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Objective: Total atrial conduction time (TACT) is the most important parameter in predicting the development of newonset atrial fibrillation. We investigated the effect of cilostazol therapy on TACT in patients with peripheral artery disease. Methods: Thirty patients with peripheral artery disease were treated with cilostazol (200 mg/day) for 6 months. The baseline echocardiographic total atrial conduction time parameter was compared with the 6-month follow-up. Results: The TACT duration was decreased in all patients compared with the baseline after therapy (121.8 ± 19.3 vs. 109.1 ± 15.9 milliseconds, p<0.001). However, left atrial (LA) diameter was not changed with the therapy. The reduction of TACT duration was correlated with the increase in mitral E wave velocity/mitral A wave velocity ratio (r=-0.48, p<0.003). Conclusion: Our results showed that 200 mg cilostazol treatment decreased TACT duration in patients with peripheral artery disease, which may also prevent the development and/or recurrence of atrial fibrillation (AF). [ABSTRACT FROM AUTHOR]

Introduction: Alcohol and substance use disorders are important public health problems with an increased risk for bloodborne and sexually transmitted infections., Objectives: To determine the frequency and risk factors of hepatitis B, hepatitis C and HIV in individuals with drug and alcohol addiction., Methodology: This prospective study was conducted in the outpatient clinic of Alcohol and Substance Abuse Treatment and Education Center (ASATEC), Izmir, Turkey. Detailed anamneses were taken from alcohol and/or drug addicts who applied to the outpatient clinic; HBV, HCV, HIV serology results in the last 6 months were examined., Results: The study group consisted of 478 persons, including 112 (23.4%) alcohol addicts, 322 (67.4%) substance addicts, and 44 (9.2%) combined alcohol and substance addicts. The mean age of the cases was 32 ± 11 years and 432 (90.4%) were male. Drug injection and needle sharing was recorded in 16.5% and 9.8% of participants, respectively. Hepatitis B surface antigen (HBsAg) positivity was found in 2.7%, anti-HCV positivity in 9.6% and HIV Ag/Ab positivity in 1.9% of the cases. Among patients using intravenous drugs, HBsAg positivity was found in 2%, anti-HCV positivity in 55%, while HIV Ag/Ab positivity was not detected. A history of sexually transmitted disease was a risk factor for HBsAg, HIV Ag/Ab positivity. Intravenous drug use, needle sharing and ecstasy use were determined as risk factors for anti-HCV positivity., Conclusions: Risky behaviors for HBV, HCV and HIV transmission are high in alcohol and substance addicts. The use of ecstasy is a novel risk factor for HCV transmission., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Hatice Burcu Açıkalın Arıkan, Nesrin Türker, Başak Bağcı, Seval Çalışkan Pala.)

Background: This study aimed to determine the prevalence of depression in perimenopausal and postmenopausal women in a semi-rural area in a city in Turkey and to evaluate perceived social support and quality of life by examining some of the variables thought to be related., Methods: The study was conducted on 827 perimenopausal and postmenopausal women aged 40-60 years. The questionnaire included sociodemographic characteristics, some variables associated with depression, questions from the Beck Depression Inventory, Multidimensional Scale of Perceived Social Support, and European Health Impact Scale - Quality of Life-8 (EUROHIS-QOL-8) scale., Results: The prevalence of depression was 23.1% (n = 191) in the study. The prevalence of depression was found to be higher in single/widowed/separated individuals (odds ratio (OR): 2.539; 95% CI: 1.593-4.047) and at poor income levels (1.980; 1.000-3.021). The frequency of depression was found to be lower in those who gave birth once or twice (0.470; 0.294-0.752), those with a high level of social support (0.959; 0.948-0.971), and those with a high level of QOL (0.836; 0.794-0.879). There was a moderate negative correlation between the depression scale and QOL scale scores (r = -0.405, P = 0.001). A weak negative correlation was found between depression and social support scores (r = -0.383, P = 0.001)., Conclusion: Women are more vulnerable to depression in premenopausal and postmenopausal periods. Being single/widowed, having a poor income level, having low social support, and low QOL are important risk factors which increase the frequency of depression., (© 2022 Japanese Psychogeriatric Society.)

Elevated gamma-glutamyltransferase (GGT) level is independently correlated with conditions associated with increased atherosclerosis, such as obesity, elevated serum cholesterol, high blood pressure and myocardial infarction. It is demonstrated that serum GGT activity is an independent risk factor for myocardial infarction and cardiac death in patients with coronary artery disease. Diabetes is also a well-known cardiovascular risk factor and an equivalent of coronary artery disease. Although the relationship between GGT and coronary artery disease has been reported, there are limited data exploring the changes of GGT in acute coronary syndromes, especially in patients with diabetes. So, this study aimed to determine changes in GGT level in diabetic and non-diabetic acute coronary syndromes. This trial was carried out at Kosuyolu Cardiovascular Training and Research Hospital and Van Yuksek Ihtisas Hospital, Turkey. A total of 219 patients (177 men and 42 women) presenting with acute coronary syndrome) and 51 control subjects between September 2007 and September 2008 were included in the study. Serum γ-glutamyltransferase and serum lipoprotein levels were determined. The resuls indicated that serum GGT levels were higher in acute coronary syndrome patients compared with control. In subgroup analyses, there was no difference between diabetic and non-diabetic subgroups. There was also weak correlation between GGT and blood glucose levels. There was no correlation between GGT and serum lipoprotein levels. In conclusion, serum GGT levels were higher in acute coronary syndrome patients. In subgroup analyses, There was no difference between diabetic and non diabetic subgroup.

Objectives: Osteoprotegerin (OPG) upregulates endothelial cell adhesion molecule response to TNF-α by upregulating angiopoietin-2 (Ang-2). The aim of this study was to investigate the association between admission plasma levels of OPG, Ang-2 and TNF-α in patients with acute ST-segment elevation myocardial infarction (STEMI) and no-reflow after primary angioplasty and subsequent left ventricular remodeling (LVR)., Methods: Ninety-two patients with first STEMIs, reperfused within 12 h of symptom onset, were included. LVR was defined as a >20% increase in LV end-diastolic volume at 6-month follow-up assessed using echocardiography., Results: The incidences of angiographic no-reflow and electrocardiographic no-reflow were 40.2% and 55.4%, respectively. Thirty-six percent of patients subsequently developed LVR. OPG levels were significantly higher in patients who developed angiographic no-reflow (173 pg/ml, interquartile range [IQR] 83-416 vs 104 pg/ml, IQR 57-235; p=0.04), electrocardiographic no-reflow (160 pg/ml, IQR 81-315 vs 102 pg/ml, IQR 47-230; p=0.025) and LVR (174 pg/ml, IQR 120-342 vs 97 pg/ml, IQR 51-219; p=0.004). In multivariable logistic regression, OPG level was an independent predictor of angiographic (OR 1.05: 95% CI 1.01-1.08 [per 10 pg/ml increase]; p=0.005) and electrocardiographic (OR 1.04: 95% CI 1.00-1.07 [per 10 pg/ml increase]; p=0.04) no-reflow. ROC analysis showed an area under the curve of 0.69 for OPG and LVR. Plasma OPG≥132 pg/ml showed a sensitivity of 72% and a specificity of 61% for predicting LVR (OR 4.05: 95% CI 1.06-15.38; p=0.04)., Conclusion: High OPG level on admission is significantly associated with no-reflow after primary angioplasty and subsequent LVR at follow-up in patients with STEMI., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The molecular basis and pathophysiology of pulmonary hypertension (PH) are rapidly evolving areas. Recently discovered angiopoietins (Ang) constitute a family of growth factors, and whether they play a causal or protective role in pulmonary hypertension has not been fully elucidated. Since left heart disease probably represents the most frequent cause of PH, we sought to determine whether there was a relationship between serum Ang-1 levels and pulmonary hypertension caused by mitral stenosis (MS). The study population was composed of 49 patients with isolated MS. These patients were then divided into group 1 [31 patients with severe MS: mitral valve area (MVA) ≤1.1 cm(2)] and group 2 (18 patients with mild-moderate MS: MVA 1.2-2.0 cm(2)). Twenty-one healthy volunteers comprised the control group (group 3). All of the subjects underwent complete transthoracic echocardiography with determination of systolic pulmonary artery pressure (PAPs). Ang-1 levels were determined in serum. Serum levels of Ang-1 were significantly higher in the control group compared to patients with severe (group 1) and mild-moderate (group 2) MS (p < 0.001). Ang-1 levels were found to have moderate inverse correlation with PAPs and left atrial (LA) diameter (r: -0.620, p < 0.001 and r: -0.489, p < 0.001, respectively). The AUC for the ROC curve for predicting PAPs <50 mmHg by serum Ang-1 level was 0.824 (95% CI 0.722-0.926, p < 0.001). A serum level of Ang-1 above 34,656 pg/ml has 74% sensitivity and 80% specificity for predicting that PH is not severe (PAPs <50 mmHg). In conclusion, the findings of this study are distinctive in the sense that they clearly demonstrate a negative correlation between serum Ang-1 levels and the degree of PH.

Objective: Socioeconomic status (SES) is associated with coronary artery disease (CAD) risk factors, coronary morbidity and mortality. In industrialized countries several studies showed that the lowest SES groups have higher coronary morbidity and mortality rates and higher coronary risk factors profile. The aim of our study was to investigate the distribution of risk factors in cases with CAD in different socioeconomic groups., Methods: Our study group consists of 550 consecutive cases with > or = 50% lesions in at least one coronary artery. Educational level and income were taken into consideration for the determination of the SES. In both sexes the distribution of eight risk factors such as, smoking, family history, diabetes mellitus, hypertension, high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), body mass index, central obesity was compared in three different groups determined according to the education and income levels., Results: In men, the distribution of risk factors did not differ according to education levels. In women, central obesity was found to be higher in the group with low education level. In men, the prevalence of low HDL-C, high LDL-C and obesity increased with increasing levels of economical status. In women, central obesity was found to be inversely related with the economic status., Conclusion: Our data show a higher risk factor profile in men with higher income level, while in women central obesity was inversely related to the income and educational level. These data should be considered in secondary prevention efforts.

Objective: World Health Organization and other international guide committees defined different obesity categories according to the body mass index (BMI) and waist circumferences. The purpose of our study was (i) to compare the dispersion of other coronary risk factors in patients with coronary artery disease (CAD) with different obesity categories that were defined according to the body mass index (BMI) and the waist circumference, (ii) to determine to which extent these cut-off values effect the dispersion of other coronary risk factors., Methods: The study group included 617 consecutive subjects (516 male, mean age - 57.2+/-10.8 years) who underwent their first angiography between January 2000 and May 2000 and in whom significant coronary lesions were detected. The distribution of risk factors such as, age, smoking, hypertension, diabetes mellitus, high LDL-C, low HDL-C, total cholesterol/HDL-C ratio, triglycerides, family history of premature CAD was compared between overweight and obese cases defined according to BMI values. The same risk factors were compared among the cases grouped as action level 1 and action level 2 defined by the waist circumference., Results: In male patients; smoking was found to be higher in overweight individuals than in obese cases (71% vs. 56%) (p<0.05). In female patients; the only difference was the ratio of total-C/HDL-C as being greater in obese group than overweight group (p<0.05). In male and female patients there was no significant difference between obese and overweight cases regarding the number of total risk factors. According to the waist circumference, in male patients, smoking was more prevalent in action level 1 group than in action level 2 group. In female patients risk factors prevalence was similar in both groups., Conclusion: In patients with CAD, the amount of total risk factors doesn't differ between overweight and obese cases and between patients with action level 1 and action level 2 of the waist circumference. These findings indicate the necessity of using the same secondary prevention approaches in patients with CAD and different levels of obesity.

Background and Aims of the Study: The presence of significant atherosclerotic coronary artery disease (CAD) in patients with valvular heart disease is an important predictor of perioperative mortality. The prevalence of CAD in patients undergoing valvular heart surgery is 20-40% in industrialized countries. The study aim was to determine CAD prevalence in Turkish patients undergoing valvular heart surgery, and to identify predictors of its presence., Methods: A total of 760 patients (357 males, 403 females; mean age 54.4+/-18.1 years) who underwent coronary angiography before valvular surgery between 1995 and 2000 was enrolled retrospectively. Single- and multi-valve involvement was present in 46% and 54% of patients, respectively. Patients with ischemic mitral regurgitation were excluded from the study. Significant CAD was defined as the presence of > or =50% diameter stenosis anyone of the coronary arteries. The presence of angina pectoris, and of risk factors (e.g. hypertension, smoking, diabetes mellitus (DM), hyperlipidemia, family history of CAD) were sought in all patients. Predictors of CAD were identified by logistic regression analysis., Results: Significant CAD was present in 15.8% of patients (24% males, 9% females) (p <0.001); the highest prevalence was in those with aortic stenosis (p <0.05). CAD was not seen in young patients (aged <45 years) with none of the above-mentioned risk factors. The highest correlation between CAD and risk factors was family history of CAD, followed by DM, hyperlipidemia, hypertension and smoking, in decreasing order., Conclusion: The study results showed that CAD in patients with valvular heart disease was less prevalent in Turkey than in industrialized countries. The incidence of coronary lesions rises notably from the age of 50 years in both males and females. Coronary angiography before valvular heart surgery could be omitted in young patients (age <45 years) with none of the coronary risk factors, or without angina.