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Öğe Acute Myocardial-Infarction - Diabetics Versus Non Diabetics(F K SCHATTAUER VERLAG GMBH, 1995) Cin, V. G.; Gök, H.; Tavlı, T.We have studied 40 patients with diabetes mellitus (mean age 62 + 8) and 45 patients without (mean age 53 + 9). All the patients were consecutively admitted to our coronary care unit with myocardial infarction. We have observed a higher incidence of heart failure (20% vs 13%), atrial fibrillation (17% vs 11%), postinfarction angina (23% vs 13%), and conduction abnormalities among diabetics. In our patients the higher mortality among diabetics is associated with cardiogenic shock and left ventricular failure. We concluded that the poorer outcome among diabetic patients with acute myocardial infarction could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery disease.Öğe Effect of Immunoglobulin E in-Hospital Period in Patients With Acute Myocardial Infarction(Elsevier Sci Ireland Ltd, 2003) Yazycy, M.; Tokaç, Ayşe; Düzenli, A.; Altunkeser, Bülent Behlül; Gök, H.Objective: Elevated Immunoglobulin E (IgE) levels have been suggested to prevent patient with acute myocardial infarction (AMI) from the com- plications. The aim of this study was to investigate the effect of Ig E on complications in patient with acute myocardial infarction. Methods: Patient suffered from AMI and having above 200IU/ml Ig E level were included in the study as a group 1. Patient suffered from AMI and having below 200IU/ml Ig E level were included in the study as a group 2. All patients were followed up in coronary care unit 4-8 days depend on their clinical status. In the follow up period, all patients were monitorized continuously electrocardiographycally and clinically; also, blood pressures were monitorized. Obtained results are presented in table.Öğe Evaluation of "Admission Index of Insulin Resistance (Airi)" as an Early Stage Risk Predictor in Nondiabetic Acute Coronary Syndromes(2002) İçli, Abdullah; Gök, H.; Altunkeser, Bülent Behlül; Özdemir, K.; Gürbilek, Mehmet; Gederet, Y. T.; Sökmen, GülizarObjective: Insulin resistance is a risk predictor for many cardiovascular diseases, but its effect on etiology and prognosis of diseases has not been clearly identified. In this study, we aimed to investigate whether admission index of insulin resistance (aIRI), recently and practically presented for determination of insulin resistance, could be a new risk predictor of early prognosis in nondiabetic acute coronary syndromes. Methods: One hundred and sixty nondiabetic patients admitted to the intensive coronary care unit and underwent coronary angiography with the diagnosis of acute myocardial infarction (AMI) (Group I; 72 patients; mean age - 58 ± 12 years) or unstable angina pectoris (UAP) (Group II; 88 patients; mean age 58 ± 10 years) were included in the study. In all patients blood glucose and insulin levels were measured on admission and AIRI was calculated by the formula of "admission glucose level X insulin level / normal blood glucose level (5mmol/L) X normal insulin level (5 mU/L)" for each patient. After determining the left ventricular ejection fraction (LVEF) and wall motion score index (LVWMSI) echocardiographically and calculating the Gensini score index from coronary angiography, the patients were followed up for major cardiac events (heart failure, atrial fibrillation, reinfarction, life-threatening ventricular arrhythmias, atrio-ventricular block, need for revascularisation and mortality) for 30 days. Results: AIRI was found higher in Group I (7.2 ± 5.3 versus 5.2 ± 4.4, p< 0.01) than in Group II. AIRI was positively correlated with Gensini score and LVWMSI (r=0.41, p<0.01 and r=0.48, p<0.48, p<0.001, respectively) and negatively correlated with LVEF (r=-0.37, p=0.001) in Group I. In addition, it was seen that positive correlation of AIRI with Gensini score (r=0.23, p=0.01) and LVWMSI (r=0.43, p=0.0001) in Group I persisted on multivariate regression analysis. Again, AIRI was significantly correlated with heart failure (r=0.42, p<0.0001) atrial fibrillation (r=0.35, p=0.002) and reinfarction (r=0.23, p=0.04) in Group I. Along with this, in multivariate regression analysis, it was correlated with heart failure (r=0.21, p<0.007), atrial fibrillation (r=0.18, p=0.01) and reinfarction (r=0.18, p=0.01). On the other hand, there was no significant correlation between AIRI and these parameters in Group II. Conclusion: AIRI can be used in early stage as a risk predictor to determine high-risk subgroups of nondiabetic patients presenting with AMI. Also AIRI, a parameter, which is practically calculated and easily used, is an independent risk factor detecting the extent of coronary artery disease and left ventricular dysfunction in patients with AMI.Öğe Evaluation of Coronary Sinus Function in Patients With Three-Vessel Disease(Elsevier Sci Ireland Ltd, 2003) Tokaç, Mehmet; Yeter, E.; Yazıcı, M.; Altunkeser, Bülent Behlül; Gök, H.; Tokgozoglu, L.[Abstract not Available]Öğe Examination of Coronary Heart Disease and Risk Factors in Asymptomatic Adults in Central Anatolia [eine Untersuchung Der Koronaren Herzerkrankung und Der Risikofaktoren Bei Asymptomatischen Erwachsenen in Zentralanatolien](1995) Gönen, M. S.; Cin, V. G.; Gök, H.; Bayram, A.; Telli, H. H.The coronary heart disease and its risk factors were investigated in Konya district which is situated in central Anatolia, Turkey. In this study 280 asymptomatic persons, who were middle aged and over (?40), were selected at random from Bozkir, a small town of Konya, which shows a homogenous structure of population. Cardiovascular system of all the cases were examined. ECG and teleradiography were taken. In 54 cases (19.3% ) hypertension, in 11 cases (3.9%) hyperglycemia and in 58 male cases (59.8%) smoking were found. Obesity was seen in 17% of male and 27% of female cases. Hypercholesterolemia in 12% of cases and hypertriglyceridemia in 7.4% of cases were also seen. In 40 cases, coronary heart disease was determined. Incidence of hypertension was increasing with age, but the rate of cigarette-smoking was not changed. Under the light of positive results of the struggle with the reversible major risk factors, periodic examinations in cases with high risk, medical and preventive treatment procedures were pointed out clearly as important issues for the physician.Öğe Examination of Coronary Heart-disease and Risk-factors in Asymptomatic Adults in Centralanatolia(F K SCHATTAUER VERLAG GMBH, 1995) Gönen, M.S.; Cin, V.G.; Gök, H.; Bayram, A.; Telli, H.H.The coronary heart disease and its risk factors were investigated in Konya district which is situated in central Anatolia, Turkey. in this study 280 asymptomatic persons, who were middle aged and over (greater than or equal to 40), were selected at random from Bozkir, a small town of Konya, which shows a homogenous structure of population. Cardiovascular system of all the cases were examined. ECG and teleradiography were taken. In 54 cases (19.3%) hypertension, in 11 cases (3.9%) hyperglycemia and in 58 male cases (59.8%) smoking were found. Obesity was seen in 17% of male and 27% of female cases. Hypercholesterolemia in 12% of cases and hypertriglyceridemia in 7.4% of cases were also seen. in 40 cases, coronary heart disease was determined. Incidence of hypertension was increasing with age, but the rate of cigarette-smoking was not changed. Under the light of positive results of the struggle with the reversible major risk factors, periodic examinations in cases with high risk, medical and preventive treatment procedures were pointed out clearly as important issues for the physician.Öğe Importance of Left Anterior Hemiblock Development in Inferior Wall Acute Myocardial Infarction(Westminster Publ Inc, 2001) Özdemir, K.; Uluca, Y.; Danış, G.; Tokac, M.; Altunkeser, Bülent Behlül; Telli, H. H.; Gök, H.The aim of this study was to investigate the clinical and angiographic importance of left anterior hemiblock (LAHB) during acute inferior myocardial infarction (AIMI) by comparing patient groups with and without LAHB after AIMI. One hundred seventy-two patients (141 men and 31 women) between 28 and 84 years of age (mean 55 +/- 10 years) with AIMI were included in the study, Patients were divided into 2 groups according to electrocardiogram (ECG) criteria: group I comprised 25 patients in whom ECG pattern characteristic of LAHB developed, group II comprised 147 patients without this pattern. According to the electrocardiogram, patients were placed in group I if the mean QRS axis was deviated to the left < 30 degrees in the frontal plane with the following pattern: increased S-wave voltage and decreased R-wave voltage in leads II, the appearance of a deep S-wave in lead II, and a terminal positive R-wave in lead aVR. Coronary angiography was performed within 2 weeks. A coronary stenosis was considered if the vessel diameter was narrowed by > 50%. The dominant coronary artery was classified as right or left or balanced. The left ventricular ejection fraction (LVEF) was calculated from left ventriculography. The mean age of the patients in group I was significantly higher (58 vs 54 years, p=0.007), while the risk factors were similar in both groups. Left anterior descending (LAD) and multivessel coronary artery disease (CAD) were found to be significantly higher in group I compared with group II (80% vs 38%, p=0.0001; 84% Vs 52%, p=0.001, respectively). The mean LVEF was found to be lower in group I (51% vs 56%, p=0.04). Peak creatine phosphokinase MB (CKMB) values were not different (216 vs 162 IU/L, p=0.09). The frequency of left dominant or balanced coronary artery was determined to be higher in group I (44% vs 17%, p=0.018). LAHB development during AIMI can be an indicator of LAD lesions, multivessel coronary artery disease, and impaired left ventricular systolic function.
