Publications by authors named "Baris Sensoy"

18 Publications

  • Page 1 of 1

Anxiety and depression levels in Covid-19 disease and their relation to hypertension.

Clin Exp Hypertens 2021 Apr 12;43(3):237-241. Epub 2020 Nov 12.

Bursa Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic , Bursa, Turkey.

: The study aimed to assess the relation of anxiety and depression levels with hypertension in COVID-19 outbreak. The analysis of the association of selected socio-demographic and clinical parameters on the presence and severity of psychological distress was also performed. : The study involved 91 patients applying with a medical history supportive of COVID-19 infection. According to the hospitalization criteria and diagnostic result of SARS-CoV-2 nucleic acid test certainty of the disease, three groups were created. Patients with positive SARS-CoV-2 nucleic acid test results were consisted of 31 hospitalized subjects. To assess the applicant psychological state, a specially developed questionnaire was used, as the presence and severities of the symptoms were assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). : Statistically, a significantly higher average level of depression and a higher incidence of anxiety were demonstrated among applicants in the Covid-19 pandemic (% 24 and % 44). Also a higher level of anxiety was demonstrated in hospitalized patients compared with the outpatient group. Different from the presence of depression symptoms, the presence of anxiety symptoms was associated independently with hypertension in our study group OR 2.6 (95% CI, 0.99-6.78) = .04). : In the aftermath of COVID-19 outbreak both anxiety and depression are common psychological disorders. Also, different from the symptoms of depression, the symptoms of anxiety are associated independently with hypertension. The described socio-demographic parameters and clinical characteristics had no impact on the symptoms of depression and anxiety irrespective of hospitalized status in the investigated groups.
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http://dx.doi.org/10.1080/10641963.2020.1847132DOI Listing
April 2021

The association between cardiac valvular calcification and fetuin-A levels in kidney transplant recipients.

Clin Exp Nephrol 2019 Oct 27;23(10):1250-1256. Epub 2019 Jun 27.

Department of Biochemistry, Uludag University, Bursa, Turkey.

Objectives: Low fetuin-A levels in hemodialysis patients can be associated with development of vascular and valvular calcifications. The mechanisms underlying vascular and valvular calcifications are multifactorial. There are a few studies showing the relationship between low fetuin-A levels and valvular calcification after kidney transplantation. We aimed to evaluate the association between serum fetuin-A levels and valvular calcification in kidney transplant recipients.

Methods: The cardiac valvular calcification was assessed by echocardiography in 56 recipients. Patients were divided into two groups as those with (n = 11) and without (n = 45) aortic and/or mitral valve calcification. The extent of valvular calcification was visually assessed according to the standard visual score method: moderately (multiple larger spots) and heavily calcified (extensive thickening and calcification) of all cusps. Serum fetuin-A levels were measured.

Results: The demographic features of both groups were comparable. There was no significant difference between regular physical exercise (63.6% vs. 55.6%), obesity (18.2% vs. 17.8%), abdominal obesity (54.5% vs. 46.7%), smoking (0% vs. 13.3%), hypertension (63.6% vs. 68.9%), left ventricular hypertrophy (45.5% vs. 33.3%) and diabetes mellitus (9.1% vs. 20%) ratios in groups with or without valvular calcification, respectively (p > 0.05). Fetuin-A levels of both groups did not differ. Fetuin-A levels positively correlated with serum creatinine (r 0.326, p = 0.014), and negatively correlated with estimated glomerular filtration rate (r - 0.297, p = 0.026).

Conclusions: We could not find a relationship between serum fetuin-A levels and valvular calcification in kidney recipients. In this population, further studies are needed to assess the role of serum fetuin-A in valvular calcification.
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http://dx.doi.org/10.1007/s10157-019-01761-2DOI Listing
October 2019

Parameters of arterial stiffness in patients with Behçet's disease and their relationship with disease duration.

Rheumatol Int 2019 Jun 26;39(6):1053-1059. Epub 2019 Mar 26.

Department of Internal Medicine, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.

The results of investigations of arterial stiffness in Behçet's disease (BD) are contradictory and the reason for this contradictory situation is not clear. The lack of studies in homogenous groups according to the duration of the disease may be the cause of conflicting results. To compare arterial stiffness by assessing pulse wave velocity (PWV) and augmentation index (AIx) measurements in healthy controls (HC) and patients diagnosed with BD with short and long disease duration. This cross-sectional study was conducted between August-November 2017 and 54 patients with BD and 34 HC were included. Patients with BD who were diagnosed within 12 months were included in the group with short disease duration (SDD) and the others in the group with long disease duration (LDD). Parameters of cardiovascular risk of all participants were recorded and PWV and AIx values were measured from the brachial artery. AIx was significantly higher in all patients with BD, patients with BD with SDD and patients with BD with LDD, than in HC (p = 0.005, p = 0.011, p = 0.004, respectively). Pulse wave velocity values were not different from HC in patients with BD. When patients with BD with SDD and LDD were compared with each other, PWV was significantly higher in patients with BD with LDD (p = 0.030). There was a moderate correlation between PWV and disease duration (Rho = 0.414, p = 0.002). Augmentation index is higher in patients with BD than HC regardless of disease duration.
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http://dx.doi.org/10.1007/s00296-019-04291-yDOI Listing
June 2019

Monocyte to high-density lipoprotein cholesterol ratio is predictive of in-hospital and five-year mortality in ST-segment elevation myocardial infarction.

Cardiol J 2016 14;23(5):505-512. Epub 2016 Jun 14.

Department of Cardiology, Turkiye Yuksek Ihtisas Education and R esearch Hospital, Ankara, Turkey.

Background: We assessed the value of monocyte to high-density lipoprotein cholesterol ratio (MHR) in predicting in-hospital and 5-year mortality and major adverse cardiovascular events (MACE) in ST-segment elevation myocardial infarction (STEMI) patients.

Methods: A group of 1,598 patients were enrolled and divided into tertiles according to MHR values. The effects of different variables on clinical outcomes were assessed by Cox regression analysis.

Results: MHR was found as an independent predictor of in-hospital mortality (HR = 3.745, 95% CI 1.308-5.950), in-hospital MACE (HR 1.501, 95% CI 1.015-1.993, p = 0.022) and 5-year mortality (HR = 2.048, 95% CI 1.225-4.091, p = 0.014) and 5-year MACE (HR 1.285, 95% CI 1.064-1.552, p = 0.009).

Conclusions: MHR is an independent predictor of in-hospital and long term mortality and MACE in STEMI.
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http://dx.doi.org/10.5603/CJ.a2016.0026DOI Listing
February 2018

Renal Dysfunction on Admission Predicts No-Reflow Phenomenon in Patients Undergoing Manual Thrombus Aspiration during Primary Percutaneous Coronary Intervention.

Acta Cardiol Sin 2016 Mar;32(2):185-93

Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey;

Background: No-reflow is a frequent complication during percutaneous coronary intervention (PCI) for acute ST segment elevation myocardial infarction (STEMI). Available data is limited regarding its impact on short-term outcomes in patients undergoing manual thrombus aspiration. Renal impairment is also associated with higher complication rates in STEMI. Herein, we aimed to evaluate the impact of baseline renal dysfunction on the no- reflow phenomenon and the association of no-reflow phenomenon with early clinical outcomes.

Methods: A total of 94 consecutive STEMI patients who underwent primary stent-based PCI and thrombus aspiration were enrolled. No-reflow was established by the use of angiographic and electrocardiographic reperfusion criteria, respectively. Additionally angiographic and clinical follow-up data were also recorded.

Results: In our study, the no-reflow phenomenon was observed in 10 patients (11%) angiographically and in 23 patients (24%) electrocardiographically. Whereas, the the estimated glomerular filtration rate (eGFR) [odds ratio (OR) 10.4], hypertension (OR 6.2), previous MI (OR 6.5), previous PCI history, (OR 4.2), predilatation (OR 7.2), final balloon pressure (OR 0.9) were found to be the significant predictors of angiographic no-reflow, only reperfusion time was the predictor of electrocardiographic no-reflow (OR 1.12) at univariate analysis. After adjustment, lower eGFR (OR 14.8) was found to be the independent predictor for angiographic no-reflow. In-hospital mortality was more common in patients with either no-reflow condition separately.

Conclusions: Longer ischemic time and lower initial eGFR values were associated with no-reflow phenomenon. Irrespective of poor reperfusion criteria, no-reflow phenomenon is associated with in-hospital outcome. Future efforts should be made to reduce the incidence of no-reflow especially in patients with lower initial eGFR values.

Key Words: Acute myocardial infarction • Glomerular filtration rate • No-reflow phenomenon • Primary percutaneous coronary intervention.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816917PMC
http://dx.doi.org/10.6515/acs20150424iDOI Listing
March 2016

Heart Failure Functional Class Associated with Depression Severity But Not Anxiety Severity.

Acta Cardiol Sin 2016 Jan;32(1):55-61

Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital;

Background: Depression and anxiety are common in heart failure (HF) patients and associated with adverse clinical outcomes. However, there are little or no published data that focuses on the relationship between these commonly observed situations and HF classes. The aim of this study was to evaluate the relationship between these psychiatric co-morbidities and HF symptom classes. As a second objective of our study, the associations between patient characteristics and depression severity were also assessed.

Methods: Our study enrolled a total of 420 HF study participants. The severity of depressive and anxiety symptoms was evaluated by Beck's depression and anxiety. The measured total scores were used to grade depression severity and anxiety as minimal/mild and moderate/severe.

Results: According to NYHA Functional Classification, 228 patients (51%) had class I symptoms, 101 (23%) had class II symptoms, 31 (7%) had class III symptoms, and class IV symptoms were noted in the remaining 60 patients (19%). The mean Beck's depression and anxiety scores were 12.4 ± 11.1 and 13.4 ± 9.0, respectively. While no association between HF symptom classes and anxiety severity was observed, a significant positive relation between HF symptom class and depression score was found.

Conclusions: The results of our study suggested that HF symptom class was positively associated with severity of depression. On the other hand, there was no association between HF symptom class and anxiety score in a wide population of heart failure patients.

Key Words: Anxiety; Depression; Heart failure.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804941PMC
http://dx.doi.org/10.6515/acs20150509aDOI Listing
January 2016

Red cell distribution width predicts totally occluded infarct-related artery in NSTEMI.

Scand Cardiovasc J 2016 Aug 3;50(4):224-9. Epub 2016 Mar 3.

a Department of Cardiology , Turkiye Yüksek İhtisas Education and Research Hospital , Ankara , Turkey ;

Objective Since non-ST segment elevation myocardial infarction (NSTEMI) patients with totally occluded infarct-related artery (TO-IRA) have worse prognosis, it is important to recognize TO-IRA in NSTEMI. Red cell distribution width (RDW) and mean platelet volume (MPV) are novel markers of inflammation and oxidative stress and were associated with poor clinical outcomes in acute coronary syndrome. In the present study, association of RDW and MPV with the presence of TO-IRA in NSTEMI was investigated. Methods Data of 201 consecutive patients who underwent coronary angiography with a diagnosis of NSTEMI were analyzed. Independent predictors of TO-IRA were investigated with logistic regression analysis. Results Sixty-six (32.8%) of the patients had TO-IRA. In patients with TO-IRA, RDW and troponin-T were significantly higher and left ventricular ejection fraction (LVEF) was lower. MPV did not differ between groups. Circumflex (CX) IRA was more common in TO-IRA group. The ROC curve analysis showed that the RDW at a cut-point of 13.95% has 76% sensitivity and 66% specificity in detecting TO-IRA. RDW, troponin-T, LVEF and CX-IRA were independent predictors of TO-IRA in NSTEMI, but MPV was not. Conclusion RDW is a cheap and readily available marker that may have a role to predict TO-IRA in NSTEMI.
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http://dx.doi.org/10.3109/14017431.2016.1152398DOI Listing
August 2016

Heart block after herpes zoster reactivation.

Int J Cardiol 2016 Jan 28;203:549-50. Epub 2015 Oct 28.

Turkiye Yuksek Ihtisas Education and Research Hospital, Turkey.

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http://dx.doi.org/10.1016/j.ijcard.2015.10.163DOI Listing
January 2016

Red Cell Distribution Width Can Predict the Significance of Angiographically Intermediate Coronary Lesions.

Med Princ Pract 2016 16;25(1):31-5. Epub 2015 Oct 16.

Cardiology Clinic, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.

Objective: In the present study, the association between red cell distribution width (RDW) with functional significance of intermediate coronary artery lesions was investigated.

Materials And Methods: Two hundred and forty-six consecutive patients, 168 males and 78 females, who underwent fractional flow reserve (FFR) measurement for angiographically intermediate coronary stenosis (40-70% in quantitative coronary analysis) in the left anterior descending coronary artery were enrolled into the study. The functional significance of intermediate coronary artery lesions was determined by FFR measurement. An FFR value <0.75 was defined as functionally significant. Venous blood samples were taken within 48 h before the FFR measurement, and RDW levels were determined by a Coulter LH Series hematology analyzer. Logistic regression analysis was used to examine the association between functional significance in FFR measurement and other variables.

Results: Of the 246 patients, 62 (25.2%) exhibited significant functional stenosis (FFR <0.75) in the FFR measurement. The mean RDW level was significantly higher in patients with significant stenosis (14.19 ± 0.73 vs. 13.69 ± 0.77, p < 0.001). In stepwise multivariate logistic regression analysis, RDW (OR = 2.489, 95% CI = 1.631-3.799, p < 0.001) and male gender (OR = 2.826, 95% CI = 1.347-5.928, p = 0.006) were independent predictors of significant functional stenosis.

Conclusion: Increased RDW levels were associated with functional significance of angiographically intermediate coronary artery stenoses.
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http://dx.doi.org/10.1159/000441001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588303PMC
September 2016

'Action potential-like' ST elevation following pseudo-Wellens' electrocardiogram.

Indian Heart J 2015 Sep-Oct;67(5):472-5. Epub 2015 Aug 4.

Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.

Coronary artery vasospasm is an important cause of chest pain syndromes that can lead to myocardial infarction, ventricular arrhythmias, and sudden death. In 1959, Prinzmetal et al described a syndrome of nonexertional chest pain with ST-segment elevation on electrocardiography. Persistent angina is challenging, and repeated coronary angioplasty may be required in this syndrome. Calcium antagonists are extremely effective in treating and preventing coronary spasm, and may provide long-lasting relief for the patient. Whereas the Wellens' syndrome is characterized by symmetrically inverted T-waves with preserved R waves in the precordial leads suggestive of impending myocardial infarction due to a critical proximal left anterior descending stenosis, the pseudo-Wellens' syndrome caused by coronary artery spasm has also rarely been reported in literature. We present a pseudo-Wellens syndrome as a cause of vasospastic angina, and a diffuse ST segment elavation on electrocardiogram resembling the Greek letter lambda, called also 'action potential-like' ECG in a patient with vasospastic-type Printzmetal angina.
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http://dx.doi.org/10.1016/j.ihj.2015.05.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593797PMC
December 2016

The classical "R-on-T" phenomenon.

Indian Heart J 2015 Jul-Aug;67(4):392-4. Epub 2015 Apr 27.

Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.

The polymorphic ventricular tachycardia (PVT) is uncommon arrhythmia with multiple causes and has been classified according to whether they are associated with long QT interval or normal QT. Whereas "Torsade de pointes (TdP)" is an uncommon and distinctive form of PVT occurring in a setting of prolonged QT interval, which may be congenital or acquired (congenital or acquired), "PVT with normal QT" is associated with myocardial ischemia, electrolyte abnormalities (hypokalemia), mutations of the cardiac sodium channel (Brugada syndrome), and the ryanodine receptor (catecholaminergic PVT). This distinction is crucial because of the differing etiologies and management of these arrhythmias. Moreover, the PVT in the setting of acute MI generally occurs during the hyperacute phase, is related to ischemia ("ischemic PVT") and is not associated with QT prolongation. It is triggered by ventricular extrasystoles with very short coupling interval (the "R-on-T" phenomenon) and is not pause-dependent. However, recently there has been described a new PVT during the "healing phase" of MI in patients with no evidence of ongoing ischemia and following excessive QT prolongation, the electrophysiologic abnormality being a "pause-dependent infarct-related TdP" due to a LQTS in healing MI patients. Therefore, "ischemic PVT" differs from "infarct-related TdP" in terms of pathophysiology and ECG manifestations.
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http://dx.doi.org/10.1016/j.ihj.2015.02.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561790PMC
December 2016

Treatment of mechanical valve thrombosis in the right heart: overview of the requirements for the new thrombolytic protocols.

Blood Coagul Fibrinolysis 2015 Mar;26(2):220-2

Cardiology Clinic, Türkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

Prosthetic valve thrombosis (PVT) is a rare but serious complication of implanted mechanical valves. Intravenous thrombolytic treatment has emerged as an alternative to surgical therapy in the management of patients with stuck valves. As tricuspid valve replacement is a rare venture, the indications for such therapy and appropriate patient selection are evolving. As the type, dose, and route of administration of thrombolytic agents differ, major complications can be seen in the rapid infusion protocols. In patients with PVT, especially with right-sided valves, thrombolysis with intravenous slow infusion has given discrete, successive sessions guided by serial transthoracic echocardiography and cine/fluoroscopy which may be achieved with a low risk of complications and a high rate of success. Our report describes the management of two patients with PVT and discusses the current status of thrombolysis in such patients.
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http://dx.doi.org/10.1097/MBC.0000000000000215DOI Listing
March 2015

Effect of herbal medicine use on medication adherence of cardiology patients.

Complement Ther Med 2014 Aug 6;22(4):648-54. Epub 2014 Jun 6.

Cardiology Clinic, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.

Purpose: Herbal drug use for cardiovascular disease is frequent and growing rapidly. The aim of this study is to investigate the effect of herbal medicine use on medication adherence of cardiology patients.

Methods: All patients admitted to the outpatient cardiology clinics, who had been prescribed at least one cardiovascular drug before, were asked to complete a questionnaire. Participants were asked if they have used any herbals during the past 12 months with an expectation of beneficial effect on health. Medication adherence was measured by using the Morisky Scale. High adherence was defined as a Morisky score <2 and a score ≥ 2 was accepted as low adherence in our study.

Results: Totally 390 patients (54.9% male and 45.1% female patients, mean age 58.9) participated in our study. 29.7% of them had consumed herbals in the past 12 months. The median Morisky score was significantly higher in herbal users than nonusers (p<0.001). Rate of low adherence, according to the Morisky Scale, was also higher in herbal users (61.2% vs. 29.9%, p<0.001). Number of herbals used was moderately correlated with the Morisky score (ρ=0.313, p<0.001). In stepwise, multivariate logistic regression analysis, herbal use was significantly associated with low medication adherence (OR: 3.76, 95% CI 2.36-6.09, p<0.001).

Conclusion: Herbal use was found to be independently associated with low medication adherence in our study population. Further studies are needed to elucidate the effect of herbal medicine use on medication adherence of cardiology patients.
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http://dx.doi.org/10.1016/j.ctim.2014.05.013DOI Listing
August 2014

N-Terminal Pro-Brain Natriuretic Peptide Level is Associated With Severity and Complexity of Coronary Atherosclerosis in Patients With Acute Coronary Syndrome.

Clin Appl Thromb Hemost 2016 Jan 2;22(1):69-76. Epub 2014 Jul 2.

Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are associated with short- and long-term mortality in acute coronary syndrome (ACS). We investigated whether baseline NT-proBNP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore). We enrolled 509 patients with ACS who underwent coronary angiography. The patients were divided into tertiles according to the SXScore: low SXScore (≤ 22), intermediate SXScore (23-32), and high SXScore (≥ 33). The NT-proBNP levels demonstrated an increase from low SXScore tertile to high SXScore tertile. The NT-proBNP levels according to the SXScore tertiles are as follows: low and intermediate (median 635 vs 1635, P = .014), low and high (median 635 vs 4568, P < .001), and intermediate and high (median 1635 vs 4568, P < .001). In multivariate analysis, NT-proBNP remained an independent predictor of high SXScore (odds ratio: 2.688, 95% confidence interval: 1.315-5.494, P = .007) together with age (P = .002), neutrophil-lymphocyte ratio (P = .017), and presence of non-ST-segment elevation ACS (P = .002). The NT-proBNP was independently associated with burden of coronary atherosclerosis in patients with ACS.
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http://dx.doi.org/10.1177/1076029614541954DOI Listing
January 2016

Association between N-terminal pro-brain natriuretic peptide levels and contrast-induced nephropathy in patients undergoing percutaneous coronary intervention for acute coronary syndrome.

Clin Cardiol 2014 Aug 7;37(8):485-92. Epub 2014 May 7.

Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.

Background: Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk for CIN. N-terminal pro-brain natriuretic peptide (NT-proBNP) is closely linked to the prognosis as a strong predictor of both short- and long-term mortality in patients with ACS.

Hypothesis: We hypothesized that NT-proBNP levels on admission can predict the development of CIN after PCI for ACS.

Methods: A total of 436 patients (age 62.27 ± 13.01 years; 64.2% male) with ACS undergoing PCI enrolled in this study. Admission NT-proBNP levels were measured before PCI. Serum creatinine values were measured before and within 72 hours after the administration of contrast agents. Patients were divided into 2 groups: CIN group and no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after contrast administration.

Results: CIN developed in 63 patients (14.4%). Baseline NT-proBNP levels were significantly higher in patients who developed CIN compared to those who did not develop CIN (median 774 pg/mL, interquartile range 177.4-2184 vs median 5159 pg/mL, interquartile range 2282-9677, respectively; P < 0.001). Multivariate analysis found that NT-proBNP (odds ratio [OR]: 3.448, 95% confidence interval [CI]: 1.394-8.474, P = 0.007) and baseline creatinine (OR: 6.052, 95% CI: 1.860-19.686, P = 0.003) were independent predictors of CIN.

Conclusions: Admission NT-proBNP level is an independent predictor of the development of CIN after PCI in ACS.
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http://dx.doi.org/10.1002/clc.22291DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6649377PMC
August 2014

Diagnostic dilemmas for underlying pathophysiology of arrhythmias originating from the right ventricle.

Indian Pacing Electrophysiol J 2014 Mar 12;14(2):99-100. Epub 2014 Mar 12.

Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952610PMC
http://dx.doi.org/10.1016/s0972-6292(16)30737-9DOI Listing
March 2014

Subacute anterior wall myocardial infarction complicated by intramyocardial dissection.

Am J Emerg Med 2012 Jun 12;30(5):834.e5-6. Epub 2011 May 12.

Tavşanlı Government Hospital, Cardiology, Kutahya, Turkey.

Myocardial dissection is a rare but fatal complication of myocardial infarction requiring urgent surgical treatment to avoid complete rupture. We report a case of intramyocardial dissecting hematoma treated with supportive pharmacologic therapy for 9 months of follow-up without surgical intervention.
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http://dx.doi.org/10.1016/j.ajem.2011.03.005DOI Listing
June 2012
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