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Öğe Cancer Therapy-Related Pulmonary Hypertension: A Review of Mechanisms and Implications for Clinical Practice(Kare Publ, 2023) Gurdogan, Muhammet; Demir, Melik; Yalta, Kenan; Gurlertop, YektaCancer therapy-related pulmonary hypertension is a rare yet potentially fatal cardiotoxicity. However, it is a reversible cause of pulmonary hypertension if detected in its early stages. Cancer therapy-related pulmonary hypertension has been encountered in patients using tyrosine kinase inhibitors, particularly dasatinib. However, it is also well known that many agents used in cancer treatment such as alkylating agents, proteasome inhibitors, thoracic radiation exposure, and immune checkpoint inhibitors are particularly associated with pulmonary hypertension evolution. In case that history, symptoms, and clinical findings suggest a potential cancer therapy-related pulmonary hypertension, echocardiography is considered as the initial tool to detect pulmonary hypertension. If the possibility of pulmonary hypertension is high based on echocardiographic data, cancer treatment, as the initial step, should be discontinued due to its potential risks and other causes for pulmonary hypertension should be investigated thoroughly. Right heart catheterization should be the next step to establish the final diagnosis, and medical management, where appropriate, should be started without delay in these patients according to their pulmonary hypertension subgroup. There exists limited information regarding the diagnostic and management strategies of cancer therapy-related pulmonary hypertension in the current guidelines. In this review article, we aim to present current literature data on the mechanisms and management of cancer therapy-related pulmonary hypertension along with its follow-up algorithm in the setting of cardio-oncology practice.Öğe The Effect of Thyroid Stimulating Hormone Level Within the Reference Range on In-Hospital and Short-Term Prognosis in Acute Coronary Syndrome Patients(Mdpi, 2019) Gurdogan, Muhammet; Altay, Servet; Korkmaz, Selcuk; Kaya, Caglar; Zeybey, Utku; Ebik, Mustafa; Demir, MelikBackground and objectives: Despite being within the normal reference range, changes in thyroid stimulating hormone (TSH) levels have negative effects on the cardiovascular system. The majority of patients admitted to hospital with acute coronary syndrome (ACS) are euthyroid. The aim of this study was to investigate the effect of TSH level on the prognosis of in-hospital and follow-up periods of euthyroid ACS patients. Materials and Methods: A total of 629 patients with acute coronary syndrome without thyroid dysfunction were included in the study. TSH levels of patients were 0.3-5.33 uIU/mL. Patients were divided into three TSH tertiles: TSH level between (1) 0.3 uIU/mL and <0.90 uIU/mL (n = 209), (2) 0.90 uIU/mL and <1.60 uIU/mL (n = 210), and (3) 1.60 uIU/mL and 5.33 uIU/mL (n = 210). Demographic, clinical laboratory, and angiographic characteristics were compared between groups in terms of in-hospital and follow-up prognosis. Results: Mean age was 63.42 +/- 12.5, and 73.9% were male. There was significant difference between tertiles in terms of TSH level at admission (p < 0.001), the severity of coronary artery disease (p = 0.024), in-hospital mortality (p < 0.001), in-hospital major hemorrhage (p = 0.005), total adverse clinical event (p = 0.03), follow-up mortality (p = 0.022), and total mortality (p < 0.001). In multivariate logistic regression analysis, the high-normal TSH tertile was found to be cumulative mortality increasing factor (OR = 6.307, 95%; CI: 1.769-22.480; p = 0.005) during the 6-month follow-up period after hospitalization and discharge. Conclusions: High-normal TSH tertile during hospital admission in euthyroid ACS patients is an independent predictor of total mortality during the 6-month follow-up period after hospitalization and discharge.Öğe Obstrüktif koroner arterler veya NON-obstrüktif koroner arterler ile beraber miyokard enfraktüsü geçiren hastaların klinik ve ekokardiyografik özellikleri ile kısa dönem prognozlarının karşılaştırılması(Trakya Üniversitesi, 2023) Demir, Melik; Altay, ServetBu çalışmada akut koroner sendrom tanısıyla hastaneye kabul edilen ve primer perkütan koroner girişim uygulanan hastaların hastane içi ve bir yıllık takip dönemindeki klinik izlem sonuçlarını, kardiyak istenmeyen olay gelişimi ile ilişkili faktörleri araştırmayı ve bu sonuçların tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü hastalarının verileriyle karşılaştırmayı amaçladık. Bu iki grubun, klinik özellikleri, hastane içi komplikasyonlar ve olayları, perkütan koroner girişim özellikleri ve 1 yıllık sonuçları karşılaştırıldı. Çalışmamızda tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü grubunda kadın hasta oranı daha yüksek saptanmıştır. Tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü grubunda atrial fibrilasyon görülme oranı daha yüksek saptanmıştır (n=12 (%11,5)). Çalışmamızda tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü grubunda C reaktif protein, tiroit stimülan hormon ve T4 daha yüksek saptanmıştır (p<0,001). Tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü grubunda kapı-balon zamanı daha yüksek saptanmıştır. Çalışmamızda oral antikuagülan ilaç kullanım oranının tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü grubunda daha yüksek olduğu saptanmıştır (n=30 (%5,0)-n=14 (%13,5), p=0,003). Enfeksiyon görülme oranı tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü grubunda daha yüksek saptanmıştır (p<0,010). Sonuç olarak çalışmamızda, tıkayıcı olmayan koroner arterler ile birlikte gelişen miyokard infraktüsü tanılı hasta popülasyonunda hastane içi mortalite daha düşük saptanırken, 1 yıllık takip döneminde mortalite açısından gruplar arasında istatiksel olarak anlamlı bir fark görülmemiştir.Öğe Perikardiyosentezin Nadir Görülen Bir Komplikasyonu veYönetimi(2020) Taylan, Gökay; Kaya, Çağlar; Demir, MelikPerikardiyal efüzyonun en önemli semptomu olan dispnenin değerlendirmesinde birçok ayırıcı tanının da ekarte edilmesi gerekmektedir. Perikardiyal tamponad saptanması sonrası tedavide acil perikardiyosentez önerilmektedir. Özellikle toraks ve diyafragma operasyonu geçirenlerde diyafragma ve kalbin normal pozisyonuna göre yer değiştirebileceği akılda tutulması gereklidir ve terapötik işlemler de komplikasyonu engelleyebilir.Öğe The Relationship Between Premature Coronary Atherosclerosis and Helicobacter pylori Infection(Erciyes Univ Sch Medicine, 2023) Taylan, Gokay; Demir, Melik; Kaya, Caglar; Kurt, Idris; Yalta, KenanObjective: Helicobacter pylori infection (HPI) might potentially lead to chronic infection and cancer development in the gastric mucosa. However, previous studies have shown that coronary artery disease might also be associated with this infection. On the other hand, this causal association has not been previously documented in the context of premature coronary atherosclerosis (PCA). In our study, we aimed to investigate the potential relationship between HPI and PCA. Materials and Methods: All consecutive patients (<= 40 years of age) (between the years 2009 and 2018) undergoing coronary angiography and gastroduodenoscopy were included in the study (n=199). Patients were divided into two groups (PCA and control). The statistically considered significant p value is <0.05. Results: One hundred ninety nine patients included those with PCA [n=61 (30%)] (51% male, average age 35 years old). HPI was detected in 70% of patients with PCA (n: 43). Statistically significant independent relationship between HPI and PCA was observed in the logistics regression analysis (p<0.001). Conclusion: HPI may be an independent risk factor for PCA.Öğe A Stent Misplaced in the Septal Perforating Artery: Right Ventricular Fistula, Interventricular Septal Hematoma, and Right Ventricular Outflow Tract Obstruction(Arquivos Brasileiros Cardiologia, 2023) Demir, Melik; Goek, Murat; Guerdogan, Muhammet; Kula, Osman; Ustabasioglu, Fethi Emre; Yalta, KenanCoronary-cameral fistulas, though mostly regarded as congenital entities, have also been encountered as complications of major traumas and percutaneous coronary interventions (PCIs).(1) On the other hand, interventricular septal (IVS) hematoma might potentially arise mostly during retrograde chronic total occlusion (CTO) interventions and has a benign course in this context.(2) Herein, we describe a challenging PCI complication (and its management strategy) presenting with IVS hematoma, right ventricular fistula, and right ventricular outflow tract (RVOT) obstruction due to a misimplanted coronary stent in the septal perforating artery (SPA).Öğe Systemic Immune-Inflammation Index: A Novel Predictor of Coronary Thrombus Burden in Patients with Non-ST Acute Coronary Syndrome(Mdpi, 2022) Ozkan, Ugur; Guerdogan, Muhammet; oeztuerk, Cihan; Demir, Melik; Akkus, Oemer Feridun; Yilmaz, Efe; Altay, ServetBackground and Objectives: Excessive coronary thrombus burden is known to cause an increase in mortality and major adverse cardiac events (MACEs) in NSTE-ACS (non-ST acute coronary syndrome) patients. We investigated the association between the systemic immune-inflammation index (SII) and coronary thrombus burden in patients with non-ST segment elevation myocardial infarction (NSTEMI) who underwent coronary angiography and percutaneous coronary intervention (PCI). Materials and Methods: A total of 389 patients with the diagnosis of NSTEMI participated in our study. Coronary thrombus burden was classified in the TIMI (thrombolysis in myocardial infarction) thrombus grade scale and patients were divided into two groups: a TIMI thrombus grade 0-1 group (n = 209, 157 males) and a TIMI thrombus grade 2-6 group (n = 180, 118 males). Demographics, angiographic lesion images, coronary thrombus burden, clinical risk factors, laboratory parameters, and SII score were compared between the two groups. Results: The high thrombus burden patient group had a higher neutrophil count, WBC count, platelet count, and systemic immune-inflammation index (SII) (p < 0.001). The receiver operating characteristic (ROC) curve analysis showed that at a cutoff of 1103, the value of SII manifested 74.4% sensitivity and 74.6% specificity for detecting a high coronary thrombus burden. Conclusions: Our study showed that the SII levels at hospital admission were independently associated with high coronary thrombus with NSTEMI.Öğe Ventricular Aneurysm Mimicking the Image of a Muscular Bridge in the Right Coronary Artery(Kare Publ, 2024) Akkus, oemer Ferudun; Demir, Melik; Ustabasioglu, Fethi Emre; Altay, Servet[Abstract Not Available]