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    Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study
    (LIPPINCOTT WILLIAMS & WILKINS, 2016) Basaran, Ozcan; Dogan, Volkan; Beton, Osman; Tekinalp, Mehmet; Aykan, Ahmet Cagri; Kalaycioglu, Ezgi; Bolat, Ismail; Tasar, Onur; Safak, Ozgen; Kalcik, Macit; Yaman, Mehmet; Inci, Sinan; Altintas, Bernas; Kalkan, Sedat; Kirma, Cevat; Biteker, Murat; Karadeniz, Fatma Ozpamuk; Tekkesin, Ahmet Ilker; Cakilli, Yasin; Turkkan, Ceyhan; Hamidi, Mehmet; Demir, Vahit; Gursoy, Mustafa Ozan; Ozturk, Mujgan Tek; Aksan, Gokhan; Seyis, Sabri; Balli, Mehmet; Alici, Mehmet Hayri; Bozyel, Serdar; Altun, Ibrahim; Calik, Feyza; Karaca, Oguz; Helvaci, Fusun; Akay, Kadriye; Canga, Yigit; Celebi, Savas; Altuntas, Emine; Ayturk, Mehmet; Gunes, Haci Murat; Bezgin, Tahir; Aksakal, Aytekin; Cakal, Beytullah; Colak, Ayse; Kaplan, Ozgur; Tatlisu, Adem; Gozubuyuk, Gokhan; Demirelli, Selami; Kaya, Adnan; Rencuzogullari, Ibrahim; Bayram, Zubeyde; Simsek, Zeki; Civan, Murat; Batgharel, Ulaankhu; Ata, Ali Ekber; Gol, Gokhan; Mert, Gurbet Ozge; Mert, Kadir Ugur; Degirmencioglu, Aleks; Candan, Ozkan; Celebi, Ozlem Ozcan; Dogan, Cem; Yavuz, Fethi; Ulucan, Seref; Arisoy, Arif; Sahin, Bingul Dilekci; Ermis, Emrah; Gokaslan, Serkan; Pektas, Idris; Tanindi, Asli; Tekin, Kamuran; Sancar, Kadriye Memic; Cekic, Edip Guvenc; Basaran, Nesrin Filiz
    This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.Of the 2086 eligible patients, 1247 (59.8%) received adequate treatment. However, off-label use was detected in 839 (40.2%) patients; 634 (30.4%) patients received UT and 205 (9.8%) received OT. Independent predictors of UT included >65 years of age, creatinine clearance 50mL/min, urban living, existing dabigatran treatment, and HAS-BLED score of <3, whereas that of OT were creatinine clearance <50mL/min, ongoing rivaroxaban treatment, and HAS-BLED score of 3.The suboptimal use of NOACs is common because of physicians' poor compliance to the guideline recommendations in patients with nonvalvular atrial fibrillation (NVAF). Older patients who were on dabigatran treatment with good renal functions and low risk of bleeding were at risk of UT, whereas patients who were on rivaroxaban treatment with renal impairment and high risk of bleeding were at risk of OT. Therefore, a greater emphasis should be given to prescribe the recommended dose for the specified patients.
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    The Role of Systemic Immune Inflammation Index for Predicting Saphenous Vein Graft Disease in Patients with Coronary Artery Bypass Grafting
    (Sage Publications Inc, 2023) Dogdus, Mustafa; Dindas, Ferhat; Yenercag, Mustafa; Yildirim, Arafat; Abacioglu, Ozge Ozcan; Kilic, Salih; Yavuz, Fethi
    As inflammation plays a significant role in the development of coronary artery disease, we hypothesized that there may be a relation between the systemic immune inflammation index (SII) and saphenous vein graft disease (SVGD). The study population consisted of 716 consecutive patients who underwent elective coronary angiography (CAG) >1 year after bypass grafting. The patients were divided into 2 groups depending on the extent of SVG patency. SII value was significantly higher in the SVGD(+) group compared with the SVGD(-) group (P < .001). In multivariate logistic regression analysis, SII (P < .001, odds ratio (OR) = 3.27, 95% CI = 1.94-5.65) and neutrophil-to-lymphocyte ratio (NLR) (P < .001, OR = 2.08, 95% CI = 1.59-3.11) were found to be independent predictors of SVGD. An SII value of >935 (x10(3)/ml) has 89.2% sensitivity and 70.6% specificity for the prediction of the SVGD, and an NLR value of >4.15 has 54.6% sensitivity and 68.5% specificity for the prediction of the SVGD. The AUC of SII was found to be greater than the AUC of NLR (P = .002), platelet-to-lymphocyte ratio (PLR) (P = .009), lymphocyte-to-monocyte ratio (LMR) (P = .013), MPV (P = .011), and C-reactive protein (CRP) (P = .034) in predicting SVGD. In conclusion, we demonstrated that SII, which is among the new inflammation indexes, is a more reliable predictor in determining SVGD than the NLR, PLR, and LMR.