Secondary prevention of coronary heart disease in elderly population of Turkey: A subgroup analysis of ELDERTURK study

Background: Secondary prevention plays an important role after acute coronary event due to high risk of adverse events in elderly. In present study we aimed to evaluate the lifestyle, management of risk factors and medical treatment for secondary protection in elderly patients with known coronary heart disease (CHD). Methods: ELDERTURK is a non-interventional, multi-centered, observational study, which included total of 5694 elderly patients ( > 65 years) from 50 centers in Turkey. In this study elderly patients from the ELDERTURK population with known CHD were evaluated for cardiovascular risk factors, comor- bidities and medication usage. Results: A total of 2976 (52.3% of study) out of 5694 patients included in the ELDERTURK study were evaluated. All had known CHD with a mean age of 73.4 ± 6.2 years and 60.3% were male. 13.0% of patients were smokers, 42.4% were overweight and 21.1% were obese. Only 23.6% of patients reported to do regular exercise, 73.4% had history of hypertension, 47.4% had dyslipidemia and 33.9% had diabetes mellitus. The rate of patients with systolic blood pressure > 140 mmHg were 31.1% and only 13.9% of patients had a recommended ≤ 70 mg/dL level of low-density lipoprotein cholesterol. Anti- platelet, statin, beta-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker usage was limited to 27.3%. Conclusions: The ELDERTURK study shows that many patients with CHD have a high prevalence of modifiable risk factors and unhealthy lifestyle. Apart from this, many patients are not receiving thera- peutic intervention and as a consequence most were not achieving the recommended goals.   

In planta determination of GaMyb transcription factor as a target of pathogen induced microRNA, mir159

One of the molecular mechanisms underlying the plant–pathogen interactions is the regulation of gene expressions in plant responses by microRNAs which are either stimulated or silenced against pathogen attacks. Among the plant miRNAs, we found that mir159 is one of which that differentially expressed upon Blumeria graminis f. sp. hordei (Bgh) infected resistant and susceptible barley lines. The study aims to confirm its role in regulating one of its putative target genes, GaMyb transcription factor, in vivo. Thus, both mir159 and GaMyb genes were co-infiltrated into tobacco as constructs of pEarlyGate100 and GFP expressing pEarlyGate103, respectively, via agrobacterium transient transformation. Our results suggest that mir159 indeed reduces the expression of GaMyb transcription factor by which, for the first time, confirm it being a biological target of mir159. To further confirm the induced expression level and the biological role of mir159 in susceptible barley by virulent Bgh pathogen infection, the differential level of disease development should be investigated in a susceptible line of barley after the over expression and/or the silencing of the gene of mir159

The prevalence of cardiovascular diseases, risk factors, and cardiovascular drug therapy in very elderly Turkish patients admitted to cardiology clinics: A subgroup analysis of the ELDER-TURK study

WOS: 000435148100007PubMed ID: 29853696Ojective: The aim of this study was to determine the baseline clinical characteristics and the cardiovascular drug usage of patients aged >= 80 years who were admitted to cardiology clinics and to compare the cardiovascular disease and risk factors with patients aged 65-79 years who participated in the Epidemiology of Cardiovascular Disease in Elderly Turkish Population (ELDER-TURK) study. Methods: The ELDER-TURK study included 5694 patients aged over 65 years who were followed up at cardiology clinics between March 2015 and December 2015. The prevalence of cardiovascular diseases and the risk factors of 1098 patients aged >= 80 years (Group II) were compared with 4596 patients aged 65-79 years (Group I). Result: The mean age of Group I was 71.1 +/- 4.31 years (male: 50.2%) and the mean age of Group II was 83.5 +/- 3.12 years (male: 47.5%). The prevalence rate was 71.3% for hypertension, 24.6% for diabetes mellitus (DM), 44.7% for coronary artery disease (CAD), 35.9% for atrial fibrillation (AF), and 15.5% for renal failure. A statistical difference in the prevalence of comorbid conditions and cardiovascular disease risk factors, such as DM, CAD, renal failure, and AF was seen in the very elderly group (p<0.001, p=0.002, p<0.001, p<0.001, respectively). In all, 28.7% of the very elderly were using a beta-blocker, 10.1% an angiotensin system inhibitor, 28.4% an angiotensin receptor blocker, and 32.7% a mineralocorticoid receptor antagonist. Conclusion: Valuable data about the prevalence of cardiovascular and comorbid diseases and medication usage among Turkey's very elderly patients who were admitted to cardiology clinics was gathered and analyzed.Turkish Society of CardiologyThe study was funded by Turkish Society of Cardiology

Evaluation of demographic and clinical characteristics of female patients presenting with MINOCA and differences between male patients: A subgroup analysis of MINOCA-TR registry

Objective: Although the prevalence and rate of myocardial infarction with non-obstructive coronary arteries (MINOCA) are higher in women than in men in previous cohorts, potential demographic and clinical differences between women who are diagnosed with MINOCA versus myocardial infarction with obstructive coronary arteries (MIOCA) have not been studied till date. In this study, we aimed to document these characteristics and to compare them between female patients with MINOCA and MIOCA. Methods: The study was a subgroup analysis of the MINO-CA-TR study. The study was a multi-center, observational cohort study that was conducted in Turkey between March 2018 and October 2018. In this study, 477 (29.3%) female patients who had been diagnosed with acute myocardial infarction were evaluated. Results: Of these women, 49 (10.3%) were diagnosed with MINOCA (mean age 58.9 +/- 12.9 years) and 428 (89.7%) had a final diagnosis of MIOCA (mean age 67.4 +/- 11.8 years). The prevalence of hypertension, hyperlipidemia, and diabetes mellitus was significantly lower in the MINOCA group than in the MIOCA group. In addition, the MINOCA group had higher rates of recent flu history and non-ST elevation myocardial infarction (NSTEMI) presentation than the MIOCA group. There were significant clinical differences in patients with MINOCA in terms of sex. The female patients were older, had higher systolic blood pressures, and lower hemoglobin levels than male patients. Conclusion: The study revealed that the prevalence of traditional coronary artery disease risk factors was lower in female patients with MINOCA than in those who had final diagnosis of MIOCA.This study was sponsored by the Cardiovascular Academy Society.Cardiovascular Academy Societ

Effects of Rapid Maxillary Expansion on the Temporomandibular Joint: A Bone Scintigraphy Study

Objectives: The purpose of this study is to assess the effects of rapid maxillary expansion (RME) on metabolic activity in the temporomandibular joints (TMJs) of young adult patients using scintigraphy

Increased serum renalase in peritoneal dialysis patients: Is it related to cardiovascular disease risk?

Background: Renalase, with possible monoamine oxidase activity, is implicated in degradation of catecholamines; which suggests novel mechanisms of cardiovascular complications in patients with chronic kidney diseases. Epicardial adipose tissue (EAT) has been found to correlate with cardiovascular diseases (CVD) in dialysis patients. The present study aimed to evaluate the association of serum renalase levels with EAT thickness and other CVD risk factors in peritoneal dialysis (PD) patients. Methods: The study included 40 PD patients and 40 healthy controls. All subjects underwent blood pressure and anthropometric measurements. Serum renalase was assessed by using a commercially available assay. Transthoracic echocardiography was used to measure EAT thickness and left ventricular mass index (LVMI) in all subjects. Results: The median serum renalase level was significantly higher in the PD patients than in the control group [176.5 (100–278.3) vs 122 (53.3–170.0) ng/ml] (p = 0.001). Renalase was positively correlated with C-reactive protein (r = 0.705, p < 0.001) and negatively correlated with RRF (r = −0.511, p = 0.021). No correlation was observed between renalase and EAT thickness or LVMI. There was a strong correlation between EAT thickness and LVMI in both the PD patients and the controls (r = 0.848, p < 0.001 and r = 0.640, p < 0.001 respectively). Conclusions: This study indicates that renalase is associated with CRP and residual renal function but not with EAT thickness as CVD risk factors in PD patients

Comparison of geriatric nutritional risk index and creatinine index in short-term mortality prediction in maintenance hemodialysis patients

Background/aim: The aim of this study is to analyze and compare the predictive values of the Geriatric Nutritional Risk Index (GNRI) and Creatinine Index (CI) in the short-term mortality of maintenance hemodialysis patients and to determine their best cut-offs. Material and Methods: A total of 169 adult hemodialysis patients were included in this retrospective, cross-sectional, and single-center study. The demographic, clinical, and laboratory data of the month in which the patients were included in the study were obtained from their medical files and computer records. All-cause death was the primary outcome of the study during a 12-month follow-up alter baseline GNRI and CI calculations. Results: The mean age of the study population was 57 +/- 16 years (49.7% were women, 15% were diabetic). During the one-year observation period, 19 (11.24%) of the cases died (8 CV deaths). The optimal cut-off value for GNRI was determined as 104.2 by ROC analysis [AUC = 0.682 +/- 0.06, (95% CI, 0.549-0.815), p = 0.01]. The low GNRI group had a higher risk for all-cause and CV mortality compared to the higher GNRI group (p = 0.02 for both in log-rank test). The optimal sex-specific cut-off was 12.18 mg/kg/day for men [AUC = 0.723 +/- 0.07, (95% CI, 0.574-0.875), p = 0.03] and was 12.08 mg/kg/day for females [AUC = 0.649 +/- 0.13, (95% CI, 0.384- 0.914), p = 0.01]. Patients with lower sex-specific CI values had higher all-cause and CV mortality (p = 0.001 and p = 0.009 in log-rank test, respectively). In multivariate cox models, both GNRI [HR = 4.904 (% 95 CI, 1.77-13.56), p = 0.002] and sex-specific CI [HR = 5.1 (95% CI, 1.38-18.9), p = 0.01] predicted all-cause mortality. The association of GNRI with CV was lost [HR = 2.6 (CI 95%, 0.54-13.455), p = 0.22], but low CI had a very strong association with CV mortality [HR = 11.48 (CI 95%, 1.25 -104), p = 0.03]. Conclusion: In hemodialysis patients, GNRI and CI have similar powers in predicting all-cause short-term mortality. The association of CI with all-cause death depends on gender. On the other hand, sex-specific CI predicts CV mortality better than GNRI

Women leaders in Cardiology. Contemporary profile of the WHO European region

AIMS: Women’s participation is steadily growing in medical schools, but they are still not sufficiently represented in cardiology, particularly in cardiology leadership positions. We present the contemporary distribution of women leaders in cardiology departments in the World Health Organization European region. METHODS AND RESULTS: Between August and December 2020, we applied purposive sampling to collect data and analyse gender distribution of heads of cardiology department in university/third level hospitals in 23 countries: Austria, Azerbaijan, Belgium, Bosnia-Herzegovina, Croatia, France, Germany, Greece, Italy, North Macedonia, Morocco, Poland, Portugal, Russia, Serbia, Slovakia, Slovenia, Spain, Switzerland, Tunisia, Turkey, Ukraine, and the UK. Age, cardiology subspecialty, and number of scientific publications were recorded for a subgroup of cardiology leaders for whom data were available. A total of 849 cardiology departments were analysed. Women leaders were only 30% (254/849) and were younger than their men counterpart (♀ 52.2 ± 7.7 years old vs. ♂ 58.1 ± 7.6 years old, P = 0.00001). Most women leaders were non-interventional experts (♀ 82% vs. ♂ 46%, P < 0.00001) and had significantly fewer scientific publications than men {♀ 16 [interquartile range (IQR) 2–41] publications vs. ♂ 44 (IQR 9–175) publications, P < 0.00001}. CONCLUSION: Across the World Health Organization European region, there is a significant gender disparity in cardiology leadership positions. Fostering a diverse and inclusive workplace is a priority to achieve the full potential and leverage the full talents of both women and men

Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey

WOS: 000468584300005PubMed ID: 30930455Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 %; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were >= 80 years and 27.1% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p= 80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.Turkish Society of CardiologyThis study was supported by Turkish Society of Cardiology