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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.
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    Prognostic Value of High Sensitive Troponin T in Patients with Chronic Ischemic Heart Disease Undergoing Percutaneous Coronary Intervention
    (Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Aktas, Halil; Kaypakli, Onur; Ozmen, Caglar; Gul, Murat; Yildirim, Oguz; Inci, Sinan; Deniz, Ali
    Objective: Several studies have investigated different cardiac biomarkers as predictors of the prognosis after percutaneous coronary interventions (PCI) in patients with chronic ischemic heart disease; nevertheless, the results of these studies are conflicting. High sensitive troponin T (Hs-TnT) measurement is a novel and sensitive method. The aim of this study was to investigate if Hs-TnT levels are a predictor of major adverse cardiovascular events (MACE) in the first year after a successful elective PCI in patients with stable angina pectoris (SAP). Material and methods: 100 patients who presented with SAP and underwent successfully elective PCI were included in the study. Patients with elevated troponin I levels (>0.1 ng/mL) before the procedure excluded from the study. Hs-TnT levels were measured before the procedure and at 3-4 hours (h) (early period) and 12-24 hours (late period) after the procedure and Hs-TnT level >14 pg/mL was considered positive. The incidence of MACE during the first year was recorded. Results: Hs-TnT levels were positive in 36% of the patients in the early period and in 54% of the patients in the late period. The incidence rate of MACE for the first year was significantly higher in the patients with positive Hs-TnT levels in the early period but not the late period (36.1% vs. 15.6%; p = 0.026) and logistic regression analysis yielded an odds ratio of 3.36. Conclusion: Hs-TnT levels measured 3-4 h after a successful elective PCI in patients with SAP can predict the incidence of MACE within the first year. Nonetheless, these results must be corroborated by other larger studies.