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    Erythrocyte sedimentation rate in acute myocardial infarction as a predictor of poor prognosis and impaired reperfusion
    (Medical Assoc Zenicadoboj Canton, 2012) Ozlu, Mehmet Fatih; Sen, Nihat; Karakas, Mehmet Fatih; Turak, Osman; Ozcan, Firat; Kanat, Selcuk; Aras, Dursun
    Aim To investigate whether the elevated erythrocyte sedimentation rate (ESR) is associated with an adverse prognosis in the patients with ST-segment elevation myocardial infarction (STEM I) undergoing primary percutaneous coronary intervention (PCI). Methods It included 140 consecutive patients undergoing primary PCI for acute STEM!, <12 hours after symptom beginning and 50 healthy age and sex matched control subjects. All patients were categorized into two groups defined by the median ESR level on admission. These two groups were compared in terms of myocardial perfusion, and one year outcomes. Results Levels of ESR were higher ill patients with STEM! than in the healthy group. Patients in the elevated ESR group had a higher incidence of impaired angiographic reperfusion compared to patients in the lower ESR group (Mean TIMI frame count; 25.5 +/- 6.5 versus 20.4 +/- 5.2, p<0.01, TMPG 0-2; 55 % versus 29%, p<0.01). In-hospital and one-year mortality rates were significantly higher in patients with higher ESR. In-hospital and one-year MACE rates were significantly greater in elevated ESR group (14%-26), compared to the lower ESR group (4%-13%). Increased ESR levels on admission emerged as independent predictors of long term prognosis. The ROC analysis revealed an optimal cut-point of >= 33 mm/h, detected I year mortality with a negative predictive value of 96%. Conclusion The high admission ESR levels are found to be related with impaired coronary flow in patients undergoing primary PC-I that possibly contribute to poor short- and long-term prognosis. Therefore, admission ESR evaluation may be helpful in identifying patients with a poor prognosis.
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    Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization
    (Ivyspring Int Publ, 2013) Tuncez, Abdullah; Kaya, Zeynettin; Aras, Dursun; Yildiz, Abdulkadir; Gul, Enes Elvin; Tekin-alp, Mehmet; Karakas, Mehmet Fatih
    In this study, we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3rd h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24th h. Fluoroscopy duration, procedure success, and complications of the radial artery were recorded. The procedure was successfully completed in all patients. RAO was detected in eight female and two male patients. In terms of RAO, there was a statistically significant difference between males and females (p=0.019). Other parameters did not show a significant correlation with RAO. Altough did not have any effect on procedural success, eight patients developed transient radial artery spasm. Gender was not associated with radial arterial spasms (p=0.19). TRA in the diagnosis and treatment of coronary artery disease has shown high procedural success and low complication rates; it addition, it presents a low economic burden. It should be used widely and be involved in the routine cardiology residency program.