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   2021| October-December  | Volume 7 | Issue 4  
    Online since January 29, 2022

 
 
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ORIGINAL ARTICLES
Medications and lifestyles of patients with cardiovascular risk factors and/or disease in turkish patients (medlife-tr)
Seyda Gunay, Omer Bedir, Serhat Caliskan, Yasemin Dogan, Hulya Cebe, Mehmet Kis, Ahmet Oz, Yunus Celik, Sinan Inci, Nihan Caglar, Mehdi Zoghi
October-December 2021, 7(4):124-131
DOI:10.4103/ijca.ijca_26_21  
Background and Aim: Lifestyles and behavoiral patterns of patients must be known to improve public health and to prevent cardiovascular diseases (CVD). In this study, we aimed to provide insights into the lifestyles and behavioral patterns of patients applied to outpatient cardiology clinics in Turkey. Materials and Methods: The participants completed a self-administered questionnaire about awareness of cardiovascular (CV) risk factors and individual CV risk levels, lifestyles, and medications. Results: A total of 2793 patients, 52.1% of females with a mean age of 57.0 ± 14.0 years were included. The most common risk factor was hypertension. The most common CVD was coronary artery disease. The calculated CV risk level of 1041 patients (37.3%) was high, while only 20.4% of all participants identified themselves as high risk. Participants were aware that hypertension, smoking, hyperlipidemia, diabetes, sedentary, family history, and aging were risk factors for CVD. About 44% of the patients reported that they used additional salt and the majority reported that they did not consume fast food. The most commonly prescribed CV drug was beta-blockers (44.9%) and 22.4% of patients were taking minimum of 5 drugs daily. Conclusion: The awareness of CV risk factors and risk levels is low in the study population. Guideline recommended medications and lifestyle changes are not sufficiently implemented.
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The relationship of fetuin-a, omentin-1, and chemerin with left ventricular ejection fraction in heart failure
Sefa Erdi Omur, Idris Bugra Cerik, Gulacan Tekin
October-December 2021, 7(4):111-118
DOI:10.4103/ijca.ijca_36_21  
Background: Heart failure (HF) is a clinical syndrome in which the heart cannot pump enough blood for the needs of the human body in terms of life functions. Some biochemical diagnostic tests as well as echocardiography play a role in the early diagnosis of this syndrome. The complex pathophysiology of HF suggests that many other markers may be useful in diagnosis and follow-up. Aim: After many recent studies, it has been suggested that adipokines fetuin-A, omentin-1, and chemerin may be suitable biomarkers for the diagnosis of HF. Our main aim in this study is to determine the relationship between fetuin-A, omentin-1, and chemerin levels with HF clinical classification. Methods: The patients admitted to the cardiology service with symptomatic HF with HF with preserved ejection fraction (HF-pEF, n = 62), HF with reduced EF (HF-rEF, n = 61) and HF with mid-range EF (HF-mrEF, n = 63) were included in the study. A total of 246 participants were evaluated by taking the control group (n = 60) for comparison. The main characteristics of all groups were recorded, and serum levels of fetuin-A, omentin-1, and chemerin were evaluated. Results: When compared with the control group, there was a significant difference for fetuin-A with the HF-rEF group (452.3 [441.4–528.9]; 555.3 [453.7–615.6] P < 0.001, respectively). When evaluating for omentin-1, there was a significant difference between the control group and HF-rEF. However, there was no significant difference for chemerin between the HF groups and the control group. Significant cutoff value for fetuin-A was found to be 485 in receiver operating characteristic analysis (area under curve: 0.74 sens: 0.72 (95% confidence interval [CI]: 0.57–0.82), spec: 0.69 (95% CI: 0.59–0.83), P < 0.001). Conclusion: Serum fetuin-A levels were found to be high in the HF-mrEF and HF-rEF groups from the HF groups and can be used in the diagnosis of the HF-rEF group.
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Early myocardial remodeling after aortic valve replacement
Deshbandhu Sharma, Sudhir Mehta, Rajnish Pathania
October-December 2021, 7(4):119-123
DOI:10.4103/ijca.ijca_28_21  
Background: Aortic valve disease leads to eccentric or concentric left ventricular (LV) hypertrophy and changes in the left ventricle function. The goal of aortic valve replacement (AVR) is to alleviate the pressure and volume overload on the left ventricle, allowing myocardial remodeling and regression of LV mass. Objectives: The objective of this study was to assess early LV remodeling in patients with severe aortic valve stenosis and/or moderate-to-severe aortic regurgitation after AVR. Materials and Methods: This prospective study was conducted in the department of cardiovascular and thoracic surgery between January 2015 and February 2016. All patients undergoing AVR exclusively over 1 year were included in the study. Patients were assessed at 1 week, 6 weeks, 3 months, and 6 months after AVR by transthoracic echocardiography. Peak and mean pressure gradients across aortic valve, LV ejection fraction, fractional shortening, LV dimensions, and LV mass along with other parameters were measured in the pre- and postoperative period. Results: A total of 33 patients with different lesions who underwent AVR were evaluated. All but one child (aged 12 years) were adults with a median age of 52 years ± 14.6 years including 21 males and 12 females. The LV mass index (LVMI) regression occurred over time in all cases. Mean LVMI decreased to 149.20 ± 53.7 g/m2 at 1 week and 120.8 ± 45.49 g/m2 at 6 weeks of AVR from its baseline value of 180.8 ± 58.9 g/m2 (P < 0.001). Six patients who were followed up to 1 year had mean LVMI 122.46 ± 50.0 g/m2. Conclusion: Marked reduction in LV mass was discerned after AVR as early as 1 week and further reduction continued up to 6 weeks; however, regression thereafter was not statistically significant.
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CASE REPORT
A 32-Year-Old Coronary Thrombus Case Found during the COVID-19 Pandemic: Could It Be Caused By Sinovac Inactivated Vaccine Or COVID-19 Late-Term Complication?
Adem Aktan, Tuncay Guzel
October-December 2021, 7(4):140-143
DOI:10.4103/ijca.ijca_46_21  
Coronavirus disease 2019 (COVID-19) infection is a public health problem, which globally is considered a pandemic, causing a significant level of morbidity and mortality. It has been defined as a viral infection, the etiology of which is unknown, causing mostly respiratory tract infections. It is surely beyond doubt that vaccine development also plays an important role in ending such pandemics as well as hygiene rules and personal protective equipment. It is becoming gradually more apparent that cardiovascular complications associated with COVID-19, such as myocardial damage, arrhythmia, acute heart failure, and venous thromboembolism, occur more frequently than what was thought before. The precise pathophysiological mechanisms of myocardial damage remain unclear but are thought to be the main pathway, with microthrombi, cytokine storm, and plaque rupture due to hypoxic damage, coronary spasm, direct endothelial, or vascular injury. In this study, we wanted to present a 32-year-old coronary thrombus case with no medical history and no risk factors, which we think may develop due to the Sinovac inactivated COVID-19 vaccine or as a late complication of COVID-19 disease. While cardiac side effects associated with inactive COVID-19 vaccines are still limited in the literature, this issue can be clarified if there are more case reports.
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ORIGINAL ARTICLES
The effect of postdilatation on coronary blood flow and inhospital mortality after stent implantation in st-segment elevation myocardial infarction patients
Oktay Senoz, Ferhat Siyamend Yurdam
October-December 2021, 7(4):132-139
DOI:10.4103/ijca.ijca_35_21  
Background: Adjunctive balloon postdilatation is often performed after stent deployment to improve stent expansion during percutaneous coronary intervention (PCI). However, aggressive mechanical expansion may increase distal thromboembolization and microvascular injury, especially for patients with ST-segment elevation myocardial infarction (STEMI). Therefore, the benefit of postdilatation in these patients remains controversial. We aimed to investigate the effects of postdilation on coronary blood flow and inhospital mortality. Materials and Methods: A retrospective analysis was made of patients who received primary PCI because of STEMI. A total of 216 patients were included, as 108 applied with postdilatation following stent implantation and 108 not applied with postdilatation using propensity score matching method. Coronary blood flow was evaluated using the thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG). Results: The baseline clinical, angiographic, and laboratory characteristics of the groups were similar (P > 0.05). No-reflow developed in 34 (15.7%) of all patients according to TIMI flow (0–2), and in 36 (16.6%) according to MBG (0–1). While the no-reflow (TIMI 0–2) rates of the groups at baseline and following stent implantation were similar (94.4% vs. 95.4%, P = 0.757 and 23.1% vs. 20.4%, P = 0.621), the final no-reflow (TIMI 0–2) rate was significantly higher in the postdilatation group (22.2% vs. 9.3%, P = 0.009). Inhospital mortality rate was determined to be higher in the postdilatation group, but it was statistically nonsignificant (8.3% vs. 5.6%, P = 0.422). Conclusion: The application of postdilatation during primary PCI increased the development of no-reflow phenomenon in STEMI patients.
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