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    (Türk Kardiyoloji Derneği, 2019) Şeker, Taner; Türkoğlu, Caner; Akkuş, Oğuz;
    entitled “The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention,” published in the Archives of the Turkish Society of Cardiology.[1] As we noted in the discussion section, “the lower in-hospital mortality of patients with VTA [visible thrombus aspiration] in our study may also be associated with a shorter door-to-balloon time, lower Killip class, and better TIMI [Thrombolysis in Myocardial Infarction] flow after TA [thrombus aspiration].” Delayed door-balloon time can be a reason for a higher Killip classification in patients without VTA, and these decompensated patients, naturally, cannot undergo revascularization during ST elevation myocardial infarction.
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    Poor myocardial blush grade accompanies to higher sudden death risk scores of hypertrophic cardiomyopathy
    (İnönü Üniversitesi, 2019) Akkuş, Oğuz; Kaplan, Mehmet; Duman, Fatma; Yalçın, Fatih
    Aim: Hypertrophic cardiomyopathy (HCM) is predominantly inherited as an autosomal dominant disease. The aim of our study was to evaluate angiographic microvascular flow and predictors of poor MBG in patients with HCM. Material and Methods: Patients with poor MBG (MBG 0/1, n=43), and patients with normal MBG (MBG 2/3, n=15) were included retrospectively. Results: Family history and left ventricular end-diastolic diameter were significantly higher in the poor MBG group (p = 0.025, p=0.021). Left atrium diameter and moderate to severe mitral regurgitation (MR) were significantly higher in the normal MBG group (p=0.034, p=0.002). Percentage of SCD risk was significantly higher in patients with poor MBG (p=0.014). Moderate and severe mitral regurgitation (odds ratio =0.013, p=0.004) and HCM-SCD risk score (odds ratio = 0,398, p=0.009) were found to be independent parameters for predicting poor myocardial blush grade. The cut-off value of HCM-SCD risk score obtained by ROC curve analysis was 3.10 for the prediction of poor myocardial blush grade (sensitivity: 76.2%, specificity: 76.7%). The area under the curve (AUC) was 0.712 (p=0.016). Conclusions: Our study results demonstrated the increased risk of sudden cardiac death accompanies poor myocardial blush grade in patients with HCM. If confirmed by further studies, poor MBG may convey SCD-HCM risk of higher rates.
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    The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention
    (Türk Kardiyoloji Derneği, 2019) Şeker, Taner; Türkoğlu, Caner; Akkuş, Oğuz; Gür, Mustafa
    Objective: The benefit of intracoronary thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not yet fully clear. The aim of this study was to investigate the clinical impact of visible thrombus aspiration (VTA) material. Methods: A total of 295 patients with a Thrombolysis in Myocardial Infarction (TIMI) flow score of 0 or 1 after an anterior STEMI were included in the study. Manual TA devices were used before performing PCI. The patients were divided into 2 groups: (1) visible thrombus aspiration (VTA) group and (2) non-visible thrombus aspiration (non-VTA) group. No-reflow was defined as TIMI grade 0, 1, or 2 flow, or TIMI grade 3 with a myocardial blush of grade 0 or 1. The primary endpoint was the occurrence of no-reflow. Results: VTA was retrieved in 178 (60.3%) of the patients. A no-reflow determination was significantly less frequent in the VTA group (p<0.001). The ejection fraction and ST-segment resolution values were higher, and the in-hospital mortality, Killip class II-IV rating, and post-pPCI TIMI frame count were lower in the VTA group (p<0.05 for each). Conclusion: VTA predicted a lower rate of in-hospital mortality and no-reflow in patients with anterior STEMI who underwent pPCI.