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    A BULLET NUCLEUS MOBILE WITH CARDIAC CYCLE
    (NOBEL ILAC, 2012) Kucukdurmaz, Zekeriya; Sezen, Yusuf; Yildiz, Ali; Gur, Mustafa; Demirbag, Recep
    We hereby report a case of atypical chest pain after a firearm injury occurring 20 years ago, which remained asymptomatic throughout the years. The patient had a positive treadmill exercise test and his coronary angiographic examination revealed plaque lesions and a bullet embedded in the myocardium. The bullet could not be localized clearly by echocardiography or computerised tomography due to the shiny nature of the metal. Penetrating gun traumas are quite frequent in developed countries and in countries in war, with most of the cases ending with death. A situation similar to our case was reported only once in the medical literature. Firearm injuries lead to free mural perforations, fistulisations between cardiac spaces and pericardial tamponade. Usually the patients die before reaching the hospital. But in asymptomatic patients, the bullet may be found as embedded in the myocardium.
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    The relationship between the existence of angiographic coronary artery calcification and the severity of coronary artery disease
    (TERMEDIA PUBLISHING HOUSE LTD, 2012) Kucukdurmaz, Zekeriya; Sezen, Yusuf; Ulas, Turgay; Bas, Memduh; Polat, Mustafa; Yildiz, Ali; Buyukhatipoglu, Hakan; Kaya, Zekeriya; Demirbag, Recep
    Background: Coronary artery calcification (CAC) is a predictor of coronary artery disease (CAD) and closely related to major adverse cardiac events. The Gensini score is a scoring system to determine the severity and extent of coronary atherosclerosis. Aim: We aimed to investigate the relationship between CAC and both the extent and severity of CAD. Material and methods: Coronary artery calcification was identified by visual examination during fluoroscopic examination. The study population was divided into two groups, according to the presence or absence of CAC. The CAC(+) group consisted of 126 patients (45 women, 81 men), the CAC(-) group 156 patients (58 women, 98 men). Gensini scores were calculated from the results of coronary angiography. Results: We identified CAC more frequently in type 2 diabetes mellitus patients, with no gender differences. Other risk factors for CAD - including age, hypertension, smoking, body mass index, waist circumference, and systolic blood pressure were not significantly different between the CAC(+) and CAC(-) groups. Serum levels of triglyceride and very low density lipoprotein (VLDL) cholesterol were significantly lower in the CAC(+) group, and diastolic blood pressure levels and type 2 diabetes mellitus (DM) frequency were higher. By logistic regression, an independent relationship was identified between the Gensini score and CAC. Conclusions: Coronary calcification seems to be more prevalent in type 2 DM patients than in the normal population. The Gensini score, that is, the extent and severity of coronary artery disease, appears to be independently related to CAC, an issue that warrants further investigation to allow for future clinical applications.
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    Turkish registry for diagnosis and treatment of acute heart failure: TAKTIK study
    (Turkish Soc Cardiology, 2016) Eren, Mehmet; Zoghi, Mehdi; Tuncer, Mustafa; Cavusoglu, Yuksel; Demirbag, Recep; Sahin, Mahmut; Serdar, Osman Akin
    Objective: The goal of this study was to develop a national database of patients hospitalized in Turkey with acute heart failure (AHF) using evaluations of diagnostic and therapeutic approaches. Methods: Patient data were collected using an Internet-based survey. A total of 588 patients were enrolled from 36 participating medical centers across the country. Results: Mean age was 62 +/- 13 years and 38% of the patients were female. Ratio of de novo AHF to study cohort was 24%. Coronary heart disease and hypertension were found in 61% and 53% of the patients, respectively. Valvular heart disease was the underlying cause in 46% of heart failure patients. The most frequent factor associated with decompensation was noncompliance with treatment, observed in 34% of patients. Systolic blood pressure was 125 +/- 28 mmHg and heart rate was 93 +/- 22 beats/minute in the cohort. The most common findings on physical examination were inspiratory fine crackles (84%), peripheral edema (64%), and cold extremities in 34%. Mean ejection fraction (EF) measured at admission was 33 +/- 13%. Preserved EF (>=%40) was present in 20% of patients. On admission, 60%, 46%, and 40% of patients were using angiotens-in-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, or aldosterone antagonist, respectively. In-hospital events were reported as 3.4% death, 1.6% stroke and 2% myocardial infarction. Conclusion: Compared to previous data collected around the world, AHF patients in Turkey were younger, had more frequently valvular heart disease as the underlying cause, and were more noncompliant with medical treatment, but overall mortality was lower. Drugs shown to reduce mortality, and which also form the basis of guideline-directed medical therapy, are still used inadequately.