Benefit of CHA2DS2-VASc score in predicting implantable cardioverter defibrillator shocks

Introduction: Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden death in eligible patients. However, it is thought that there is a relationship between the ICD shocks and increased morbidity and mortality. In this study, we examined the relationship between ICD shocks and the CHA2DS2-VASc scoring, which has gained frequent use in predicting cardiac events recently. Material and Methods: Retrospective baseline characteristics and three-year follow-ups of patients with ICDs with appropriate indication were studied. Patients were divided into two groups: patients who have received ICD shock(s) and patients who have not received any ICD shock. These groups were compared for baseline characteristics and CHA2DS2-VASc scores. Results: CHA2DS2-VASc scores of heart failure (HF) patients in our study population were significantly higher than those who did not receive any shock within three years following the ICD implantation. The rate of appropriate or inappropriate ICD shocks was %16 in the HF patients implanted with ICD for primary prevention while it was %66 in patients implanted with ICD for secondary prevention. The incidence of atrial fibrillation was 68% in 37 patients who received inappropriate shock while it was 7% in those who did not receive inappropriate shock (those who received appropriate shocks or did not receive any shock) (p<0.001). Conclusion: In conclusion, this study demonstrated a relation between the CHA2DS2-VASc score and appropriate and inappropriate ICD shocks. The CHA2DS2-VASc score is a simple tool that may predict ICD shocks

Cardiac resynchronization therapy in a patient with persistent left superior vena cava draining into coronary sinus

13th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS) -- MAR 23-26, 2017 -- Cesme, TURKE

Relationship between discordance of lipid parameters and mortality after acute coronary syndrome

European Atherosclerosis So

Nikotin bağımlılığının koroner arter hastalığı ciddiyetiyle ilişkisi

Purpose: Smoking cessation is essential to prevent coronary artery disease and its poor outcomes however, it is difficult to quit for some smokers due to higher degree of nicotine dependence. Although smoking has been well demonstrated to be associated with coronary artery disease, its association with nicotine dependence is unknown. Recent studies show that the Syntax score is a new tool for the risk stratification of patients with complex coronary artery disease. In this retrospective study, we aimed to evaluate whether Fagerström test score for nicotine dependence was associated with the complexity of coronary artery disease as evaluated by Syntax score. Material and Methods: The study population consisted of smoking status patients with currently smoking who underwent coronary angiography. Patients were divided into four groups according to Syntax score tertiles: as control group (Syntax score 0; n = 25) low risk group 1(Syntax score 1-22; n = 25), intermediate risk group 2 (Syntax score 23-32; n = 25) and high risk group 3 (Syntax score > 32; n = 25). Fagerström test was conducted for nicotine dependence at outpatient visits and phone callings by one physician. Results: The Fagerström test score was prominently related with Syntax score and was a significant predictor of Syntax score after adjustment for other risk factors. Conclusion: The Fagerström test score was significantly associated with the complexity of with coronary artery disease evaluated by Syntax score. Further prospective studies are needed to verify this finding

Ameliyat Öncesi Değerlendirilen Hastaların Antikoagülan ve Antiplatelet İlaç Kullanım Farkındalığı

Objective: To determine anticoagulant and anti-platelet medication awareness of peri-operative patients Method: A questionnaire was applied to the 208 preoperative patients taking anticoagulants (AC) or anti-platelets (AP). The questionnaire included the questions about whether they were using any drug that thinners blood or prevents clots, indication and duration of drug use, whether they underwent an operation while using the drug, whether they knew that the drug should be discontinued in case of undergoing an operation and presence of a planned surgical procedure when commencing the drug. Results: Mean age of the study population was 63.3±12.7 years and 50.5% of the patients were male, 27.9 % of the patients were illiterate, 39.4% of patients were not aware of using AC or AP and 12.5% of patients didn’t know duration of AC or AP use. An operation had been planned before commencement of the drug in 9.1% of the patients. The incidence of undergoing a surgical procedure while using AC or AP was 18.8%. While 23.1 % were urgent, 76.9% were elective procedures. General anesthesia was applied in 41% of these patients. When the patients who were aware or unaware of AC or AP use were compared, mean age was younger and level of education was higher among the patients who were aware of using AC or AP (p=0,018 and p<0,001 respectively). No difference was detected between the patients who were using old or new generation drugs with regard to awareness of drug use (p=0.113). Conclusion: Patients who are taking AC or AP may have to undergo surgical procedures more than once while using these drugs. However, an important proportion (39.4 %) of these patients was found to be unaware of using AC or AP

Discordance of low density lipoprotein cholesterol and non-high density lipoprotein cholesterol and coronary artery disease severity

87th Congress of the European-Atherosclerosis-Society (EAS)European Atherosclerosis So

Association between admission glucose and coronary collateral flow in ST-Elevation myocardial infarction patients

13th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS) -- MAR 23-26, 2017 -- Cesme, TURKE

Bleeding risk in patients with acute coronary syndrome in a Turkish population results from the Turkish acute coronary syndrome registry (TACSER) study

Objective Bleeding is one of the most important causes of mortality in patients with acute coronary syndrome (ACS). This study therefore aimed to investigate bleeding risk in patients with ACS who were scheduled to receive dual antiplatelet therapy (DAPT) in Turkey. Methods This was a multicentre, observational, cross-sectional cohort study. The study population included 963 patients with ACS from 12 centres in Turkey. We used the Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score to predict the bleeding risk for all the patients. The patients were divided into high (>= 25) or low (= 25). Compared with the male patients, the female patients had higher PRECISE-DAPT scores (28.2 +/- 15.7 vs 18.4 +/- 13.6,P = 25 was 53%, while among the male patients, the score occurred at a rate of 22%. The female patients had lower haemoglobin (Hb) levels than the male patients (12.1 +/- 1.7 vs 13.8 +/- 1.9,P < .001) and lower creatinine clearance (70.7 +/- 27.5 vs 88.7 +/- 26.3,P < .001). The in-hospital bleeding rates were higher among the patients with high PRECISE-DAPT scores than among those who did not have high scores. Furthermore, the patients with high PRECISE-DAPT scores had a higher in-hospital mortality rate compared with those with low PRECISE-DAPT scores (1% vs 0%,P = .11). Conclusions The mean PRECISE-DAPT score was high among the patients with ACS in this study, indicating that the bleeding tendency was high. This study showed that the PRECISE-DAPT score may help physicians determine the type and duration of DAPT, especially in patients with ACS in Turkey

Nutritional status and severity of coronary artery disease

Objective The aim of this study is to evaluate the association between Nutritional Risk Index (NRI), a simple tool to assess nutritional status, and coronary artery disease severity and complexity in patients undergoing coronary angiography. Methods This study is a retrospective analysis of 822 patients undergoing coronary angiography. Patients with previous revascularization were excluded. Gensini and SYNTAX scores were calculated according to the angiographic images to determine atherosclerosis severity. NRI was calculated as follows: NRI = [15.19 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. In patients ≥65 years of age, Geriatric NRI (GNRI) was used instead of NRI. GNRI was calculated as follows: GNRI = [14.89 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. Patients were then divided into three groups as previously reported: NRI < 92, NRI 92–98 and NRI > 98. Gensini and SYNTAX scores were compared between three groups. Results The mean age of study population was 61.9 ± 11.1 years. NRI 98 was measured in 212, 321 and 289 patients, respectively. There was no difference regarding to sex, BMI, smoking, hypertension and diabetes mellitus between three groups. Patients with NRI < 92 had the highest mean Gensini score than the patients with NRI 92–98 and NRI > 98 (38.0 ± 40.6 vs. 31.17 ± 42.4 vs. 25.8 ± 38.4, P = 0.005). Also patients with NRI < 92 had the highest mean SYNTAX score than the patients with NRI 92–98 and NRI > 98 (11.8 ± 12.9 vs. 9.3 ± 12.4 vs. 7.7 ± 11.8, P = 0.001). Also, Gensini score of ≥20 and high SYNTAX score of ≥33 were associated with lower NRI (P < 0.001 and P < 0.001, respectively). Conclusion In our study, nutritional status evaluated by the NRI was associated with more extensive and complex coronary atherosclerosis in patients undergoing coronary angiography