The Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

Background: AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) is a prospective,multicenter study designed with the aim of describing the prevalence and epidemiology ofAF practice in Turkey. This study aims to evaluate stroke risk in non-valvular atrial fi brillation(AF) and anticoagulant drug utilization within conformity to AF guidelines.Methods: Patients were recruited in 17 referral hospitals refl ecting all the population of7 geographical regions of Turkey. 2242 consecutive patients who had been admitted with AFon ECG were included in the study. 1745 of these patients, who had non-valvular AF, wereincluded in the statistical evaluation. Stroke risk was evaluated with the CHA2DS2-VASc score.Results: The average age of participants was determined to be 69.2 ± 11.5 years (56%female). Persistent-permanent AF was found to be the most common type of non-valvularAF (78%). The most common comorbid disorder was hypertension (73%). It was found thatoral anticoagulant therapy was used by 40% of all patients, 37% of whom had effective INR(2.0–3.0). Upon multivariate analysis, age was found to be the only independent predictorof stroke among the variables’ effects on thromboembolic events that created CHA2DS2-VAScabbreviations (OR 1.026, p < 0.001).Conclusions: These results suggest that stroke risk scores should be thoroughly heededbased on guidelines, and that anticoagulation must be applied according to their guidance

Protective effect of heparin in the end organ ischemia/reperfusion injury of the lungs and heart

Abstract Background Ischemia/reperfusion (I/R) injury is harmful to the cardiovascular system and is responsible for the inflammatory response and multiple organ dysfunctions. In this study we investigated the effect of activated clotting time level on the aortic cross-clamping triggers a systemic inflammatory response and it effects to lungs and heart. Methods End organ concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO) and heat shock protein 70 (HSP-70) were determined in four groups of Spraque Dawley rats: ischemic control (operation with cross clamping received IP of 0.9% saline at 2 ml/kg n=7) Sham (operation without cross clamping, n=7), heparin (ACT level about 200), High dose heparin (ACT level up to 600) The infrarenal aorta was clamped for 45 minutes by a mini cross clamp approximately 1cm below the renal artery and 1cm iliac bifurcation in all groups without sham group. Heparin was given intraperitoneal (IP) before the procedure. All rats were sacrificed 48 h later. In a second experiment, the effects of I/R on remote organs (lungs and heart) were harvested for analysis. We evaluated tissue levels of myeloperoxidase, interleukin-6, and heat shock protein (HSP-70) were analyzed as markers oxidative stress and inflammation. Histological analyses of the organs were performed. Results The lungs paranchymal MPO and HSP-70 levels significantly decreased (p0.05) in heparinized and high dose heparinized groups when compared to ischemic control group. Histopathological evaluation as edema, cell degeneration, inflammation statistically significantly decreased in both group heparinized and high dose heparinized compared with ischemic control group (p Conclusion Heparin decreased remote organs injury on the lung and heart after ischemia/reperfusion of infra-renal section of the body in the rat model. So, we should be balance to act level for avoid to I/R injury per operative and early post operative period as providing ACT level nearly 200.</p

The Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

WOS: 000324268900016PubMed ID: 23677730Background: AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) is a prospective, multicenter study designed with the aim of describing the prevalence and epidemiology of AF practice in Turkey. This study aims to evaluate stroke risk in non-valvular atrial fibrillation (AF) and anticoagulant drug utilization within conformity to AF guidelines. Methods: Patients were recruited in 17 referral hospitals reflecting all the population of 7 geographical regions of Turkey. 2242 consecutive patients who had been admitted with AF on ECG were included in the study. 1745 of these patients, who had non-valvular AF, were included in the statistical evaluation. Stroke risk was evaluated with the CHA(2)DS(2)-VASc score. Results: The average age of participants was determined to be 69.2 +/- 11.5 years (56% female). Persistent-permanent AF was found to be the most common type of non-valvular AF (78%). The most common comorbid disorder was hypertension (73%). It was found that oral anticoagulant therapy was used by 40% of all patients, 37% of whom had effective INR (2.0-3.0). Upon multivariate analysis, age was found to be the only independent predictor of stroke among the variables' effects on thromboembolic events that created CHA2DS2-VASc abbreviations (OR 1.026, p < 0.001). Conclusions: These results suggest that stroke risk scores should be thoroughly heeded based on guidelines, and that anticoagulation must be applied according to their guidance

Antioxidant support in composite musculo-adipose-fasciocutaneous flap applications: An experimental study

Free radicals are chemicals that play roles in the etio-pathogenesis of ischaemia-reperfusion injury. Various antioxidants have been used in an attempt to mitigate the damage induced by these chemicals. In the present study, the antioxidative effects of grape seed extract (proanthocyanidin), tomato extract (lycopene), and vitamin C (ascorbic acid) on a composite re-established-flow inferior epigastric artery based rectus abdominis muscle-skin flap model on which experimental ischaemia was induced were investigated. The rats have been administered antioxidants for 2 weeks prior to the surgery and for 2 more weeks thereafter. Macroscopic, histopathological, and biochemical analyses were carried out at the decision of the experiment. It was found that flap skin island necrosis was significantly reduced in the proanthocyanidin, lycopene, vitamin C groups (p < 0.001). Statistical analyses showed significant decreases in inflammation, oedema, congestion, and granulation tissue in the proanthocyanidin and lycopene groups compared to the vitamin C and control groups (p < 0.001). When the viability rates of fat and muscle tissues were examined, significant improvements were found in the proanthocyanidin and lycopene groups in comparison to the other groups (p < 0.001). Serum antioxidant capacity measurements revealed significant differences in the lycopene group compared to all other groups (p < 0.001). It is concluded that lycopene and proanthocyanidin are protective antioxidants in rat composite muscle-skin flap ischaemia-reperfusion models

The Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

Background: AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) is a prospective,multicenter study designed with the aim of describing the prevalence and epidemiology ofAF practice in Turkey. This study aims to evaluate stroke risk in non-valvular atrial fi brillation(AF) and anticoagulant drug utilization within conformity to AF guidelines.Methods: Patients were recruited in 17 referral hospitals refl ecting all the population of7 geographical regions of Turkey. 2242 consecutive patients who had been admitted with AFon ECG were included in the study. 1745 of these patients, who had non-valvular AF, wereincluded in the statistical evaluation. Stroke risk was evaluated with the CHA2DS2-VASc score.Results: The average age of participants was determined to be 69.2 ± 11.5 years (56%female). Persistent-permanent AF was found to be the most common type of non-valvularAF (78%). The most common comorbid disorder was hypertension (73%). It was found thatoral anticoagulant therapy was used by 40% of all patients, 37% of whom had effective INR(2.0–3.0). Upon multivariate analysis, age was found to be the only independent predictorof stroke among the variables’ effects on thromboembolic events that created CHA2DS2-VAScabbreviations (OR 1.026, p &lt; 0.001).Conclusions: These results suggest that stroke risk scores should be thoroughly heededbased on guidelines, and that anticoagulation must be applied according to their guidance

Predictors of Anticoagulant Treatment in Patients With Nonvalvular Atrial Fibrillation: Results From Atrial Fibrillation in Turkey: Epidemiologic Registry

The aim of the study was to assess the factors associated with the anticoagulation treatment in patients with atrial fibrillation (AF). A total of 2242 consecutive patients who had been admitted with AF on their electrocardiogram were included in the study. After excluding valvular AF, 1745 patients with nonvalvular AF were analyzed. Mean CHA2DS2-VASc score [cardiac failure, hypertension, age >= 75 (doubled), diabetes, stroke (doubled), vascular disease, age 65 -74 and sex category (female)], frequency of persistent/permanent AF, hypertension, diabetes mellitus (DM), stroke history, body mass index, and left atrial diameter were significantly higher in patients receiving anticoagulant therapy. Stroke history, persistent/permanent AF, hypertension, DM, age, heart failure, and left atrial diameter were independent predictors of warfarin prescription. Labile international normalized ratio was the only independent negative predictor of effective treatment with warfarin. In this study, we demonstrated that stroke history, persistent/permanent AF, hypertension, DM, and left atrial diameter were positive predictors, whereas advanced age and heart failure were negative predictors of oral anticoagulant use in patients with nonvalvular AF