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    Association between MMP-3 and MMP-9 polymorphisms and coronary artery disease
    (SPANDIDOS PUBL LTD, 2016) Beton, Osman; Arslan, Serdal; Acar, Burak; Ozbilum, Nil; Berkan, Ocal
    Matrix metalloproteinase (MMP)-3 and MMP-9 polymorphisms are characterized by plaque stability in coronary arteries. The aim of the current study was to investigate the 5A/6A polymorphism in the MMP-3 gene and C/T polymorphism in the MMP-9 gene in patients with coronary artery disease (CAD). The study population consisted of 400 patients who underwent coronary angiography. There were two groups consisting of 200 consecutive patients with CAD, presenting with stable angina pectoris, and 200 consecutive patients exhibiting normal coronary arteries. Two single nucleotide polymorphisms in the MMP gene, MMP-3 and MMP-9, were detected using a polymerase chain reaction-restriction fragment length polymorphism assay. Mean age, gender distribution, smoking status, presence of diabetes mellitus and hypercholesterolemia were identified to be similar between the groups. One hundred and twenty seven (63.5%) patients had hypertension in the CAD group, whereas only 55 (27.5%) patients had hypertension in the control group (P< 0.001). No significant difference in frequency of alleles and genotypes of MMP-9 C -> T between the CAD and control groups was identified. The 5A allele frequency of MMP-3 in the CAD group was significantly higher when compared with the control group (P< 0.001; odds ratio=2.18). The genotype frequency of MMP-3 5A/5A in the CAD group was significantly higher when compared with the controls (P=0.005). When compared with the homozygous wild-type (6A/6A) genotype of the MMP-3 gene, the cumulative frequency of heterozygote and homozygote genotypes of the MMP-3 gene was significantly higher in the CAD compared with the control group (P<0.001). Thus, the present study demonstrated that the 5A/5A and 6A/5A+5A/5A genotypes of the MMP-3 gene were associated with an increased risk of CAD.
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    Rationale, Design, and Methodology of the MORCOR-TURK Trial: Predictors of In-hospital MORtality in CORonary Care Patients in Turkey
    (Kare Publ, 2023) Kahraman, Fatih; Ersoy, Ibrahim; Yilmaz, Ahmet Seyda; Atici, Adem; Tekin, Alpin Mert; Acar, Burak; Kaya, Caglar
    Background: Coronary care units are sophisticated clinics established to reduce deaths due to acute cardiovascular events. Current data on coronary care unit mortality rates and predictors of mortality in Turkey are very limited. The MORtality predictors in CORonary care units in TURKey (MORCOR-TURK) trial was designed to provide information on the mortality rates and predictors in patients followed in coronary care units in Turkey. Methods: The MORCOR-TURK trial will be a national, observational, multicenter, and noninterventional study conducted in Turkey. The study population will include coronary care unit patients from 50 centers selected from all regions in Turkey. All consecutive patients admitted to coronary care units with cardiovascular diagnoses between 1 and 30 September 2022 will be prospectively enrolled. All data will be collected at one point in time, and the current clinical practice will be evaluated (ClinicalTrials.gov number NCT05296694). In the first step of the study, admission diagnoses, demographic characteristics, basic clinical and laboratory data, and in-hospital management will be assessed. At the end of the first step, the predictors and rates of in-hospital mortality will be documented. The second step will be in cohort design, and discharged patients will be followed up till 1 year. Predictors of short- and long-term mortality will be assessed. Moreover, a new coronary care unit mortality score will be generated with data acquired from this cohort. Results: The short-term outcomes of the study are planned to be shared by early 2023. Conclusion: The MORCOR-TURK trial will be the largest and most comprehensive study in Turkey evaluating the rates and predictors of in-hospital mortality of patients admitted to coronary care units.
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    Refractory Vasovagal Syncope Despite Tilt Training: Should Paroxetine be Included in the Treatment?
    (Galenos Publ House, 2024) Asarcikli, Lale Dino; Beton, Osman; Acar, Burak; Beton, Nur; Birtan, Hasan; Zekican, Guezin; Yilmaz, Nuryil
    BACKGROUND/AIMS: To investigate the efficacy of selective serotonin reuptake inhibitors (SSRI) for preventing spontaneous vasovagal syncope (VVS) in patients with refractory VVS despite home-based tilt training (TT). MATERIALS AND METHODS: We included 111 consecutive patients with VVS. All patients were instructed to increase salt and fluid intake, perform counterpressure maneuvers, and perform TT. The first control visit was scheduled within 2 months of the initial treatment. Paroxetine 20 mg was added to TT in patients with refractory VVS despite TT (TT plus SSRI group) at the first control visit, and patients without refractory VVS who continued TT (TT group). The clinical features of the patients, spontaneous VVS attacks before and after treatment, and follow-up data were recorded. RESULTS: A total of 111 consecutive patients (67 females; age: 32 +/- 12 years) were treated with TT (64 patients) or TT plus SSRI (47 patients). The mean follow-up was 8.9 +/- 3.3 months after the first control visit. During follow-up, 38 (80.9%) patients in the TT + SSRI group and 30 (46.9%) in the TT group were asymptomatic (p<0.001). In the univariate analyses, TT plus SSRI treatment and TT treatment during follow-up were predictors of an asymptomatic course. Multivariate analysis showed that TT plus SSRI therapy (odds ratio: 4,785, 95% confidence interval: 4,78411,501, p<0.001) as the sole predictor of asymptomatic course at follow-up. CONCLUSION: The addition of paroxetine to the treatment of patients with recurrent VVS who do not respond to TT and conventional treatment is an effective and well-tolerated treatment method for preventing vasovagal attacks.