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  • Küçük Resim
    Öğe
    Acil geçici kalp pili takılan hastaların klinik özellikleri ve hastane içi mortalite oranları
    (2021) Yurdam, Ferhat Siyamed; Erseçgin, Ahmet; Şenöz, Oktay; Yapan Emren, Zeynep
    Giriş: Geçici kalp pili(GKP) uygulaması birçok bradiaritminin acil tedavisinde hayat kurtarıcı role sahiptir.Özellikle ilaçların etkisiz olduğu infra nodal atriyoventriküler blokların (AVB) acil tedavisi için tek seçenektir.Bu çalışmada,kliniğimizde acil GKP uygulanan hastaların klinik özelliklerini ve hastane içi mortalite oranlarını tespit etmeyi amaçladık. Gereç ve Yöntem:Ekim 2016-Haziran 2021 tarihleri arasında kliniğimizde acil GKP tak ılan 229 hasta çalışmaya dahiledildi. Hastaların klinik ve laboratuvar özellikleri hastane kayıtları vasıtasıyla geriye dönük olarak incelendi. Bulgular: Hastaların 225’ine bradiaritmi nedeniyle, 4’üne ise taşiaritmi nedeniyle (over-drive pacing amaçlı) GKP implante edildi.GKP gerektiren bradiaritmi nedenleri s ırasıyla; idiopatik (%33.3), ilaçlar (%30.6), iskemi (%30.6), hiperpotasemi (%4.9) ve konjenital at riyoventriküler bloktu (%0.4). En s ık bradikardi türü 2. ve 3. derece atriyoventriküler bloklardı (%77.3). Bradiaritmi nedeniyle GKP tak ılan hastaların 110 (%48.9)’una kalıcı kalp pili implantasyonu gerekti. Hastaların 35 (%15.3)’inde hastane içi mortalite gelişti. Mortalite oranı, iskemi ve hiperpotasemi gruplarında diğerlerine göre anlamlı olarak daha yüksekti (p<0.001). Sonuç: Acil GKP implantasyonu gerektiren en sık neden idiopatik ardından iskemi ve ilaçlardı. Hiperpotasemi ve iskeminin neden olduğu ciddibradikardilerde hastane içimortalite oranı oldukça yüksektir
  • Küçük Resim
    Öğe
    Clinical features and factors affecting in-hospital mortality of patients who underwent pericardiocentesis due to moderate to severe pericardial effusion
    (2021) Şenöz, Oktay; Yapan Emren, Zeynep; Erseçgin, Ahmet; Emren, Volkan; Yurdam, Ferhat Siyamend; Nazlı, Cem
    Introduction: The aim of this study was to determine the primary etiology of pericardial effusion in patients undergoing percutaneous pericardiocentesis. Possible in-hospital mortality related predictors were also investigated. Patients and Methods: A retrospective analysis was made of the clinical and laboratory features of 268 patients who underwent pericardiocentesis due to moderate to severe pericardial effusion between January 2009 and March 2020. Results: The patients comprised 57.5% males and 42.5% females with a mean age of 62.3 ± 15.4 years. Cardiac compression was detected in 220 (82.1%) patients, of which 208 (77.6%) were clinically tamponade and 12 (4.5%) were asymptomatic cardiac compression. The most common symptom was dyspnea (58.6%) and 10.8% of patients were asymptomatic. Pericardial fluid was exudate in 235 (87.7%) patients. The most common causes were malignancy (37.3%) followed by idiopathic (22.1%) and iatrogenic (12.7%) causes. The patients with asymptomatic cardiac compression were more likely to have malignant effusion than those with other etiologies (p= 0.001). In-hospital mortality developed in 37 (13.8%) patients. The independent predictors of in-hospital mortality were determined as follows; etiology other than infectious or idiopathic (OR= 3.447; 95% CI= 1.266, 9.386; p= 0.015), and receiving antithrombotic therapy (OR= 2.306; 95% CI= 1.078, 4.932; p= 0.031). Conclusion: Malignancy is the most common cause of moderate to severe pericardial effusions. The detection of cardiac compression in asymptomatic patients may be an important indicator of malignancy. Receiving antithrombotic therapy and having a non-idiopathic and non-infectious etiology may be predictors of in-hospital mortality.
  • Küçük Resim
    Öğe
    COVID-19 Salgını döneminde valvüler olmayan atriyal fibrilasyon nedeniyle yeni nesil oral antikoagülan kullanan hastalarda kanama komplikasyonlarının araştırılması
    (2022) Şenöz, Oktay; Emren, Sadık Volkan; Yapan Emren, Zeynep; Yurdam, Ferhat Siyamend
    Amaç: COVID?19 pandemisi döneminde hastane başvurularının azalması; yeni oral antikoagülan kullanan hastaların takibini zorlaştır? maktadır. Bu bağlamda COVID?19 pandemisi döneminde yeni oral antikoagülan kullanan hastalarda kanama sıklığının araştırılması amaçlandı. Gereç ve Yöntem: Bu çalışma Mayıs 2020 ve Mayıs 2021 tarihleri arasında yapılmış kesitsel bir çalışmadır. COVID?19 pandemi döne? minde en az bir yıldır yeni oral antikoagülan kullanan 216 hasta dahil edilmiştir. Hastaların majör ve minör kanama oranları ve buna et? ki eden ön gördürücüler araştırılmıştır. Bulgular: Hastaların yaş ortalaması 72±10’du ve 129 (%60) hasta kadındı. 46 (%21) hastada kanama saptandı (%3 majör, %18 minör kanama). Kanama gelişen %12 hastada doz azaltımı yapılırken, %7 hastada ilaç kesilmiştir. Çok değişkenli analizlerde düzensiz ilaç kul? lanımı risk oranı: 14,91 (%95 Güven aralığı: 2,451?90,692, p=0,003), kadın cinsiyet risk oranı: 5,507 (%95 güven aralığı: 2,117?14,327, p<0,001), diyabet risk oranı: 2,319 (%95 güven aralığı: 1,069?5,031, p=0,033), HAS?BLED skoru risk oranı: 1,571 (%95 güven aralığı: 1,035?2,384 p=0,034) kanama ile ilişkili bağımsız değişken olarak bulunmuştur. Sonuç: Yeni oral antikoagülan kullanan hastalarda kanama komplikasyonları COVID?19 döneminde de hala bir sorun olmaya devam et? mektedir
  • Küçük Resim
    Öğe
    Effect of COVİD-19 pandemic and coronavac vaccine on blood pressure regulation in chronic hypertensive patients
    (2021) Şenöz, Oktay; Erseçgin, Ahmet; Demir, Yusuf; Yurdam, Ferhat Siyamend; Yapan Emren, Zeynep; Gürses, Ecem
    Objective: The most common comorbidity in patients with Covid-19 infection is hypertension. Apart from the direct effects of the virus on hypertensive patients, the pandemic period also negatively affected these patients. In addition, the effect of the newly discovered CoronaVac vaccine, which has been widely used in our country in recent months for the prevention of covid-19 infection, on blood pressure regulation is unknown. In this study, we aimed to investigate the effects of the pandemic period and the CoronaVac vaccine in patients receiving treatment for essential hypertension.Method: One hundred ninety-six patients who applied to the cardiology outpatient clinic between 4 June - 9 July 2021, were treated for essential hypertension and had at least 1 dose of CoronaVac vaccine were included in the study. In the pre-pandemic, pre-vaccine and post-vaccine period, mean home and office blood pressures of the patients were examined separately. Results: While the mean home blood pressures of the patients differed significantly between the pre-pandemic and pre-vaccine pandemic period (systolic: 125.1±12.6 vs 129.1±14.1 mmhg, p<0.001, diastolic: 75.3±9.7 vs 77.1±9.8 mmhg, p=0.004), there was no significant difference between the pre- and post-vaccination period (systolic: 129.1±14.1 vs 129.7±13.7 mmhg, p=0.229, diastolic: 77.1±9.8 vs 77.9±9.9 mmhg, p=0.091). Similarly, while office blood pressures differed significantly between the pre-pandemic and pre-vaccine pandemic period (systolic: 133.5±16.5 vs 136.1±16.4 mmhg, p=0.015, diastolic: 79.4±10.9 vs 81.2±12.1 mmhg, p=0.036), there was no significant difference between the pre- and post-vaccination period (systolic: 136.1±16.4 vs 135.6±16.9 mmhg, p=0.651, diastolic: 81.2±12.1 vs 81.1±11.2mmhg, p=0.914). Conclusion: While the Covid-19 pandemic increased the blood pressure of chronic hypertensive patients, the CoronaVac vaccine did not affect the blood pressure regulation of these patients.
  • Küçük Resim
    Öğe
    Platelet-Lymphocyte ratio is a predictor for the development of no-reflow phenomenon in patients with ST-segment elevation myocardial infarction after thrombus aspiration
    (Wiley, 2021) Şenöz, Oktay; Emren, Sadık Volkan; Ersecgin, Ahmet; Yapan Emren, Zeynep; Gül, İlker
    Backround We aimed to evaluate the utility of the preprocedural platelet-lymphocyte ratio (PLR) for predicting the no-reflow phenomenon after thrombus aspiration during percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Method We retrospectively analyzed postprocedural thrombolysis in myocardial infarction (TIMI) flow grades and myocardial blush grades (MBG) of 247 patients who underwent a PCI procedure with thrombus aspiration.We divided these patients into two groups according to whether they had no-reflow (TIMI < 3, MBG < 2) or not (TIMI 3, MBG >= 2). Results No-reflow developed in 43 (17%) patients.Preprocedural PLR was significantly higher in the no-reflow group (183.76 +/- 56.65 vs 118.32 +/- 50.42 p < 0.001).Independent predictors of no-reflow were as follows: higher preprocedural platelet-lymphocyte ratio (PLR) (OR = 1.018; 95% CI = 1.004, 1.033; p = 0.013),mean corpuscular volume (MCV) (OR = 1.118; 95% CI = 1.024, 1.220; p = 0.012) and SYNTAX Score-2 (OR = 1.073; 95% CI = 1.005, 1.146; p = 0.036). PLR of 144 had 79% sensitivity and 75% specificity for the prediction of no-reflow. Conclusion PLR is a reliable predictor for no-reflow in STEMI patients undergoing thrombus aspiration.