

Thrombotic occlusion of the radial artery is the most frequent complication of transradial angiography. This study sought to investigate biomarker-based predictors of radial artery occlusion (RAO) after coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). Consecutive patients who underwent cardiac catheterization through radial artery route for diagnostic or therapeutic purposes were included in the study retrospectively. The clinical, laboratory, and angiographic data were obtained from hospital records. All patients were invited for a follow-up visit one week after discharge and radial artery pulse examination was performed. The patients with reduced or absent radial artery pulse or complaints related with the radial artery intervention site at follow-up visit were examined by a radiologist with superficial Doppler ultrasonography. The patients were categorized according to the patency of the radial artery and there were 46 patients with an occluded radial artery and 204 patients with a patent radial artery after CAG and/or PCI. Platelet count was higher in the occluded artery group than in the patent radial artery group. Creatinine level was lower and estimated glomerular filtration rate (e-GFR) was higher in the occluded radial artery group compared to the patent radial artery group. Multivariate logistic regression analysis showed that platelet count (OR: 1.010, 95%CI: 1.001-1.018, P=0.031) and creatinine (OR:0.030, 95%CI: 0.001-0.821, P=0.038), but not e-GFR (OR: 1.031, 95%CI: 0.991-1.073, P=0.128) were independently associated with RAO. Platelet count and creatinine were found to be independent predictors of RAO after transradial cardiac catheterization.

Amaç: Koroner arter çapları akut koroner sendromlar sırasında kullanılacak stent çapını belirlemek için çok önemlidir. Özellikle osteal lezyonlarda referans alınacak başka bir damar olmaması sorun oluşturmaktadır. Çalışmamızın amacı normal koroner arter yapısına sahip koroner arter hastalığı (obstrüktif veya ektatik koroner arter) olmayan hastalarda, koroner arter çaplarıyla hastaların antropometrik ölçümlerinin korelasyonunu incelemektir. Gereç ve Yöntemler: Retrospektif olarak yürütülen bu çalışmaya koroner anjiografi yapılmış ve anjiografik olarak plak ve ektazi izlenmeyen 102 hasta dahil edildi. Hastalar el bilek çevrelerine göre üç gruba ayrıldı. Hastaların klinik ve anjiografik görüntüleri hastane otomasyon sisteminden değerlendirildi. Bulgular: Bilek çevresi grupları arasındaki değerlendirmede gruplar arasında istatistiksel olarak anlamlı bir fark olduğu izlenmiştir. Sol ana koroner arter, sirkumfleks arter, sol ön inen arter için bilek çevresi çapları ile pozitif korelasyon izlenmiştir. Bilek çevresi ile sol ana koroner çapı arasında r=0.390, p<0.001, sol ön inen arter çapı arasında r=0.244, p=0.013, sirkumfleks arter çapı arasında r=0.303, p=0.002 ve sağ ana koroner çapı arasında r=0.223, p=0.024 pozitif korelasyon olduğu görülmüştür (Spearman, p<0.05). Çalışmamızda elde ettiğimiz sonuçlara göre bilek çevresi 15.5 üstünde olan hastaların %80 inin sol ana koroner arter arter çapı 4.0 mm üzerindedir. Sonuç: Bu çalışmada özellikle, bilek çevresi ile sol ana koroner arter çapı arasında istatistiksel açıdan önemli pozitif korelasyon bulunmuştur. Sol ana koroner arter, osteal lezyonlarında intravasküler ultrasonografi kullanılamayan durumlarda kullanılacak stent boyutunun belirlenmesinde bu pozitif korelasyonun önemli bir özellik olabileceği düşünülmektedir. Daha geniş kapsamlı çalışmalarla bilek çevresi ve sol ana koroner arter çapı arasında bir formülasyon elde edilebilir

Aims: Angiography and interventional treatment modalities in peripheral arterial disease have recently been widely used because they are easier to perform and more comfortable than surgical treatment. Revascularization is the most effective treatment method in cases such as critical leg ischemia in this disease where pharmacological agents are also widely used. In this study, we aimed to investigate interventional treatment methods in peripheral arterial disease in our center. Methods: Patients who underwent peripheral angiography or endovascular intervention in the Cardiology Clinic of Kırıkkale University Medical Faculty Hospital between March 2020 and June 2024 were retrospectively reviewed. Results: A total of 55 patients, including 10 women and 45 men, were included in the study. The mean age of the patients included in the study was 64 years. Of the angiographic procedures, 46 were performed in the lower extremity, 6 in the upper extremity and 3 in the renal arteries. Endovascular treatment were performed in 26 of them. Of the endovascular treatment, 11 were balloon angioplasty and 15 were stent implantation. In 5 patients, peripheral bypass was decided. Conclusion: Interventional treatment of peripheral arterial disease is increasingly and successfully performed in our center.