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    Relationship between cryptogenic ischemic stroke and P wave peak time
    (2024) Koyun, Emin; Koyuncu, İlhan; Dindaş, Ferhat; Dogdus, Mustafa; Öcek, Levent
    Objectives: This study aimed to examine whether P wave peak time (PWPT), a predictor of atrial fibrillation (AF), is significantly higher at the time of diagnosis in cryptogenic ischemic stroke patients. Patients and methods: The retrospective was conducted with 118 individuals (72 males, 46 females; mean age: 66.4±13.8 years) with cryptogenic ischemic stroke in the patient group and 118 individuals (77 males, 41 females; mean age: 63.2±16.1 years) without cerebrovascular disease in the control group between January 2021 and December 2023. The groups were compared regarding PWPT. Results: As a result of multivariate regression analysis, PWPT-D2 and PWPT-V1 were found to be independent predictors of cryptogenic ischemic stroke. In the ROC analysis, when PWPT-D2 was >51.5 msec, the sensitivity for the diagnosis of cryptogenic ischemic stroke was found to be 80%, and the specificity was 76%. When PWPT-V1 was >46 msec, the sensitivity for the diagnosis of cryptogenic ischemic stroke was found to be 75%, and the specificity was 73%. Conclusion: P wave peak time is an important predictor of cryptogenic ischemic stroke. The reason for the high PWPT level in these patients may be undetected AF. Therefore, longer-term rhythm Holter may be recommended in these patients.
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    Relationship between HALP and PNI score with 1-month mortality after CABG
    (Frontiers Media Sa, 2024) Koyuncu, İlhan; Koyun, Emin
    Background: Coronary heart disease (CHD) is the most common cause of cardiovascular disease (CVD). CHD is among the most common causes of mortality and morbidity world wide. In addition, CHD is one of the most important causes of health expenditures world wide. Today, coronary artery bypass grafting (CABG) operations are a widely used surgical procedure and have an important place in the treatment of CHD. Many scoring systems have been evaluated to estimate the risk of mortality and morbidity. 30-day mortality rates after CABG have been reported as 1-4% in large-scale studies. Objectives: The aim of our study was to evaluate the relationship between 1-month mortality in patients undergoing CABG and the Hemoglobin, albumin, lymphocyte, platelet index (HALP score) and Prognostic nutritional index (PNI) calculated using laboratory data in the preoperative period. Methods and design: A total of 239 patients who underwent CABG were evaluated retrospectively. Preoperative biochemical and hemogram values, demographic characteristics, comorbidities, HALP score and PNI values of the patients were recorded. The patients were divided into two groups: Exitus group (n = 51) and survival group (n = 188). The data of the two groups were compared, mainly HALP score and PNI. Results: It was observed that 51 of 239 patients (21.3%) developed exitus during the 30-day follow-up after CABG. When demographic data are compared; advanced age, female gender, history of DM (Diabetes Mellitus), history of HL (hyperlipidemia) and smoking were found to be associated with mortality. When laboratory data are compared; high troponin levels, low hemoglobin, low lymphocyte and low albumin levels were found to be associated with mortality. Low HALP score (p < 0.001) and low PNI (p < 0.001) were also found to be associated with mortality. In univariate and multivariate regression analysis; advanced age, history of DM, HALP score and PNI were found to be independent predictors of 30-day mortality after CABG. It was determined that a cut-off value of 0.29 for the HALP score and 39.1 for PNI had found, respectively, 81 and 79% sensitivity and 82 and 80% specificity. Conclusion: Preoperatively measured HALP score and PNI can be used to predict 1-month mortality after CABG.
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    The Prognostic Value of Bendopnea In-Hospital Mortality In Patients With Acute Coronary Syndrome
    (2024) Sivri, Fatih; Koyuncu, İlhan; Gül, İlker; Ardıç, Mustafa Lütfullah; İçen, Yahya Kemal
    Background: Bendopnea, also known as flexi-dyspnea, has recently been defined as the development of shortness of breath within 30 seconds by bending forward in patients with systolic and decompensated heart failure. There is no clear data in the literature regarding acute coronary syndrome (ACS) patients and in-hos-pital mortality. This study investigated the effect of the presence of bendopnea on in-hospital mortality in ACS patients. Materials and Methods: A cross-sectional analysis was conducted on patients admitted with ACS (unstable angina and non-ST elevation myocardial infarction (NSTEMI)) between March 2023 and January 2024. The presence of orthopnea, bendopnea, paroxysmal nocturnal dyspnea PND and venous jugular distention (VJD) recorded. Coronary angiography was performed in all patients. A total of 395 patients were enrolled in this study. Results: The patients were divided into 2 groups as living and deceased. The deceased group was significantly older. Bendopnea, PND, and orthopnea were statistically higher in the deceased group. left ventricular ejec-tion fraction(LVEF) was statistically lower, syntax score was statistically higher in the deceased group. Age (%95 CI:1.254-1.627 , OR: 1.411 p:0.001), uric acid (%95 CI: 1.151-1.394 OR: 1.278 p:0.001), bendopnea (%95 CI: 1.285-1.611 OR: 1.452 p: 0.001), syntax score (%95 CI: 1.103-1.358 OR: 1.258 p:0.001) were shown to be independent risk factors for mortality. Conclusions: The presence of bendopnea in patients with ACS may be closely associated with in-hospital mor-tality.