After long years of using warfarin for atrial fibrillation, new oral anticoagulants (NOACs) became available for decreasing the risk of ischemic stroke. Our aim was to observe the physicians prescribing patterns of NOACs. This prospective observational study included patients using NOACs applying consecutively to our outpatient clinic. Physical examination was performed, and patient history, electrocardiogram, transthoracic echocardiography, and biochemical results were collected. Bleeding and ischemic stroke risk scores (HAS-BLED and CHA2DS2-VASc scores) were calculated. We evaluated patients' characteristics, risk factors, concomitant drug usage, and physicians' choices. The study consisted of 174 patients using NOACs (dabigatran 113 patients, rivaroxaban 61 patients), with a mean age of 70.7 ± 8.8 years. The mean HAS-BLED score was 1.74 ± 0.9 and the mean CHA2DS2-VASc score was 3.7 ± 1.2. Fifty-three (30.4%) patients were prescribed low-dose NOAC according to the optimal dose, and 12 (6.8%) patients were prescribed high-dose NOAC according to the optimal dose. We compared optimal dose and undertreatment groups to find out if there was any predicting factor for physicians to use low dose of NOACs, but there was no significant difference between the two groups for age, sex, concomitant chronic disease, and CHA2DS2-VASc and HAS-BLED scores. NOACs were prescribed to patients mostly with high CHA2DS2-VASc score and low HAS-BLED score. Low-dose NOAC usage according to the optimal dose was frequent. Frequent coagulation monitoring and drug incompliance are big deficiencies at atrial fibrillation in use of warfarin. NOACs overcome these difficulties; however, physicians' hesitation to use NOACs with the optimal dosage may be another limitation in real-world practice.

Resistin, which is derived from the gene of RSTN, belongs to a family of cysteine-rich secretory proteins called resistin-like molecules (RELMs). Increased serum resistin levels are associated with coronary artery disease (CAD) and the risk of cardiovascular death. Patients (n = 214) with an initial diagnosis of stable angina pectoris, unstable angina pectoris, and myocardial infarction without ST-segment elevation and referred to catheter laboratory for coronary angiography were enrolled in the study. We aimed to investigate the relationship between increased serum resistin level and CAD. The severity of CAD was calculated by the Gensini scoring system. In conclusion, we established a significant correlation between serum resistin levels and CAD (P = .010). Also, serum resistin levels correlated with the Gensini score that represents the severity of CAD angiographically (P = .010).

No abstract

Objective:Pulmonary artery hypertension (PAH) is characterized by remodeling of the small pulmonary arteries, leading to a progressive increase in pulmonary vascular resistance and right ventricular failure. In this study, we aimed to share our 10 years of experience dealing with pulmonary hypertension (PH) and provide information in real-life settings in terms of demographics, clinical course, PH subgroup distribution, and treatment patterns in patients with PAH in a tertiary center.Methods:In this retrospective, single-center, observational study, we screened the patients who applied to PH outpatient clinic of İstanbul University Institute of Cardiology due to the suspicion of PAH between 2008 and 2017. While group 1, 4, and 5 PH patients were included, group 2 and 3 PH patients were excluded from the study.Results:Our study group comprised 162 patients (115 females, 71%). The female: male ratio was 2.4. The mean age was 52±16 years. Most (86.4%) of the patients were in group 1 PH (PAH). The rest (13.6%, n=22) of the patients were in group 4 PH (chronic thromboembolic PH). In group 1 PH, 45.7% of patients (n=64) were classified as having idiopathic PAH (IPAH) after excluding the alternative diagnosis using PH diagnostic algorithm. The remaining 54.3% of group 1 PH patients (n=76) had various diseases that caused PAH, which is called associated PAH (APAH); APAH group included PAH associated with congenital heart diseases (n=70), connective tissue disorders (scleroderma, n=4) and portal hypertension (n=2).Conclusion:Our data provides important information in real-life settings in terms of demographics, clinical course, PH subgroup distribution, and treatment patterns in patients with PAH in a reference tertiary center in Turkey.

The NSQIP risk calculator and RCRI scores failed to accurately predict the risk of perioperative cardiac complications (Tab. 3, Ref. 30). Text in PDF www.elis.sk.

Pulmoner arteriyal hipertansiyon (PAH) hastalarında D vitamini düzeylerinin sağlıklı gönüllülerden oluşan kontrol grubuyla kıyaslanması ve hastalık şiddetiyle D vitamini düzeyi arasındaki ilişkinin araştırılması. Yöntemler: Çalışmamız tek merkezli, kesitsel bir çalışma olup, pulmoner hipertansiyon (PH) polikliniğimizde PAH tanısı ile takip edilen 36 hasta ve yaş-cinsiyet eşleştirilmiş 24 sağlıklı gönüllüden oluşmaktadır. PAH tanısı, güncel Avrupa Kardiyoloji Cemiyeti ve Avrupa Solunum Derneği 2015 PH kılavuzu tanı algoritması önerileri doğrultusunda konuldu. Kontrol grubu olarak, bilinen bir kardiyak veya sistemik-enflamatuvar hastalık öyküsü olmayan, herhangi bir ilaç kullanmayan, tüm sistem fizik muayenesi normal, elektrokardiyografik (EKG) ve ekokardiyografik (Eko) incelemede patoloji saptanmayan sağlıklı gönüllüler seçildi. Tüm hastalarda ve sağlıklı gönüllülerde sabah 8 saat açlık kan örnekleri alınarak, plazma 25-OH vitamin D düzeyleri ölçüldü (Elecsys® Vitamin D Testi). Bulgular: Çalışma popülasyonumuz 36 PAH hastası ve yaş-cinsiyet eşleştirilmiş 24 sağlıklı gönüllüden oluşmaktaydı. Hastaların 24 tanesinde (%67) doğumsal kalp hastalığıyla ilişkili PAH (PAH-DKH), 12 tanesinde (%33) idiyopatik PAH (IPAH) mevcuttu. Tüm çalışma grubunun yaş ortalaması 41.4 ± 14.0 iken PAH hastaları ve kontrol grubunda yaş ortalaması benzerdi (median 42 & 40 yaş). Her iki grupta da kadın cinsiyet baskındı. Sağlıklı gönüllüler ve PAH hastaları arasında vücut kitle indeksi, kreatinin, ürik asit, hematokrit düzeyi açısından bir fark yoktu. Vitamin D düzeyleri ise PAH hastalarında (7.7 ± 6.2 U/L) sağlıklı gönüllülere göre (21.9 ± 14.1 U/L) belirgin olarak düşük saptandı (p<0.001). Vitamin D düzeyi PAH hastalarında kontrol grubuna göre düşük saptanmakla birlikte, D vitamini düzeyi ile ne fonksiyonel kapasite (DSÖ FK III & FK II), ne de altta yatan etiyolojik neden (PAH-DKH & IPAH) arasında ilişki saptanamadı

Aim: Our aim was to examine the effect of CYP2C9 and VKORC1 polymorphisms on warfarin dose requirements in Turkish patients. Materials & methods: 24 warfarin prescribed patients were included and analyzed for eight VKORC1 and 6 CYP2C9 polymorphisms in the study. Results: Patients with CYP2C9 *1/*1 and VKORC1 -1639 GG and GA genotypes required higher warfarin doses in comparison to wild type VKORC1 genotype. Patients with CYP2C9 *1/*3 and VKORC1 -1639 GG genotypes simultaneously, required the lowest dose of warfarin (4.64 mg/day). Patients with CYP2C9 *1/*1 and VKORC1 9041 AA genotype were found to require higher warfarin doses. Conclusion: Our results provide additional evidence to support the hypothesis that CYP2C9 *2, *3, VKORC1 9041 G > A polymorphisms explain considerable proportion of inter-individual variability in warfarin dose requirement.

Objectives:We aimed to investigate the effect of resveratrol on diabetic cardiomyopathy in streptozocininduced diabetic rats. Materials and Methods:Rats were injected with streptozocin to establish diabetes model. After four weeks, heart tissues were collected for histopathological examination and immunoexpression of nitric oxide synthases-2 (NOS-2) and transforming growth factor-β1 (TGF-β1). Lipid peroxidation was evaluated. Results:In diabetic rats, cardiac muscle cell thickness (hypertrophy), TGF-β1 and NOS-2 expression were increased significantly when compared to control group. Administration of resveratrol in diabetic rats causes a significant reduction both in cardiac muscle cell thickness, TGF-β1 and NOS-2 expression in these rats.Blood glucose levels were significantly increased in diabetic rats expectedly, but there was no important difference between diabetic rats and resveratrol administrated diabetic rats in terms of blood glucose levels. Conclusion:We showed protective effects of resveratrol on dilated cardiomyopathy on diabetic rats by reducing oxidative stress. As the prevalence of diabetes mellitus is increasing, resveratrol supplementation could help preventing diabetic cardiomyopathy.