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    Association between metabolic syndrome and late saphenous vein graft disease
    (Turkish Soc Cardiology, 2006) Yilmaz, Mehmet Birhan; Guray, Umit; Guray, Yesim; Biyikoglu, Senay Funda; Kisacik, Halil L.; Korkmaz, Sule
    Objectives: Saphenous vein grafts have been widely used in coronary bypass operations for many years. We investigated the association between metabolic syndrome (MS) and late saphenous graft disease. Study design: The study included 193 patients (16 females, 177 males; mean age 62 +/- 8 years; range 39 to 86 years) in whom at least one saphenous vein graft had been used during coronary bypass operation of at least 10-year history. All the patients underwent coronary angiography for anginal complaints or preoperative assessment. Patients were classified into two groups. Group 1 was comprised of 72 patients with patent saphenous graft, whereas group 2 included 121 patients without patency or with associated lesions. The two groups were compared in terms of their medications, anthropometric measurements, blood biochemistry, and the presence of hypertension, diabetes mellitus, smoking, and MS. Results: Metabolic syndrome was less frequent in group 1 than in group 2 (22% vs. 45.6%, p=0.003). Metabolic syndrome score, derived from the sum of MS components, was higher in group 2 than in group 1 (2.3 +/- 1 vs. 1.8 +/- 1.2, p=0.003). In a multivariate logistic regression analysis, duration from bypass to coronary angiography (beta=0.812, p=0.017) and MS score (beta=0.590, p=0.005) were found to be independent factors related to saphenous graft patency. Conclusion: Metabolic syndrome score seems to be associated with late saphenous vein graft disease. Early measures for MS may affect the prognosis of patients undergoing coronary bypass operations.
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    Fine vs. coarse atrial fibrillation: Which one is more risky?
    (KARGER, 2007) Yilmaz, Mehmet Birhan; Guray, Yesim; Guray, Umit; Cay, Serkan; Caldir, Vedat; Biyikoglu, Senay Funda; Sasmaz, Hatice; Korkmaz, Sule
    Background: Atrial fibrillation (AF) is a frequent arrhythmia, associated with morbidity and mortality. It is identified by two types on surface electrocardiogram as fine and coarse AF. We aimed to search the association of subtypes of AF with clinical parameters. Methods: Eight hundred and eleven consecutive patients, who had AF attack which lasted longer than 24 h or more, were evaluated along with clinical and laboratory data. Results: Coarse AF was noticed in 51.7% (n = 419), and fine AF in 48.3% (n = 392). Sex was associated with subtype of AF such that coarse AF was present in 46.5% of male patients, but in 56.1% of female patients (p = 0.009). Coarse AF was present in 85.3% of patients with mitral stenosis, whereas it was present in 35.3% of patients with normal heart valve (p < 0.001).). Patients having fine AF were significantly older than those having coarse AF (64 +/- 12, 57 +/- 13 years, p < 0.001). 19.6% of those with coarse AF had history of cerebrovascular event (CVE), whereas 13.5% of those with fine AF had history of CVE (p = 0.021). After controlling for age in the multivariable logistic regression analysis, presence of coarse AF (B = 1.585, p = 0.031) was found to be independently associated with the history of CVE. Conclusion: AF is identified by two morphological forms on the surface electrocardiogram. These two forms were found to be associated with different clinical parameters, acting on vascular endpoints differently. Copyright (c) 2007 S. Karger AG, Basel.
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    Metabolic syndrome increases the risk of significant coronary artery involvement in patients with peripheral artery disease
    (LIPPINCOTT WILLIAMS & WILKINS, 2006) Yilmaz, Mehmet Birhan; Guray, Yesim; Guray, Umit; Biyikoglu, Senay Funda; Tandogan, Izzet; Korkmaz, Sule
    Background Peripheral artery disease is a common condition, mainly associated with clinical cardiovascular risk factors. Patients with peripheral artery disease suffer from coronary artery disease-related complications. On the other hand, metabolic syndrome, as a constellation of specific risk factors, represents a risk factor for cardiovascular mortality. Metabolic syndrome might increase the risk of significant coronary artery disease in patients with peripheral artery disease. We aimed to examine the association of metabolic syndrome with the angiographically shown coronary artery involvement in patients with peripheral artery disease. Methods Two hundred and forty-seven patients with peripheral artery disease (mean age 60 +/- 9.5 years, 223 men/24 women), who were referred to coronary angiography, were evaluated. The resting ankle-brachial pressure index was measured with the patient in supine position. Patients with > 70% diameter stenosis were considered to have significant coronary artery disease. Results In all, there were 223 male/24 female patients with mean ankle-brachial pressure index of 0.7 +/- 0.2, and mean age of 60 +/- 9.5 years. Metabolic syndrome was present in 53% (n = 131) of all patients. Significant coronary artery disease was more frequently encountered in patients with peripheral artery disease and metabolic syndrome than in those without metabolic syndrome (73.3 vs. 40.5%, P < 0.001). The presence of metabolic syndrome increased the risk of having significant coronary artery disease in patients with peripheral artery disease by 4.027 fold. Lower ankle-brachial pressure index (P = 0.038, B = 2.567), older age (P < 0.001, B = 1.075), presence of metabolic syndrome (P = 0.015, B = 2.247), and presence of diabetes mellitus (P < 0.001, B = 1.293) were found to be independent predictors of significant coronary artery disease in patients with peripheral artery disease in multivariable regression. Conclusion Metabolic syndrome seems to increase the risk of significant coronary artery disease in patients with peripheral artery disease.