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Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiography findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the predictors of warfarin use in patients with non-valvular atrial fibrillation (AF). This study was the first to be conducted in a Turkish population. Materials and methods: Patients who presented to our outpatient clinic with the diagnosis of AF between September 2008 and October 2009 were enrolled. The patients were classified according to the CHADS2 risk scoring system recommended by the AHA/ACC/ESC guidelines for the classification of stroke risk in non-valvular AF patients. The probable variables influencing the use of warfarin were determined as age, sex, income level, healthcare coverage, lifestyle, place of residence, classification of AF, hypertension, diabetes mellitus, coronary artery disease, thyrotoxicosis, cardiac insufficiency, left ventricular dysfunction, stroke risk stratification, and history of stroke or systemic embolism (SE). Results: Among the 570 patients enrolled in the study, 144 were excluded because of insufficient patient information or refusal to participate, while 101 patients were excluded due to valvular AF. Thus, the evaluation was based on 325 patients (133 males and 192 females; mean age: 65 ± 10). According to the CHADS2 scoring, 62.2% of the patients were at high risk, 26.8% were at moderate risk, and 11.1% were at low risk. Only 19.7% of the patients were on warfarin treatment. In the logistic regression analysis, a history of stroke or SE, high income level, and the presence of persistent and permanent AF were found to be positive predictors of warfarin use, while advanced age was a negative predictor of warfarin use. Conclusion: This study demonstrated that a history of stroke or SE, high income level, presence of persistent and permanent AF, and advanced age are independent predictors of warfarin use in non-valvular AF patients. [ABSTRACT FROM AUTHOR]

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We present the case of a patient in whom a previously undetected anomalous origin of the circumflex coronary artery caused myocardial ischemia and led to positive myocardial scintigraphic results. Subsequent coronary angiography showed that the left circumflex coronary artery arose from the right coronary ostium--an anomaly that has been associated with chest discomfort--without atherosclerotic lesions. The peripheral distribution of the left circumflex artery was normal. We describe the clinical and angiographic findings in our patient and discuss the relationship between coronary artery anomalies and ischemia. [ABSTRACT FROM AUTHOR]