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    A New Scoring System for the Evaluation of Ibrutinib-Associated Arrhythmias in Chronic Lymphocytic Leukemia: The ACEF Score
    (Galenos Publ House, 2024) Koyuncu, Ilhan; Koyuncu, Betuel; Ugur, Mehmet Can; Koyun, Emin; Senoz, Oktay; Dogdus, Mustafa; Bilgir, Oktay
    Objective: Bruton tyrosine kinase inhibition in cardiac tissue causes inhibition of the PI3K-AKT signaling pathway, which is responsible for protecting cardiac tissue during stress. Therefore, there is an increase in the risk of arrhythmia. This study explores the prediction of that risk with the Age-Creatinine-Ejection Fraction (ACEF) score as a simple scoring system based on the components of age, creatinine, and ejection fraction. Materials and Methods: Patients diagnosed with chronic lymphocytic leukemia (CLL) and receiving ibrutinib treatment for at least 1 year were evaluated with echocardiography and Holter electrocardiography and the results were compared with a control group of CLL patients who had not received treatment. ACEF score was calculated with the formula age/left ventricular ejection fraction+1 (if creatinine >2.0 mg/dL). Results: When the arrhythmia development of the patients was evaluated, no statistically significant difference was found between the control and ibrutinib groups in terms of types of arrhythmias other than paroxysmal atrial fibrillation (PAF). PAF was found to occur at rates of 8% versus 22% (p=0.042) among ibrutinib non -users versus users. For patients using ibrutinib, an ACEF score of >1.21 predicted the development of PAF with 77% sensitivity and 75% specificity (area under the curve: 0.830, 95% confidence interval: 0.698-0.962, p<0.001). Conclusion: The ACEF score can be used as a risk score that predicts the development of PAF in patients diagnosed with CLL who are scheduled to start ibrutinib.
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    Comparison of clinical and angiographic results in COVID-19-positive and -negative patients undergoing primary coronary intervention due to ST-elevation myocardial infarction
    (Wolters Kluwer Medknow Publications, 2021) Emren, Zeynep; Gediz, Rahman; Levent, Fatih; Emren, Sadik; Senoz, Oktay
    Introduction: Although coronavirus disease-19 (COVID-19) primarily causes respiratory system infection, it may cause thrombosis in the cardiovascular system. In this regard, we aimed to compare cardiovascular outcomes between COVID-19-positive and -negative patients with ST-segment elevation myocardial infarction (STEMI). Methods: This was a retrospective study that consecutively included 96 COVID - and 36 COVID+ patients with STEMI. Clinical, laboratory, and angiographic characteristics were obtained from hospital records, and these variables were compared between groups. Results: COVID-19 patients with STEMI had higher Killip score (3-4) (78 vs. 30, P < 0.001) and mortality (42% vs. 21%, P = 0.017). Among COVID-19 patients with STEMI, 83% had lung infiltration. According to the angiographic findings, COVID-19 patients had a shorter door to balloon time (35 ± 20 vs. 49 ± 17, P = 0.013), glycoprotein IIb/IIIa antagonist use, and shorter door to balloon time. Conclusion: COVID-19 patients with STEMI had a higher rate of cardiogenic shock and mortality. © 2021 Society of Cardiovascular Academy. All rights reserved.
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    Comparison of short-term outcomes of patients with embolism-protected and unprotected carotid artery stenting
    (2024) Demir, Yusuf; Senoz, Oktay; Eren, Abdurrahman; Demir, Ali Rıza
    Objectives: This study aimed to evaluate the effect of using or not using a protective device on clinical outcomes in patients undergoing carotid artery stenting. Patients and methods: A total of 80 patients (53 males, 27 females; mean age: 68.1±9.1 years; range, 47 to 93 years) with symptomatic severe carotid artery stenosis or asymptomatic severe carotid artery stenosis were included in the prospective study between March 2016 and August 2018. The patients were divided into two groups: those who used an embolism protection device (n=60) and those who did not (n=20). Results: In terms of primary endpoints, rates of ischemic stroke (5% vs. 5%, p=1.00) and transient ischemic attack (5% vs. 0%, p=0.56) were found to be similar between the protected and unprotected groups after carotid artery stenting. While total embolism numbers (2.11±2.62 vs. 1.26±2.19, p=0.072) and infarct sizes (8.80±4.5 mm vs. 9.00±5.05 mm, p=0.97) were similar between the protected and unprotected groups, the presence of silent microemboli was higher in the unprotected group (40% vs. 15%, p=0.02). Conclusion: Although embolism protection devices do not reduce the risk of clinically significant embolism, they significantly reduce the risk of silent microemboli.
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    The correlation between the left atrial volume index and atrial fibrillation development in heart failure with mildly reduced ejection fraction and long-term follow-up results
    (Taylor & Francis Ltd, 2022) Guzel, Tuncay; Kis, Mehmet; Senoz, Oktay
    Background The European Society of Cardiology has recently defined heart failure (HF) patient group with a left ventricular ejection fraction (LVEF) of 41-49% as a different category with the term heart failure with mildly reduced ejection fraction (HFmrEF). In this study, we aimed to conduct a research about the correlation between left atrial volume index (LAVI) and atrial fibrillation in patients HFmrEF. Methods A total of 282 patients HFmrEF who were admitted to the cardiology department from three different centres were included in the study. The study was planned as multicenter, cross-sectional study. The patients were divided into two groups as sinus rhythm and atrial fibrillation based on their electrocardiographic findings. Results It was found out that Nt-ProBNP, LA area, LAVI, pulmonary artery pressure, and severe mitral regurgitation rates were significantly higher in the AF group (p < 0.001). ROC analysis resulting in LAVI > 30.5 had 64% sensitivity and 66% specificity in the predicting presence of AF (ROC area under the curve: 0.660, 95% CI: 0.587-0.733, p < 0.001). We also observed that the LA area being >16.55 predicting presence of AF with 60% sensitivity and 58% specificity (ROC area under the curve: 0.624, 95% CI: 0.549-0.699, p = 0.002). Conclusion In the study conducted, we found a correlation between AF and LAVI values in patients in the HFmrEF group. If the LAVI value increases in the follow-up of this group of patients with echocardiography, close follow-up in terms of AF may allow the early control and treatment of AF-related incidents.
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    The effect of postdilatation on coronary blood flow and inhospital mortality after stent implantation in st-segment elevation myocardial infarction patients
    (Wolters Kluwer Medknow Publications, 2021) Senoz, Oktay; Yurdam, Ferhat Siyamend
    Background: Adjunctive balloon postdilatation is often performed after stent deployment to improve stent expansion during percutaneous coronary intervention (PCI). However, aggressive mechanical expansion may increase distal thromboembolization and microvascular injury, especially for patients with ST-segment elevation myocardial infarction (STEMI). Therefore, the benefit of postdilatation in these patients remains controversial. We aimed to investigate the effects of postdilation on coronary blood flow and inhospital mortality. Materials and Methods: A retrospective analysis was made of patients who received primary PCI because of STEMI. A total of 216 patients were included, as 108 applied with postdilatation following stent implantation and 108 not applied with postdilatation using propensity score matching method. Coronary blood flow was evaluated using the thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG). Results: The baseline clinical, angiographic, and laboratory characteristics of the groups were similar (P > 0.05). No-reflow developed in 34 (15.7%) of all patients according to TIMI flow (0-2), and in 36 (16.6%) according to MBG (0-1). While the no-reflow (TIMI 0-2) rates of the groups at baseline and following stent implantation were similar (94.4% vs. 95.4%, P = 0.757 and 23.1% vs. 20.4%, P = 0.621), the final no-reflow (TIMI 0-2) rate was significantly higher in the postdilatation group (22.2% vs. 9.3%, P = 0.009). Inhospital mortality rate was determined to be higher in the postdilatation group, but it was statistically nonsignificant (8.3% vs. 5.6%, P = 0.422). Conclusion: The application of postdilatation during primary PCI increased the development of no-reflow phenomenon in STEMI patients. © 2022 International Journal of the Cardiovascular Academy Published by Wolters Kluwer-Medknow.