Bakirci, Eftal Murat; Degirmenci, Husnu; Hamur, Hikmet

Degirmenci, Husnu; Bakirci, Eftal Murat

Kalkan, Kamuran; Hamur, Hikmet; Yildirim, Erkan; Ipek, Emrah; Ermis, Emrah; Ozturk, Mustafa; Karal, Huseyin; Korkmaz, Ali Fuat; Bayantemur, Murat; Demirelli, Selami

Syntax score (SS) and Gensini score (GS) are used to determine the complexity and severity of coronary artery disease. Although there are some studies indicating the individual relationship of these scoring systems with the carotid intima–media thickness (cIMT) and epicardial fat tissue (EFT), there was no previous study that compared the SS and GS in that respect. We aimed to assess the relationship of SS and GS with predictors of atherosclerosis. We enrolled 522 patients. There were positive correlations between GS and SS tertiles with cIMT and EFT. According to multivariate linear regression analysis for GS, EFT (β: 0.035, t: 2.63, and P =.49) and cIMT (β: 0.339, t: 2.97, and P =.053) were not independently associated. For SS, EFT (β: 0.009, t: 6.5, and P =.006) and cIMT (β: 1.2, t: 10.1, and P =.001) were independently and significantly associated. We showed that the SS is significantly associated more with surrogate markers of atherosclerosis such as EFT and cIMT than the GS.

Hamur, Hikmet; Onk, Oruc Alper; Vuruskan, Ertan; Duman, Hakan; Bakirci, Eftal Murat; Kucuksu, Zafer; Degirmenci, Husnu; Buyuklu, Mutlu; Topal, Ergun

Chronic total occlusion (CTO) is a common finding in 40% of the patients with peripheral arterial disease (PAD). The aim of this study was to investigate the determinants of CTO in patients with PAD. The study included a total of 211 nonanemic patients with PAD. All patients were categorized according to the Fontaine classification. In lower extremity angiography cohorts, CTO- patients were designated as group 1 and CTO+ patients were designated as group 2. Patients with CTO had significantly higher red cell distribution width (RDW), neutrophil-lymphocyte ratio, uric acid, and high-sensitivity C-reactive protein compared to patients without CTO (P ≤.001, P =.036, P ≤.001, and P =.015, respectively). Albumin, total bilirubin, and direct bilirubin were significantly lower in the patients with CTO compared to patients without CTO (P =.023, P ≤.001, and P =.049, respectively). Multivariate logistic regression analysis showed that RDW, uric acid, and total bilirubin were independent predictors of CTO in patients with PAD. We demonstrated that increased RDW and uric acid levels and lower total bilirubin values were independently associated with CTO in patients with PAD.

Hamur, Hikmet; Duman, Hakan; Demirtas, Levent; Bakirci, Eftal Murat; Durakoglugil, Murtaza Emre; Degirmenci, Husnu; Kalkan, Kamuran; Yildirim, Erkan; Vuruskan, Ertan

Bilirubin may have important antiatherosclerotic effects. Prediabetes (PD), the intermediate stage before diabetes mellitus, is associated with increased cardiovascular morbidity and mortality. We evaluated the relationship between serum bilirubin levels and carotid intima-media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with PD. We enrolled 170 consecutive patients with PD. The patients underwent ultrasonography to evaluate cIMT. The patients were divided into groups according to cIMT values (<0.9 vs ≥0.9 mm). The patients with cIMT ≥ 0.9 mm had significantly higher diastolic blood pressure, neutrophil-lymphocyte ratio (NLR), and glycated hemoglobin values compared with patients having cIMT < 0.9 mm, whereas total and direct bilirubin values were significantly lower in this group. Multivariate regression analyses revealed NLR and total bilirubin as the independent predictors of subclinical atherosclerosis. The present study demonstrated that NLR and lower total bilirubin levels were independent predictors of subclinical atherosclerosis in patients with PD. Simple measures such as NRL and total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with PD.

Hamur, Hikmet; Duman, Hakan; Bakirci, Eftal Murat; Kucuksu, Zafer; Demirelli, Selami; Kalkan, Kamuran; Degirmenci, Husnu

We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of thrombus burden in patients with acute myocardial infarction. Patients (n = 229; male 72.9%; mean age 63 ± 13.4 years) who were admitted with ST-segment elevation myocardial infarction (STEMI) were enrolled. Patients were divided into 2 groups. Group 1 was defined as low thrombus burden and group 2 was defined as high thrombus burden. Patients with high thrombus burden had higher total bilirubin levels (14.4 [4.3-22.9] vs 7.7 [2.4-20.3] μmol/L, P ≤.001), (0.84 [0.25-1.34] vs 0.45 [0.14-1.19] mg/dL P ≤.001) and direct bilirubin levels (3.1 [2.1-8.4] vs 1.7 [0.5-6.5] μmol/L, P ≤.001), (0.18 [0.03-0.49] vs 0.10 [0.03-0.38] mg/dL, P ≤.001). At multivariate analysis, total bilirubin (odds ratio: 1.05, 95% confidence interval: 1.03-1.08, P ≤.001) was the independent predictor of high thrombus burden. In conclusion, total bilirubin level is independently associated with high thrombus burden in patients with STEMI.

Cetin, Mustafa; Bakirci, Eftal Murat; Baysal, Erkan; Tasolar, Hakan; Balli, Mehmet; Cakici, Musa; Abus, Sabri; Akturk, Erdal; Ozgul, Sami

We investigated 2 hypotheses: (1) a relationship between platelet indices and stable coronary artery disease (CAD) and acute ST-segment elevation myocardial infarction (STEMI) and (2) a relationship between platelet indices on admission and thrombolysis outcomes in patients with STEMI. A total of 260 patients were enrolled. The white blood cell (WBC) and platelet distribution width (PDW) were found to be increased in patients with STEMI (P for both <.001). White blood cell and PDW were independent predictors of acute STEMI. Mean platelet volume (MPV) and PDW were significantly higher in the thrombolysis failure group than in the thrombolysis success group (9.9 ± 1.8 vs 9.2 ± 1.5 fL, P =.021 and 17.7 ± 1.0 vs 16.4 ± 2.1 fL, P <.001, respectively). Mean platelet volume and PDW were independent predictors of thrombolysis failure. Patients with acute STEMI had higher PDW than did patients with stable CAD. In addition, higher PDW and MPV seem to correlate with thrombolysis failure in patients with STEMI.

Cetin, Mustafa; Balli, Mehmet; Tasolar, Hakan; Cakici, Musa; Bakirci, Eftal Murat