20 research outputs found

    Türkiye’deki ulusal ailevi hiperkolesterolemi kayıt çalışmalarının temel ve tasarımı: A-HIT1 ve A-HIT2 çalışmaları

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    Objective: Familial hypercholesterolemia (FH) is a genetic disease characterized by extremely high levels of cholesterol, leading to premature atherosclerosis. Although many countries have already addressed the burden of FH by means of national registries, Turkey has no national FH registry or national screening program to detect FH. Creation of a series of FH registries is planned as part of Turkish FH Initiative endorsed by the Turkish Society of Cardiology to meet this need. This Article provides detailed information on the rationale and design of the first 2 FH registries (A-HIT1 and A-HIT2).Methods: A-HIT1 is a nationwide survey of adult homozygous FH (HoFH) patients undergoing low-density lipoprotein (LDL) apheresis (LA) in Turkey. A-HIT1 will provide insight into the clinical status of HoFH patients undergoing LA. Primary objective of this cross-sectional study is to identify how HoFH patients on LA are managed. Inclusion criteria are age >12 years, diagnosis of HoFH, and regular LA treatment. All available apheresis centers were electronically invited to participate in the study. the principal physicians of each center will respond to a questionnaire regarding their attitude toward LA. For each patient, another questionnaire will be used to collect data on clinical status, medication use, and disease data. in addition, patients will be asked to complete self-report questionnaires that provide information on quality of life, disease-related anxiety, and depression. A-HIT2 is a registry of adult FH patients presenting at outpatient clinics. At least 1000 FH patients will be recruited from 30 outpatient clinics representing the 12 statistical regions in Turkey based on the EU NUTS classification. Sites specializing in cardiology, internal medicine, and endocrinology were invited to participate. the primary objective of this cross-sectional study is to determine clinical status and management of patients in Turkey diagnosed with FH. Eligibility for screening was defined as having LDL-cholesterol level >160 mg/dL. Inclusion criteria are age >18 years and diagnosis as possible FH (total score of >2 according to Dutch Lipid Clinic Network criteria). in addition to measuring clinical status of patients, a short survey to assess patient level of disease awareness will also be administered.Conclusion: A-HIT1 and A-HIT2 are the first nationwide FH registries in Turkey and will provide important information on the management of Turkish FH patients. in addition, it is planned that they will guide establishment of a national policy for the diagnosis and treatment of FH in TurkeyAmaç: Ailevi hiperkolesterolemi (AH), erken ateroskleroza yol açan aşırı yüksek kolesterol düzeyleri ile karakterize genetik bir hastalıktır. Birçok ülke ulusal kayıt çalışmaları vasıtasıyla AH yükünü belirlemiş olmalarına rağmen, Türkiye'de Ulusal AH kayıt çalışması veya AH saptanması için ulusal bir tarama programı bulunmamaktadır. Bu eksiği gidermek için Türk Kardiyoloji Derneği tarafından desteklenen Türk AH projesi kapsamında bir dizi AH kayıt çalışması planlanmıştır. Bu yazı, AH kayıt çalışmalarının ilk ikisinin (A-HIT 1 ve A-HIT2) temeli ve tasarımı hakkında ayrıntılı bilgi vermek üzere hazırlandı.Yöntemler: A-HIT1, Türkiye'de LDL-aferezi (LA) tedavisi altındaki yetişkin Homozigot AH (HoAH) hastalarının ülke çapında kayıt çalışmasıdır. A-HIT1, LA altındaki HoAH hastalarının klinik durumuyla ilgili bilgi sağlayacaktır. Bu kesitsel çalışmanın birincil amacı, LA tedavisi alan HoAH hastalarının nasıl yönetildiğini saptamaktır. Çalışmanın içleme kriterleri, 12 yaşından büyük olmak, HoAH tanısı konmuş ve düzenli LA tedavisi altında olmaktır. Tüm mevcut aferez merkezleri, elektronik ortamda çalışmaya davet edilmiştir. Her merkezden bir sorumlu hekim, merkezin LA'ya karşı tutumuyla ilgili bir anket dolduracaktır. Her hasta için de klinik durumu, tedavisi ve hastalığı ile ilgili bir anket tamamlanacaktır. Buna ek olarak hastaların yaşam kaliteleri, hastalıkla ilgili endişe ve depresyonları hakkında bilgi sağlayan 3 anket hastalar tarafından dolduracaklardır. A-HIT2, polikliniklere başvuran yetişkin AH hastalarının kayıt çalışmasıdır. Türkiye'nin 12 "Nuts" İstatistiki Bölgesini temsil eden 30 poliklinikten en az 1000 AH hastası alınacaktır. Kardiyoloji, iç hastalıkları ve endokrinoloji üzerine uzmanlaşmış merkezler çalışmaya davet edilmişlerdir. Kesitsel yapıdaki bu çalışmanın birincil amacı, Türkiye'de AH tanısı almış hastaların klinik durumlarını ve tedavilerini saptamaktır. Tarama için uygunluk LDL-kolesterol düzeylerinin >160 mg/dL olması olarak tanımlanmıştır. Çalışmaya dahil edilme kriterleri >18 yaş ve olası AH tanı almak olarak belirlenmiştir (Hollanda Lipid klinikleri ağı kriterlerine göre toplam >2 puan). Hastaların klinik durumunu belirleyen bilgilere ek olarak, hastalığın farkındalık düzeyini değerlendirmek için kısa bir anket uygulanacaktır.Sonuç: A-HIT1 ve A-HIT2, Türkiye'deki ilk ülke çapındaki AH kayıt çalışmalarıdır ve Türk AH hastalarına yaklaşımın durumu hakkında önemli bilgiler sağlayacaklardır. Aynı zamanda, AH'nin tanı ve tedavisi için ulusal bir politika oluşturmaya rehberlik etmek üzere planlanmışlardı

    Evaluation of the impact of treatment on endothelial function and cardiac performance in acromegaly

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    Objective: To evaluate the effects of treatment on left ventricular (LV) performance and endothelial function in patients with acromegaly. Method: Nineteen patients with active acromegaly (AA), 18 patients with cured/well-controlled acromegaly (CA), and 25 healthy control subjects were studied. LV performance was evaluated by two-dimensional/Doppler echocardiography and Doppler tissue imaging (TDI). Flow-mediated dilatation (FMD) was measured by B-mode ultrasound. Endothelial cell markers; thrombomodulin (TM), and P-selectin were also measured. Results: Tei index was higher than the control subjects in both acromegaly groups. The ratio of early and late diastolic annular velocities (Em'/Am') was significantly lower in the AA group than the other groups (P 0.05). In the CA group, P-selectin was higher than the controls and was even higher in the AA (P < 0.05). TM was significantly higher in the active group (P < 0.05) and not different than the controls in the CA group. Conclusion: TDI determine LV performance changes in acromegaly earlier than conventional echocardiographic methods. Endothelial function both in the form of FMD and endothelial cell markers is impaired in acromegaly. While in cured acromegaly endothelial cell injury, as evidenced by TM levels, is decreased, endothelial dysfunction still persists. (Echocardiography 2010;27:990-996)

    Preliminary results from a nationwide adult cardiology perspective for pulmonary hypertension: RegiStry on clInical outcoMe and sUrvival in pulmonaRy hypertension Groups (SIMURG)

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    Objective: the present study was designed to evaluate the characteristics of pulmonary hypertension (PH) and adult cardiology practice patterns for PH in our country.Methods: We evaluated preliminary survey data of 1501 patients with PH (females, 69%; age, 44.8±5.45) from 20 adult cardiology centers (AdCCs).Results: the average experience of AdCCs in diagnosing and treating patients with PH was 8.5±3.7 years. Pulmonary arterial hypertension (PAH) was the most frequent group (69%) followed by group 4 PH (19%), group 3 PH (8%), and combined pre- and post-capillary PH (4%). PAH associated with congenital heart disease (APAH-CHD) was the most frequent subgroup (47%) of PAH. Most of the patients' functional class (FC) at the time of diagnosis was III. the right heart catheterization (RHC) rate was 11.9±11.6 per month. Most frequently used vasoreactivity agent was intravenous adenosine (60%). All patients under targeted treatments were periodically for FC, six-minute walking test, and echo measures at 3-month intervals. AdCCs repeated RHC in case of clinical worsening (CW). the annual rate of hospitalization was 14.9±19.5. In-hospital use of intravenous iloprost reported from 16 AdCCs in CWs. Bosentan and ambrisentan, as monotreatment or combination treatment (CT), were noted in 845 and 28 patients, respectively, and inhaled iloprost, subcutaneous treprostinil, and intravenous epoprostenol were noted in 283, 30, and four patients, respectively. Bosentan was the first agent used for CT in all AdCCs and iloprost was the second. Routine use of antiaggregant, anticoagulant, and pneumococcal and influenza prophylaxis were restricted in only two AdCCs.Conclusion: Our nationwide data illustrate the current status of PH regarding clinical characteristics and practice patterns

    Data on prevalence of metabolic syndrome in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors

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    Objective: The incidence of metabolic syndrome varies greatly in developed and developing countries. In the last 10 to 15 years, important studies have been performed examining the incidence of metabolic syndrome in Turkey. This article is a meta-analysis of the studies that investigated the incidence of metabolic syndrome this country

    Breast artery calcification as an opportunistic predictor of cardiovascular disease

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    Background Atherosclerotic cardiovascular disease is still the leading cause of mortality for women. Breast cancer screening with mammography is recommended in all women aged over 40 years. Aims Whether breast artery calcification (BAC) is associated with cardiovascular disease is not clear. We aimed to evaluate the association between BAC and the presence of coronary atherosclerosis determined by CT. Methods All patients who underwent both mammography and coronary CT angiography between January 2010 and December 2016 were screened, and patients with a duration of less than 12 months between CT and mammography were included. Results A total of 320 women were included and BAC was detected in 47 (14.6%) patients. BAC was correlated with age and CT coronary calcium score. Both the frequency of critical coronary artery stenosis (34% vs 10.6%; p = 0.001) and CT coronary calcium score (5.5 vs 0; p = 0.001) was significantly higher in patients with BAC. The absence of BAC was a strong predictor of the absence of significant coronary artery disease (p = 0.001). BAC was independently associated with all-cause mortality after excluding patients with breast cancer (HR: 5.32; p = 0.013). Conclusion Breast artery calcification is associated with coronary calcium score and significant coronary stenosis. A high BAC score is related to increased mortality

    Data on smoking in Turkey: Systematicreview, meta-analysis and meta-regression of epidemiological studies oncardiovascular risk factors

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    Objective: Smoking is one of the most important public health problems and preventable causes of mortality in Turkey. Major healthcare policies have been implemented to combat this problem over the past 10 years. The aim of this study was to conduct a systematic review and meta-analysis of epidemiological studies performed in the country in the last 15 years to determine the prevalence of smoking in Turkey
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