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    Adropin and circadian variation of blood pressure
    (VIA MEDICA, 2018) Bolayir, Hasan Ata; Kivrak, Tarik; Gunes, Hakan; Bolayir, Asli; Karaca, Ilgin
    Background: Nocturnal hypertension and non-dipping pattern are often associated with endothelial dysfunction. Previous studies suggested that adropin, a novel secreted energy homeostasis protein, has the unique ability to regulate endothelial cell function. Aim: This study aims to investigate the association between absolute night-time blood pressure (BP) and circadian BP pattern with serum adropin and high-sensitivity C-reactive protein (hsCRP) levels in patients with newly diagnosed untreated arterial hypertension. Methods: Twenty-four-hour ambulatory BP monitoring was recorded in 100 hypertensives (50 dippers, 50 non-dippers) and 50 healthy controls. Serum levels of adropin and hsCRP were measured and recorded. Results: A strong correlation was found between night-time BP levels with adropin and hsCRP levels (p < 0.001). On the other hand, the non-dipper group demonstrated lower adropin levels compared to the dipper and normotensive groups: non dipper group, 2580 +/- 457 pg/mL; dipper group, 3298 +/- 530 pg/mL; normotensive group, 3681 +/- 411 pg/mL; p < 0.001). HsCRP levels were significantly higher in the non-dipper group than in the two other groups (p = 0.017). In a multivariate logistic regression analysis, adropin (p = 0.012) and hsCRP (p = 0.039) were independently associated with a non-dipping pattern. Conclusions: Decreased adropin levels were found in the nocturnal hypertensive and non-dipper groups. Adropin and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that decreased levels of adropin in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to a possible future role of adropin in identifying hypertensive patients at higher risk of target organ damage.
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    The association between serum serglycin level and coronary artery disease severity in patients with stable angina pectoris
    (VIA MEDICA, 2018) Bolayir, Hasan Ata; Kivrak, Tarik; Gunes, Hakan; Bolayir, Asli; Karaca, Ilgin
    Background: Serglycin plays a key role in the inflammatory status however the relationship between coronary artery disease (CAD) and serglycin is still unknown. Aim: In this study, we aimed to investigate association of serglycin levels with CAD severity in patients with stable angina pectoris (SAP). Methods: In total, 100 SAP patients diagnosed by coronary angiography and clinical manifestations, and 100 control subjects matched for age and sex were enrolled in this case-control study. Plasma levels of serglycin, high-sensitivity C-reactive protein (hsCRP), lipid profiles, and clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the SYNTAX score (SS) assessed by coronary angiography. Results: Positively correlated with the SS (r = 0.564, p < 0.001), the plasma serglycin level in the SAP group was higher than that in the control group (11.17 +/- 1.82 vs. 19.28 +/- 1.88 ng/mL, p < 0.001). The plasma serglycin level was an independent predictor for both SAP (odds ratio [OR] 1.037, 95% confidence interval [CI] 1.020-1.054, p < 0.001) and a high SS (OR = 1.087, 95% CI 1.051-1.124, p < 0.001) in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, the plasma serglycin level was found to have a better predictive value for a high SS (area under the curve [AUC] 0.858, 95% CI 0.788-0.929, p < 0.001) compared with hsCRP (AUC 0.665, 95% CI 0.557-0.773, p = 0.006; Z = 2.94, p < 0.001), with an optimal cut-off value of 17.25 ng/mL (sensitivity 94.3%, specificity 68.2%). Conclusions: Plasma serglycin levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.
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    Cancer antigen-125 levels predict long-term mortality in chronic obstructive pulmonary disease
    (INFORMA HEALTHCARE, 2015) Kaya, Hakki; Zorlu, Ali; Yucel, Hasan; Dogan, Omer Tamer; Sarikaya, Savas; Aydin, Gulay; Kivrak, Tarik; Yilmaz, Mehmet Birhan
    Background: Cancer antigen-125 (CA-125) might be a useful biomarker to predict long-term mortality in patients with recent exacerbation of chronic obstructive pulmonary disease (COPD). Methods: A total of 87 consecutive patients with COPD were evaluated prospectively. Mean age of patients was 68 +/- 10 years (55% males, 45% females) with a median follow-up period of 49 months. Optimal cut-off value of CA-125 to predict mortality was found as >93.34 U/ml, with 91% specificity and 40% sensitivity. Results: After follow-up, 20 out of 87 (23%) experienced cardiovascular death. CA-125 levels were higher among those who died compared to those who survived [55 (12-264) versus 28 (5-245) U/ml, p = 0.013]. In multivariate Cox proportional-hazards model with forward stepwise method, only CA-125 > 93.34 U/ml on admission (HR 3.713, 95% Cl: 1.035-13.323, p = 0.044) remained associated with an increased risk of death. Conclusions: For the first time, we demonstrated that CA-125 helps the risk stratification of patients with COPD.
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    Effect of altitude on ticagrelor-induced dyspnea in patients with acute coronary syndrome
    (Sage Publications Ltd, 2023) Kocabay, Gonenc; Kivrak, Tarik; Karaca, Ozkan; Karasu, Mehdi; Kaya, Hakki; Kanar, Batur; Orscelik, Ozcan
    Objective: This study aimed to define the association between altitude and ticagrelor-associated dyspnea in patients with acute coronary syndrome (ACS). Methods: We studied consecutive patients with de novo ACS who were admitted to two centers at a low altitude (18 and 25 m, n = 65) and two centers at a high altitude (1313 and 1041 m, n = 136). We managed them with ticagrelor between May 2017 and September 2017. Patients with ACS underwent an interventional procedure within <90 minutes in those with ST elevation and within <3 hours in those without ST elevation. We recorded the incidence of dyspnea in patients with ACS receiving ticagrelor therapy. Results: The mean age was 59.5 +/- 10 years, and the mean ejection fraction was 43% +/- 18%. A total of 110 (56.7%) patients had ST elevation and 84 (43.3%) did not. There were no significant differences in cardiac risk factors, concurrent medications, or procedural variables between the two groups. Dyspnea developed during hospitalization in 53 (38%) patients from high-altitude centers and in 13 (20%) patients from low-altitude centers (66 patients represented 32% of the total ACS cohort). Conclusions: Dyspnea is a common multifactorial symptom in patients following development of ACS. Ticagrelor-induced dyspnea appears to be associated with altitude.
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    Higher cancer antigen 125 level is associated with the presence of permanent atrial fibrillation in systolic heart failure patients
    (ACTA CARDIOLOGICA, 2016) Kaya, Hakki; Zorlu, Ali; Yucel, Hasan; Tatlisu, Mustafa Adem; Kivrak, Tarik; Coskun, Abuzer; Yilmaz, Mehmet Birhan
    Introduction Atrial fibrillation (AF) is a common arrhythmia in heart failure (HF). Recent studies have shown that serum cancer antigen-125 (CA-125) levels are elevated in HF, and high levels of CA-125 in HF patients with sinus rhythm have been shown to be associated with the development of new onset AF. However, the relation between CA-125 levels and the presence of AF in HF is unknown. In this study we investigated whether plasma CA-125 levels in patients with systolic HF could predict the presence of AF. Methods The study was a retrospective cohort design including 205 stable systolic HF patients who were selected during outpatient clinic visits and who had CA-125 measurement and an electrocardiogram within the last one month before admittance to cardiology clinic. Patients were classified into two groups based on the presence of AF (n=67) or sinus rhythm (n=138). Results The mean age of the patients was 68 11 years. CA-125 levels were significantly higher in patients with AF than patients with SR [33 (3-273) vs 102 (7-296) U/ml, P < 0.001]. CA-125 level, presence of right ventricular dilatation, pericardial effusion, moderate to severe TR and MR, and left atrial diameter were found to be associated with the presence of AF in univariate analysis. In a multivariate logistic regression model, only the CA-125 level remained associated. Also, according to the ROC curve analysis, the optimal cut-off level of CA-125 for predicting AF was 91 U/mL with a specificity of 84% and a sensitivity of 54%. Conclusion We have shown that the CA-125 levels can be used to predict AF in patients with systolic HF.
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    Relationship between endothelial dysfunction and microalbuminuria in familial Mediterranean fever
    (AVES, 2016) Gunes, Hakan; Kivrak, Tarik; Tatlisu, Mustafa; Kaya, Hakki; Yilmaz, Mehmet Birhan
    Objective: The aim of our study is to investigate the relationship between microalbuminuria and flow-mediated dilatation in familial Mediterranean fever (FMF) patients. Material and Methods: In our study, there were two groups consisting of 54 patients who were out of the attack period (43 of whom had no microalbuminuria and 11 of whom had microalbuminuria) and 40 healthy controls (M/F: 12/28). Results: There was no statistically difference between patient and control groups'age (25.06 +/- 8.07, 22.89 +/- 6.00 years, respectively). Flow-mediated dilatation (FMD) percentages were significantly different between the three groups (p=0.01). It was observed that there was a correlation between microalbuminuria and FMD percentage. Conclusion: Endothelial dysfunction and renal damage occurred as a result of low-grade chronic inflammation. Microalbuminuria, which is the indicator of renal damage and endothelial dysfunction, and FMD show that endothelial functions can be used in the following of early detection of renal damage and endothelial functions in FMF patients.
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    The role of SCUBE1 in the development of late stent thrombosis presenting with ST-elevation myocardial infarction
    (ELSEVIER DOYMA SL, 2018) Bolayir, Hasan Ata; Kivrak, Tarik; Gunes, Hakan; Akaslan, Dursun; Sahin, Omer; Bolayir, Asli
    Introduction and Aim: There is an important link between platelets and inflammation, thrombosis, and vascular and tissue repair mechanisms. SCUBE1 (signal peptide-CUB-EGF domain-containing protein 1) may function as a novel platelet-endothelial adhesion molecule and play pathological roles in cardiovascular biology. Stent thrombosis (ST) following percutaneous coronary intervention is an uncommon and potentially catastrophic event that can manifest as myocardial infarction and sudden death. High platelet reactivity is a risk factor for thrombotic events, including late ST. For this reason, in the current study, we researched the rote of SCUBE1 in the development of late coronary ST. Methods: We included 40 patients admitted to our hospital with a diagnosis of ST-elevation myocardial infarction (STEMI) and signs of late ST on a coronary angiogram. For the control group, we recruited 50 healthy gender-and age-matched individuals who were seen for health check-ups. We also randomly included 100 patients with a diagnosis of STEMI without ST. Results: There were no significant differences between the groups in terms of baseline and demographic characteristics. The mean SCUBE1 level in patients with STEMI with late ST at admission and the STEMI without ST group was significantly higher than in the control group (p<0.01). The mean SCUBE1 level in the STEM! with late ST group was significantly higher than in the STEM1 without ST group (p=0.03). In multivariate regression analysis, serum SCUBE1 (odds ratio [OR]: 1.022; 95% confidence interval [CI]: 1.011-1.033, p<0.001) remained an independent predictor for the presence of Late ST. In addition, receiver operating characteristic curve analysis was used to determine the optimal SCUBE1 cut-off value for predicting late ST. The area under the curve was 0.972 (95% CI 0.95-0.98). The SCUBE1 cut-off value was 59.2 ng/ml, with a sensitivity of 95.4% and specificity of 82.9%. Conclusion: The present work is the first clinical study to demonstrate that serum SCUBE1 levels are significantly higher in patients with late ST and serum SCUBE1 was an independent predictor for the presence of late ST in our study population. (C) 2018 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.