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  • Küçük Resim
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    Effect of Modified Global Risk Classification on Prognosis at Patients Undergoing Bypass Surgery and Percutaneous Coronary Intervention with Multi-vessel Disease
    (Aves Press Ltd, 2018) Kaypakli, Onur; Sahin, Durmus Yildiray; Deniz, Ali; Aktas, Halil; Akilli, Rabia Eker; Icen, Yahya Kemal; Caglayan, Caglar Emre
    Objective: The aim of this study was to compare mortality and myocardial infarction in patients with multi-vessel disease using Modified Global Risk Classification (mGRC). Methods: We divided 579 patients into low, intermediate risk with a high EuroSCORE (IE), intermediate risk with a high SYNTAX score (IS), and high Modified Global Risk groups. Patients were evaluated for death, myocardial infarction, cerebrovascular events, need for re intervention, and a primary endpoint, which denotes the occurrence of any one of the four events. Results: Comparing the bypass surgery and percutaneous coronary intervention groups using mGRC showed significantly better prognostic results in the bypass surgery patients for the rate of the occurrence of the myocardial infarction for the IS group (p=0.047). In terms of the primary endpoint, the EuroSCORE, SYNTAX score, and Global Risk Classification (GRC) were found to be independent risk factors in logistic regression analysis. The ability of GRC to discriminate for the 1-year mortality was found to be better than that of the EuroSCORE and SYNTAX score. Conclusion: With the evaluation of the EuroSCORE and SYNTAX score together, the modified GRC, which includes both anatomical and clinical risk factors, provides an additional benefit for predicting the prognosis and decision of treatment in patients with multi-vessel disease.
  • Küçük Resim
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    New genetic risk factors for myocardial infarction at young patients in Southern Turkey
    (Cukurova Univ, Fac Medicine, 2020) Akilli, Rabia Eker; Cagliyan, Caglar Emre; Kaypakli, Onur; Kanadasi, Mehmet; Demirtas, Mustafa
    Purpose: Genetic predisposition plays an important role in the development of atherosclerosis in young patients. The aim of this study was to determine the relationship between myocardial infarction and HLA antigens in young patients who had myocardial infarction in southern region of Turkey. Materials and Methods: We enrolled 50 patients (36 male, 14 female, mean age 45.0 +/- 7.1) who had myocardial infarction before 45 years old in men and 55 years old in women and 50 healthy subjects (31 male, 19 female, mean age 51.5 +/- 5.5) as a control group into the study. Venous blood samples were collected for HLA tissue typing and determining trombogenic factors. Histocompatibility antigens (HLA-A,B,C,-DQ,-DR) were studied with Polymerase Chain Reaction (PCR)-Sequance Spesific Oligonucleotide typing (SSO) method. Results: Frequency of HLA antigens in patients and controls were 38% and 10% for HLA-A24, 40% and 10% for HLA-DQB2, 26% and 6% for HLA-DRB1-7 and 52% and 26% for HLA-DRB4-1. Chi square test revealed a significant relation with the disease and the presence of these antigens. In the logistic regression analysis, smoking, Lp(a), homocysteine and HLA-DQB1 subtype were independently associated with development of MI in young patients. Conclusion: The presence of HLA-A24, HLA-DQB2, HLA-DRB1-7 and HLA-DRB4-1 may be used as genetic markers for the tendency to coronary artery disease in southern region of Turkey.