Publications by authors named "Alev Arat Ozkan"

Background And Aim: Diabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic.

Methods And Results: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020.

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Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic.

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Background And Aim: High-dose statin therapy before percutaneous coronary intervention (PCI) is thought to reduce the occurrence of Peri-procedural Myocardial Infarction (PPMI), which is associated with increased mortality and prolonged hospitalization, especially in statin naïve patients. This study aims to investigate the effect of rosuvastatin loading dose on PPMI and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing elective PCI, considering their statin use.

Methods: One hundred sixty-five patients with stable coronary artery disease (CAD) without heart failure (HF) or chronic kidney disease (CKD) were included in the study.

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Article Synopsis
  • * A study involving over 16,600 STEMI patients found a 16% reduction in PPCI procedures in 2020 compared to 2019, with the elderly experiencing the most significant delays.
  • * Consequently, there was a notable increase in 30-day mortality rates during the pandemic, particularly among older patients, attributed to longer ischemia times and treatment delays.
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Article Synopsis
  • The COVID-19 pandemic significantly reduced the number of primary percutaneous coronary interventions (PPCIs) for ST-segment elevation myocardial infarction (STEMI) patients by 16% in 2020 compared to 2019.
  • Despite this reduction affecting both genders equally, 30-day mortality rates increased notably for female patients during the pandemic, while male patients did not show a significant change.
  • The analysis highlights the importance of addressing gender-specific outcomes in cardiac care during public health crises.
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Background: In patients undergoing percutaneous coronary intervention (PCI), drug eluting stents (DES) are currently the standard of care. Stent design and alloy composition, biocompatibility of the drug-eluting polymer coating, the antiproliferative agent properties and release are the three main characteristics that affects DES performance. Cre8 (Alvimedica, Istanbul, Turkey) is a polymer-free amphilimus-eluting stents (PF-AES).

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Article Synopsis
  • The "smoking paradox" refers to lower mortality rates in smokers among STEMI patients, particularly in the context of modern primary PCI protocols during the COVID-19 pandemic.
  • A large retrospective study revealed that among 16,083 STEMI patients, active smokers had better postprocedural blood flow and lower mortality rates compared to both non-smokers and previous smokers.
  • The findings suggest that despite initial challenges in treatment, active smoking was linked to improved heart health outcomes in this patient population, indicating the need for further investigation into this unexpected relationship.
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Article Synopsis
  • - The study examined how SARS-CoV-2 positivity affects outcomes for patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI), using data from the ISACS-STEMI COVID-19 registry.
  • - Results showed that SARS-CoV-2 positive patients were older, more likely to experience cardiogenic shock, and had worse post-procedural outcomes, including lower blood flow and increased need for thrombectomy.
  • - Importantly, SARS-CoV-2 positivity was linked to higher in-hospital mortality (25.7% vs 7%) and significantly increased 30-day mortality rates (34.4% vs 8.5%), indicating that the virus
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Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study.

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Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment.

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Article Synopsis
  • The study aimed to analyze how the COVID-19 pandemic impacted primary percutaneous coronary intervention (PPCI) procedures and patient outcomes for those with ST elevation myocardial infarction (STEMI) compared to the period before the pandemic.
  • It involved a retrospective analysis of data from 16,674 patients across various regions, showing a significant decrease in PPCI procedures during the pandemic (16% reduction) along with increases in treatment delays and mortality rates.
  • Findings highlight that older adults were particularly affected, and the increased time to treatment likely contributed to both in-hospital and 30-day mortality rates rising during the pandemic.
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Unlabelled: Background OBJECTIVE: To investigate the effects of peripheral muscle training (PMT) and different inspiratory muscle training (IMT) methods on respiratory functions, exercise capacity, and biochemistry parameters in coronary artery disease patients with metabolic syndrome.

Methods: This prospective, single-blind, randomized-controlled study included 60 patients of stable coronary artery disease with metabolic syndrome (New York Heart Association [NYHA] Class I-II, left ventricular ejection fraction >40%). Patients were randomly divided into three groups: neuromuscular electrical stimulation (NMES) plus PMT group (NMES + PMT group, n = 20), IMT plus PMT group (IMT + PMT group, n = 20) and PMT group (PMT group, n = 20).

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Objective: Since the first World Symposium on Pulmonary Hypertension (WSPH; Geneva, 1973), pulmonary hypertension (PH) has been defined as a mean pulmonary artery pressure (mPAP) ≥25 mm Hg measured at right heart catheterization (RHC) while at rest in the supine position. At the 6th WSPH congress (Nice, 2018), a new proposal was presented defining pre-capillary PH as mPAP >20 mm Hg, with pulmonary arterial wedge pressure (PAWP) <15 mm Hg, and pulmonary vascular resistance (PVR) >3 WU. The aim of this study was to investigate the impact of the new definition of PH on the number of pre-capillary PH patients.

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Stent fracture is a rare complication of drug-eluting stent implantation with a reported rate of 0.84%-3.2% in various clinical studies with first-generation drug-eluting stents and 29% in autopsy studies.

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Although statins have been shown to prevent contrast-induced acute kidney injury in patients with acute coronary syndromes, the benefit of statins is not known for patients at high risk for nephropathy who undergo elective coronary angiography. Two hundred twenty consecutive statin-naive patients with chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73 m(2)) who underwent elective coronary or peripheral angiography were randomly assigned to receive rosuvastatin (40 mg on admission, followed by 20 mg/day; n = 110) or no statin treatment (control group, n = 110).

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We determined the effect of 6-month rosuvastatin treatment on blood lipids, oxidative parameters, apolipoproteins, high-sensitivity C-reactive protein, lipoprotein(a), homocysteine, and glycated hemoglobin (HbA1c) in patients with metabolic syndrome (MetS). Healthy individuals (men aged >40 years and postmenopausal women) with a body mass index ≥ 30 (n = 100) who fulfilled the National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria for MetS were included. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels decreased (P < .

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Coronary heart disease is the main cause of death in the world as well as in Turkey. It's not only a health issue but also a social problem with a high economic burden and negative impact on quality of life. The majority of deaths are attributable to acute coronary syndromes (ACS) and their complications.

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We evaluated the relationship between admission blood glucose levels and estimated coronary flow by the thrombolysis in myocardial infarction (TIMI) frame count (TFC) method in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). The TFC of 121 consecutive patients with STEMI were evaluated after pPCI. Patients with admission glucose levels > 198 mg/dL (11 mmol/L) were defined as hyperglycemic.

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Concomitant occurrence of pulmonary embolism and acute coronary syndrome is rare. The early diagnosis and treatment of acute coronary syndrome with right ventricular myocardial ischemia during acute pulmonary embolism (APE) are crucial. The irreversible right ventricular myocardial dysfunction is a major risk factor for mortality from APE.

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Objectives: Risk stratification in acute coronary syndromes is an important diagnostic tool guiding future therapy. We evaluated the correlation between the AHCPR (Agency for Health Care Policy and Research) risk classification and angiographic morphology in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Study Design: A total of 163 patients hospitalized with the diagnosis of NSTE-ACS were prospectively enrolled.

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Introduction: To determine whether elevated N-terminal pro-BNP (NT pro-BNP) predicts pulmonary artery systolic pressure increase on exercise stress echocardiography in asymptomatic or mildly symptomatic patients with moderate to severe mitral stenosis.

Methods And Results: Forty-one asymptomatic or mildly symptomatic patients with moderate to severe mitral stenosis and 21 age- and sex-matched healthy subjects. Transthoracic echocardiography was performed in all patients to assess the severity of the valve disease and to measure pulmonary artery pressure before and immediately after treadmill exercise.

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