Süleyman Özbiçer

Background: The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance. We aimed to investigate the relationship between the TyG index and aortic intima-media thickness (IMT) in individuals without diabetes mellitus and atherosclerotic cardiovascular disease undergoing transoesophageal echocardiography due to suspected structural heart disease. Methods: One hundred twenty-two patients enrolled in the study between January 2021 and June 2021. Patients were divided into two groups according to their median IMT; patients with an IMT equal to or less than 1.42 mm were low IMT group, and higher than 1.42 mm were high IMT group. Triglyceride-glucose index were higher in the high IMT group (8.69 ± 0.59 vs. 8.37 ± 0.53, p = .003). Results: Triglyceride-glucose index was correlated with IMT ( r = 0.259, p = .005) and in binary logistic regression analysis age and TyG was independently associated with having high IMT ( β = 0.076, exp(B)=1.079 95%CI = 1.041–1.118, p < .001 and β = 0.847, exp( B)= 2.334 95%CI= 1.048–5.199, p = .038, respectively). Conclusion: We found an independent relationship between TyG and IMT of the thoracic aorta, an early marker of subclinical atherosclerosis in patients without known atherosclerotic cardiovascular disease or diabetes. Therefore, the TyG index can identify high-risk subjects in the general population.

Background: Subclinical atherosclerosis develops in the thoracic aorta early in life. Insulin resistance is a well-established risk factor for the development of atherosclerosis. The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance regardless of glucose tolerance or obesity. We aimed to investigate the relationship between the TyG index and aortic intima-media thickness (IMT) in patients without diabetes mellitus and cardiovascular disease undergoing transesophageal echocardiography due to suspected structural heart disease.Methods: One hundred twenty-two patients enrolled in the study between January 2021 and June 2021. Triglyceride-glucose index was calculated using fasting laboratory parameters, and major cardiovascular risk factors and IMT of the thoracic aorta were recorded. Patients were divided into two groups according to their median IMT; patients with an IMT equal to or less than 1.42 mm were low IMT group, and higher than 1.42 mm were high IMT group.Results: Triglyceride-glucose index were higher in the high IMT group (8.69 ± 0.59 vs. 8.37 ± 0.53, p= 0.003). Triglyceride-glucose index was correlated with IMT (r=0.259, p=0.005) and in binary logistic regression analysis age and TyG was independently associated with having high IMT (β = 0.076, exp(B)=1.079 95%CI = 1.041 – 1.118, p<0.001 and β=0.847, exp(B)= 2.334 95%CI= 1.048- 5.199, p=0.038, respectively)Conclusion: We found an independent relationship between TyG and IMT of the thoracic aorta, an early marker of subclinical atherosclerosis in patients without atherosclerotic cardiovascular disease. Therefore, the TyG index can identify high-risk subjects among healthy subjects.

Background and Aims: Subclinical atherosclerosis begins to develop in the thoracic aorta early in life. Insulin resistance is a well-established risk factor for the development of atherosclerosis. The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance regardless of glucose tolerance or obesity. We aimed to investigate the relationship between the TyG index and aortic intima-media thickness (IMT) in patients without diabetes mellitus and cardiovascular disease undergoing transesophageal echocardiography due to suspected structural heart disease.Methods: One hundred twenty-two patients enrolled in the study between January 2021 and June 2021. Triglyceride-glucose index was calculated using fasting laboratory parameters, major cardiovascular risk factors and IMT of the thoracic aorta were recorded. Patients were divided into two groups according to their median IMT; patients with an IMT equal to or less than 1.42 mm were low IMT group, and higher than 1.42 mm were high IMT group.Results: Triglyceride-glucose index were higher in the high IMT group (8.69 ± 0.59 vs. 8.37 ± 0.53, p= 0.003). Triglyceride-glucose index was correlated with IMT (r=0.259, p=0.005) and in binary logistic regression analysis age and TyG was independently associated with having high IMT (β = 0.091, exp(B)=1.095 95%CI = 1.041 – 1.152, pConclusion: We found an independent relationship between TyG and IMT of the thoracic aorta, an early marker of subclinical atherosclerosis in patients without atherosclerotic cardiovascular disease. Therefore, the TyG index can be used to identify high-risk subjects among healthy subjects.

Aim: We investigated the relationship between thrombolysis in myocardial infarction (TIMI) thrombus grade and thiol/disulfide levels. Materials & methods: 182 non-ST elevation myocardial infarction...

Purpose: The aim of this study was to investigate the diagnostic value of ischemia modified albumin (IMA) in early non-ST elevation myocardial infarction (NSTEMI) patients diagnosed with high-sensitive cardiac troponin (hs-cTn)assays. Materials and Methods: In the first three hours of symptom onset, one hundred sixty-two patients without cardiovascular disease history admitted to our hospital with NSTEMI were enrolled between March 2018 and August 2019. The patients' IMA levels were compared with IMA levels of randomly selected, age and the sex-matched control group comprised of 61 subjects with normal coronary angiography results. Results: IMA levels of NSTEMI patients were higher than the control group. In receiver operating characteristic (ROC) curve analysis, a value equal or greater than 0.3855 ABSU has an 82% sensitivity and a 99.4% specificity for diagnosing NSTEMI (AUC: 0.962, 95% CI: 0.937 – 0.986,). In addition, ROC curve analysis revealed moderate predictive power for distinguishing three-vessel disease (cut-off value: 0.4290 ABSU, sensitivity 78.4% and specificity 56.3%, AUC: 0.696, 95% CI: 0.616 – 0.776,). IMA levels were positively correlated with Gensini scores of the patient group. Conclusion: Ischemia-modified albumin, when used alone, was very useful in distinguishing NSTEMI from non-ischemic controls. Besides, IMA levels were positively correlated with CAD severity. Amaç: Bu çalışmada yüksek duyarlılığa sahip kardiyak troponin (hs-cTn) testleri ile tanı konulan erken dönem ST yükselmesiz miyokard infarktüsü (NSTEMI) hastalarında iskemi modifiye albümin (İMA) 'nın tanısal değerini araştırmayı amaçladık. Gereç ve Yöntem: Mart 2018 ve Ağustos 2019 tarihleri arasında hastanemize NSTEMI ile başvuran kardiyovasküler hastalık öyküsü olmayan 126 hasta kaydedildi. Hastaların IMA düzeyleri rastgele seçilen, yaş ve cinsiyet eşleştirilmiş koroner anjiyografi sonuçları normal olan 61 deneğin IMA düzeyleri ile karşılaştırıldı. Bulgular: NSTEMI hastalarının IMA seviyeleri kontrol grubuna göre daha yüksekti. İşlem karakteristiği (ROC) eğri analizinde, 0,3855 ABSU' ya eşit veya daha büyük bir değer, NSTEMI tanısı için %82 duyarlılığa ve%99,4 özgülüğe sahiptir (EAA: 0,962, %95 CI: 0,937 – 0,986). Ek olarak, ROC eğrisi analizi, üç damar hastalığını ayırt etmek için orta düzeyde tahmin gücü ortaya koydu (sınır değeri: 0,4290 ABSU, duyarlılık %78,4 ve özgüllük %56,3, EAA: 0,696, %95 CI: 0,616 – 0,776). İMA düzeyleri ile hasta grubunun Gensini puanları arasında pozitif korelasyon vardı. Sonuç: İskemi modifiye albümin tek başına kullanıldığında, NSTEMI' yi iskemik olmayan kontrollerden ayırt etmede oldukça yararlı olmuştur. Ayrıca, IMA seviyeleri KAH şiddeti ile pozitif korelasyon gösteriyordu.

The coronavirus 19 pandemic causes heavy strain on the healthcare systems of countries worldwide. During the pandemic, fear of contracting the infection made the patients with cardiovascular complaints refrain from hospital admittance. This resulted in severe mechanical complications of myocardial infarction. In our hospital we had two ventricular septal ruptures (VSR) as a complication of late admitted inferior myocardial infarction. Having two VSR cases within three days was unusual for us due to the decreased incidence of VSR in the primary PCI era. However, two cases is not enough to reach the conclusion that mechanical complications of myocardial infarction increased during the pandemic, similar case reports from different countries and statements of senior interventional cardiologists support this assertion

Background: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct-related artery (IRA) patency before percutaneous coronary intervention (PCI) is known to be a strong pre­dictor of improved clinical outcome. Aim: We aimed to investigate the effects of chronic statin treatment before admission on IRA patency after myocardial infarction. Methods: In this study, 938 ST elevation myocardial infarction (STEMI) patients admitted to the hospital within the first 12 h of symptom onset were prospectively enrolled (male, n = 682; female, n = 256; mean age 58.6 ± 12.4 years). All patients underwent emergent primary PCI. Patients were divided into two groups based upon angiographic IRA patency. Impaired IRA patency was defined as Thrombolysis In Myocardial Infarction (TIMI) grade 0 and 1 flow (non-patent IRA group). Angiographic IRA patency was defined as TIMI 2 and 3 flow (patent IRA group). Results: Previous statin usage was more frequent in the patent IRA group (n = 138; 71.9%), than in the non-patent IRA group (n = 110; 14.7%; p < 0.001). Pre-PCI IRA patency was independently associated with body mass index (odds ra­tio [OR] = 1.087, 95% confidence interval [CI] 1.005–1.176, p < 0.001), previous chronic statin use (OR 0.065, 95% CI 0.043–0.098, p = 0.039), ejection fraction (OR 1.041, 95% CI 1.018–1.064, p < 0.001), and SYNTAX score (OR 0.927, 95% CI 0.899–0.957, p < 0.001) in multivariate logistic regression analysis. Conclusions: Chronic pre-treatment with statins is a significant predictor of the IRA patency in patients with STEMI. Background: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct-related artery (IRA) patency before percutaneous coronary intervention (PCI) is known to be a strong pre­dictor of improved clinical outcome. Aim: We aimed to investigate the effects of chronic statin treatment before admission on IRA patency after myocardial infarction. Methods: In this study, 938 ST elevation myocardial infarction (STEMI) patients admitted to the hospital within the first 12 h of symptom onset were prospectively enrolled (male, n = 682; female, n = 256; mean age 58.6 ± 12.4 years). All patients underwent emergent primary PCI. Patients were divided into two groups based upon angiographic IRA patency. Impaired IRA patency was defined as Thrombolysis In Myocardial Infarction (TIMI) grade 0 and 1 flow (non-patent IRA group). Angiographic IRA patency was defined as TIMI 2 and 3 flow (patent IRA group). Results: Previous statin usage was more frequent in the patent IRA group (n = 138; 71.9%), than in the non-patent IRA group (n = 110; 14.7%; p < 0.001). Pre-PCI IRA patency was independently associated with body mass index (odds ra­tio [OR] = 1.087, 95% confidence interval [CI] 1.005–1.176, p < 0.001), previous chronic statin use (OR 0.065, 95% CI 0.043–0.098, p = 0.039), ejection fraction (OR 1.041, 95% CI 1.018–1.064, p < 0.001), and SYNTAX score (OR 0.927, 95% CI 0.899–0.957, p < 0.001) in multivariate logistic regression analysis. Conclusions: Chronic pre-treatment with statins is a significant predictor of the IRA patency in patients with STEMI.

Aim: The correct estimation of the VA origin as RVOT or LVOT results in reduced ablation duration reduced radiation exposure and decreased number of vascular access. In our study, we aimed to detect the predictive value of S-R difference in V1-V2 for differentiating the left from right ventricular outflow tract arrhythmias.

Objective: We aimed to investigate the relationship between the morning blood pressure (BP) surge and arterial stiffness in patients with newly diagnosed hypertension. Subjects and methods: Three hundred and twenty four (mean age 51.7 ± 11.4 years) patients who had newly diagnosed hypertension with 24 h ambulatory BP monitoring were enrolled. Parameters of arterial stiffness, pulse wave velocity and augmentation index (Aix) were measured by applanation tonometry and aortic distensibility was calculated by echocardiography. Results: Compared with the other groups, pulse wave velocity, day–night systolic BP (SBP) difference (p < 0.001, for all) and hs-CRP (p = 0.005) were higher in morning BP surge high group. Aortic distensibility values were significantly lower in morning BP surge high group compared to the other groups (p < 0.05, for all). Morning BP surge was found to be independently associated with pulse wave velocity (β = 0.286, p < 0.001), aortic distensibility (β= −0.384, p < 0.001) and day–night SBP difference (β = 0.229, p < 0.001) in multivariate linear regression analysis. Conclusions: We found independent relationship between morning BP surge and arterial stiffness which is a surrogate endpoint for cardiovascular diseases. The inverse relationship between morning BP surge and aortic distensibility and direct relation found in our study is new to the literature.