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A Case of Familial Mediterranean Fever Who Was Presented with Acute Coronary Syndrome
(Düzce Üniversitesi, 2009) Ordu, Serkan; Kaya, Ahmet; Aydın, Mesut; Dindar, Gökhan; Özhan, Hakan; Yazıcı, Mehmet
Familial Mediterranean fever is an autosomal recessive disease manifested by recurrent attacks of peritonitis, plevritis and arthritis, and characterized by clinical, histological and laboratory evidence for localized and systemic inflammation. Systemic inflammation is an important factor in the initiation and development of atherosclerosis. We report here a patient with long-standing FMF who was presented with acute coronary syndrome during the febrile attacks
Akut koroner sendrom ile prezente olan ailesel Akdeniz Ateşi (FMF) olgusu
(2009) Ordu, Serkan; Kaya, Ahmet; Aydın, Mesut; Dindar, Gökhan; Özhan, Hakan; Yazıcı, Mehmet
Ailesel Akdeniz Ateşi (FMF), klinik olarak tekrarlayan peritonit, plevrit ve artrit gibi seröz zar tutulumuyla karakterize, histolojik ve laboratuar bulgularıyla lokalize veya sistemik inflamasyon kanıtları olan, otozomal resesif geçiş gösteren genetik bir hastalıktır. Sistemik inflamasyon, ateroskleroz başlangıcı ve gelişimi açısından önemli bir faktördür. Biz burada uzun süredir FMF tanısıyla tedavi alan bir hastanın, febril atakları esnasında akut koroner sendrom gelişerek semptom verebileceğini gösterdik.
Assessment of cardiac functions in patients with adenotonsillar hypertrophy
(2011) Ordu, Serkan; Özhan, Hakan; Uzun, Hakan; Alemdar, Recai; Erden, İsmail; Yazıcı, Mehmet; Gültekin, Erol
Amaç: Bu çalışmanın amacı, adenotonsiller hipertrofisi (ATH) olan ve olmayan çocuklarda kardiyak fonksiyonları değerlendirmektir. Materyal ve Metod: Pediatri polikliniği tarafından adenotonsiller hipertrofi tanısı konmuş doksan bir çocuk (26 kız, 65 erkek) ve 23 sağlıklı olgu, yaş ve cinsiyet eşleştirilmeli sağlıklı çocuklar (10 kız, 13 erkek) çalışmaya dahil edilmiştir. Tüm hastalara 2D ekokardiyografi ve Doppler tetkiki yapılmıştır. Bulgular: Ortalama mitral E, A dalgaları ve deselerasyon zamanı, ATH olan grupta daha uzun bulunmuştur. Aynı zamanda kalp boşlukları ve hacimleri de daha yüksek ölçülmüştür. Pulmoner ve mitral regurjitasyon oranı, ATH olan grupta daha sık saptanmıştır. Adenotonsiller grade, ortalama pulmoner arterial basınçla ilişkili bulunmuştur. (r: 0.44 p: 0.001). Mitral kapak kalınlığı, tonsiller hipertrofi derecesiyle güçlü bir şekilde korele saptanmıştır. (r: 0.73; p.0.001). Sonuç: ATH, hafif diastolik disfonksiyon ve kalp boşluklarında dilatasyona yol açabilmektedir. Mitral kapak kalınlığı, adenotonsiller grad ile güçlü bir şekilde korele bulunmuştur.
Assessment of cardiac functions in patients with adenotonsillar hypertrophy
(Duzce University Medical School, 2011) Ordu, Serkan; Özhan, H.; Uzun, H.; Alemdar, R.; Erden, I.; Yazıcı, M.; Gültekin E.
Background: The aim of this study is to compare cardiac function in children with and without adenotonsillar hypertrophy (ATH). Materials and methods: Ninety-one children (26 female 65 male) who were diagnosed as ATH in the pediatric outpatient clinic and twenty-three completely healthy, age-sex matched children (10 female 13 male) were included in the study. All patients underwent a complete twodimensional transthoracic echocardiographic and Doppler study. Results: Mean mitral E, A and deceleration time were significantly longer in ATH group. Also chamber areas and volumes were bigger. Pulmonary and mitral regurgitation were statistically more frequent in ATH group. Adenotonsillar grade was positively related with mean pulmonary arterial pressure (r: 0.44 p: <0.001). Mitral valve thickness was strongly correlated with tonsillar hypertrophy grade (r: 0.73; p.<0.001). Conclusions: ATH may lead to mild diastolic dysfunction and chamber dilatation. Mitral valve thickness was strongly correlated with adenotonsillar grade. © 2011 Düzce Medical Journal.
Associations of alcohol consumption with blood pressure, lipoproteins, and subclinical inflammation among Turks
(Elsevier Science Inc, 2008) Onat, Altan; Hergenç, Gülay; Dursunoğlu, Dursun; Ordu, Serkan; Can, Günay; Bulur, Serkan; Yüksel, Hüsniye
Gender-related impact of alcohol consumption on blood pressure (BP), serum lipoprotein profile, and C-reactive protein (CRP) concentrations was evaluated prospectively. Alcohol drinking status was assessed as abstainers and categories of light, moderate, and heavy (daily >40 ml ethanol) intake. Mean age of the 3,443 men and women who were followed up for a mean of 7.4 years was 47.6 +/- 12 years. In each multivariable linear or logistic regression analysis, alcohol drinking status was adjusted for age, sex, smoking status, and physical activity. Among men. drinking was significantly associated positively with low-density lipo protein (LDL) cholesterol, apolipoprotein (apo) B, systolic and diastolic BR and with CRP in a log-linear manner exhibiting features of a threshold at heavy drinking. With respect to response of serum triglycerides to light-to-moderate drinking, whereas men exhibited a significant increase, women exhibited a decline (P < .05). Lower BPs (P < .03) and CRP levels (P = .032) were observed in female drinkers than abstainers and, as distinct from men, no increases in LDL cholesterol and apoB were noted. Heavy drinking tended to protect the sexes against the risk of developing low high-density lipoprotein cholesterol levels in prospective multi adjusted analyses. Sex modulates response of cardiometabolic risk variables to moderate alcohol consumption among Turks. Only women respond with lower triglycerides and CRP, whereas men show a log-linear positive association of drinking categories with BP, LDL cholesterol, apoB, and CRP. (C) 2008 Elsevier Inc. All rights reserved.
Carbohydrate Antigen-125 and N-Terminal Pro-Brain Natriuretic Peptide Levels Compared in Heart-Failure Prognostication
(Texas Heart Inst, 2012) Ordu, Serkan; Özhan, Hakan; Alemdar, Recai; Aydın, Mesut; Çağlar, Onur; Yüksel, Hatice; Kandiş, Hayati
Carbohydrate antigen-125 (CA-125) is emerging as a prognostic biomarker of risk in heart failure. In a prospective study, we compared the prognostic values of CA-125 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable heart failure. We enrolled 102 consecutive chronic, stable, systolic-heart-failure patients (68 men and 34 women; median age, 71 yr) from November 2008 through February 2010. We measured baseline NT-proBNP and CA-125 levels and compared their prognostic values. The primary endpoint was all-cause death and other major adverse events, defined as hospitalization for decompensated heart failure or acute coronary syndrome. During a mean follow-up period of 14 +/- 2 months, 12 patients died and 35 others sustained major adverse events. We found that CA-125 level significantly correlated with New York Heart Association functional class, pulmonary artery pressure, microalbuminuria, creatine kinase-MB fraction, and hemoglobin, albumin, and NT-proBNP levels. Upon receiver operating characteristic curve analysis, CA-125 and NT-proBNP had similar accuracy in predicting major adverse events and death: for major adverse events, area under the curve (AUG) was 0.699 for CA-125 (P=0.002) and 0.696 for NT-proBNP (P=0.002); for death, AUC was 0.784 for CA-125 (P=0.003) and 0.824 for NT-proBNP (P=0.001). Multivariate Cox regression analysis showed that CA-125 levels greater than 32 U/mL and NT-proBNP levels greater than 5,300 pg/mL had independent prognostic value for major adverse events and death. We conclude that baseline CA-125 and NT-proBNP levels are comparably reliable as heart-failure markers, and that CA-125 can be used for prognosis prediction in heart failure. (Tex Heart Inst J 2012;39(1):30-5)
Carbohydrate antigen-125 and N-terminal pro-brain natriuretic peptide levels: Compared in heart-failure prognostication
(2012) Ordu, Serkan; Özhan, Hakan; Alemdar, Recai; Aydın, Mesut; Çağlar, Onur; Yüksel, Hatice; Kandiş, Hayati
Carbohydrate antigen-125 (CA-125) is emerging as a prognostic biomarker of risk in heart failure. In a prospective study, we compared the prognostic values of CA-125 and aminoterminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable heart failure. We enrolled 102 consecutive chronic, stable, systolic-heart-failure patients (68 men and 34 women; median age, 71 yr) from November 2008 through February 2010. We measured baseline NT-proBNP and CA-125 levels and compared their prognostic values. The primary endpoint was all-cause death and other major adverse events, defined as hospitalization for decompensated heart failure or acute coronary syndrome. During a mean follow-up period of 14 ± 2 months, 12 patients died and 35 others sustained major adverse events. We found that CA-125 level significantly correlated with New York Heart Association functional class, pulmonary artery pressure, microalbuminuria, creatine kinase-MB fraction, and hemoglobin, albumin, and NT-proBNP levels. Upon receiver operating characteristic curve analysis, CA-125 and NT-proBNP had similar accuracy in predicting major adverse events and death: for major adverse events, area under the curve (AUC) was 0.699 for CA-125 (P=0.002) and 0.696 for NT-proBNP (P=0.002); for death, AUC was 0.784 for CA-125 (P=0.003) and 0.824 for NT-proBNP (P=0.001). Multivariate Cox regression analysis showed that CA-125 levels greater than 32 U/mL and NT-proBNP levels greater than 5,300 pg/mL had independent prognostic value for major adverse events and death. We conclude that baseline CA-125 and NT-proBNP levels are comparably reliable as heart-failure markers, and that CA-125 can be used for prognosis prediction in heart failure. © 2012 by the Texas Heart® Institute, Houston.
A case of acute stent thrombosis treated successfully with intracoronary tirofiban
(Via Medica, 2010) Erden, İsmail; Özhan, Hakan; Ordu, Serkan
Acute stent thrombosis (AST) is occasionally observed during percutaneous coronary intervention in patients with acute coronary syndrome (ACS). It may jeopardize hemodynamic status. Currently, there is no adequate solution for this problem. We report our experience with an ACS patient who developed AST associated with cardiogenic shock after percutaneous coronary stent deployment. Intracoronary administration of tirofiban immediately restored the coronary flow of the target vessel, and the disastrous condition was reversed. Our experience suggests that intracoronary administration of tirofiban can be considered as an option in cases of AST during percutaneous coronary intervention.
A case of atrial fibrillation due to Momordica charantia (bitter melon)
(K Faisal Spec Hosp Res Centre, 2010) Erden, İsmail; Ordu, Serkan; Erden, Emine C.; Çağlar, Sabri O.
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A case successfully treated giant ventricular septal rupture after acute myocardial infarction
(Springer, 2007) Kaya, Ahmet; Kaya, Yasemin; Ordu, Serkan; Özkökeli, Mehmet; Özhan, Hakan; Dağlar, Bahadır; Mehmet, Yazıcı
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Cystatin C Levels in Patients With Dipper and Nondipper Hypertension
(Lippincott Williams & Wilkins, 2012) Ordu, Serkan; Özhan, Hakan; Alemdar, Recai; Yıldırım, Hayriye; Güngör, Adem; Çağlar, Sabri Onur; Bulur, Serkan
Objective: Subjects with nondipper hypertension carry a higher risk of cardiovascular events than their normotensive counterparts. The present study was designed to investigate cystatin C levels in patients with dipper and nondipper hypertension. Methods: Eighty-eight consecutive patients who had been treated with antihypertensive drugs for at least 6 months were included in the study. Dipping and nondipping patterns were detected with ambulatory blood pressure monitoring. Clinical, laboratory, and ambulatory blood pressure monitoring data of patient groups with nondipper and dipper hypertension were compared. Results: Patients in the nondipper group were older than those in the dipper group. Serum cystatin C level was higher in the patients in the nondipper group. Cystatin C was negatively correlated with the rate of systolic blood pressure fall at night (r = -0.41; P < 0.001). Linear regression analyses revealed that only cystatin C level was a significant correlate of nocturnal systolic blood pressure decrease. Logistic regression analyses also showed that cystatin C was an independent predictor of nondipping pattern (odds ratio, 3.586; 95% confidence interval, 1.432-8.98; P = 0.006]). Conclusion: The present study showed that cystatin C is higher in patients with nondipper hypertension patients.
Dipper ve nondipper hipertansiyon hastalarında asimetrik dimetil arjinin düzeyleri
(2010) Güngör, Adem; Aydın, Yusuf; Celbek, Gökhan; Başar, Cengiz; Alemdar, Recai; Ordu, Serkan; Özhan, Hakan
Amaç: Asimetrik dimetil arjinin (ADMA), nitrik oksit sentezinin endojen bir inhibitörü olup aynı zamanda endotel disfonksiyonunun bir göstergesidir. Non-dipper hipertansiyon (HT) tipine sahip hastalarda yapılan çalışmalarda endotel disfonksiyonun dolayısıyla hedef organ hasarının dipper HT tipi olan hastalardan daha fazla olduğu gösterilmiştir. Biz çalışmamızda bu iki grup arasında endotel fonksiyonu değişikliklerini ADMA seviyelerine bakarak karşılaştırdık. Gereç ve yöntem: Bu çalışmaya 6 ay içerisinde Düzce Üniversitesi Tıp Fakültesi iç hastalıkları ve kardiyoloji polikliniğine başvuran ve daha önceden esansiyel HT tanısı konulup medikal tedavi ile takip edilen 87 hasta dahil edildi. Hastalar ambulatuar kan basıncı ölçümü yapılarak dipper ve non-dipper olmak üzere iki gruba ayrıldı. Hastaların vucut kitle indeksi(VKİ), sistolik kan basıncı ve diyastolik kan basıncı, trigliserid, total kolesterol, düşük dansiteli lipoprotein(LDL) kolesterol, yüksek dansiteli lipoprotein(HDL) kolesterol ve ADMA ölçümleri yapıldı. Bulgular: Grupların yaş, VKİ ve lipid değerleri arasında istatistiksel olarak fark yoktu (p0.05). Dipper grubunda bakılan ADMA seviyeleri 1.290.17 ?mol/L, non-dipper grubunda ise 1.270.13 ?mol/L idi. Dipper ve non-dipper grupları arasında ADMA açısından anlamlı farlılık yoktu (p0.575). Sonuç: ADMA seviyeleri HT hastalarında bozulmuş endotel fonksiyonuna bağlı olarak yüksek olarak bulunur. Kan basıncının non-dipper tipinde endotel disfonksiyonu dipper tipi olanlara göre daha fazladır. Çalışmamızda iki tip arasında ADMA seviyelerinde farklılık bulunamamıştır.
Echocardiographic Evaluation Of The Left Ventricular Diastolic Functions In Rheumatoid Arthritis
(Düzce Üniversitesi, 2010) Bulur, Serkan; Önder, Elif; Ordu, Serkan; Çalık, Yalkın; Baki, Ali Erdem; Ozhan, Hakan; Yazıcı, Mehmet
Background and aim: The aim of this study was to evaluate LVDF in patients with RA, analyzing conventional Doppler and tissue Doppler echocardiographic imaging (TDI) which is a new echocardiographic application. Method: Forty-six patients with RA and 31 healthy persons were included in this study. Duration of disease ranged from 0 to 12 years (mean 4,2 ± 4,3 / years). All patients and the control group were evaluated by M-mode, two-dimensional, conventional Doppler echocardiography and TDI. Results: When compared with controls, the RA group showed that basal clinic and echocardiographic parameters, left atrial diameter, left ventricular diameters, left ventricular ejection fraction, left ventricular wall thicknesses of these two groups were similar. Among conventional Doppler transvalvular mitral flow parameters, early diastolic flow velocity (E) (p = 0,001), late diastolic flow velocity (A) (p = 0,03) and deceleration time (p ? 0,001) values were higher in patients with RA than that in the control group. E/A ratio was found to be lower in patients with RA than that in the control group (p ? 0,001). Mitral annular early diastolic velocity, among TDI parameters, was found to be lower in patients with RA than that in the control group (p = 0,01). Mitral annular late diastolic velocity was also found to be higher in RA patients (p = 0,007). Conclusion: A comparison between age and sex of RA patients and healthy individuals revealed that left ventricular conventional Doppler and TDI parameters of RA patients were impaired
The effect of non-dipper pattern of hypertension on erectile dysfunction
(Taylor & Francis Ltd, 2010) Erden, İsmail; Özhan, Hakan; Ordu, Serkan; Yalçın, Sübhan; Başar, Cengiz; Çağlar, Onur; Kayıkçı, Ali
Background. The purpose of this study was to evaluate the relationship between erectile dysfunction (ED) and non-dipper pattern in hypertensive patients. Methods. A total of 750 consecutive patients with essential hypertension, who had been evaluated with ambulatory BP monitoring, were screened for this study. One hundred and thirty-two male patients (age range 28-54 years) who had fulfilled the inclusion and exclusion criteria were included in the final analysis. Dipper and non-dipper patterns were detected and sexual function was assessed by the self-administered questionnaire of the International Index of Erectile Function (IIEF). Results. There was no significant difference between the two groups regarding the number of medications taken and the proportion of each class of antihypertensive medications. Mean age, body mass index, lipid profiles, rate of smoking were similar between the two groups. IIEF score was significantly higher in non-dippers than dippers (p=0.009). Non-dipping was also found to be an independent determinant for ED. Conclusion. The result of the present study further suggests that non-dipping is a risk indicator for early deterioration of erectile function in hypertensive patients.
Effect of olmesartan medoxomil on cystatin C level, left ventricular hypertrophy and diastolic function
(Taylor & Francis Ltd, 2009) Albayrak, Sinan; Ordu, Serkan; Özhan, Hakan; Yazıcı, Mehmet; Aydın, Mesut; Alemdar, Recai; Kaya, Ahmet
Serum cystatin C concentration is an alternative measure of kidney function that is less affected by age, sex or muscle mass, and is a more sensitive indicator of early renal dysfunction than creatinine-based estimations of glomerular filtration rate. Cardiovascular sequela increases progressively with the increase in left ventricular mass. Our goal was to evaluate the effect of olmesartan medoxomil on cystatin C levels and left ventricular hypertrophy (LVH) in patients with hypertension. Forty-four newly diagnosed hypertensive patients (27 women and 17 men) were recruited in the study. Olmesartan medoxomil (20 mg/day) was started and the patients were followed up for 6 months. Baseline echocardiographic findings (i.e. left ventricular mass index), serum creatinine, urine albumin/creatinine ratio (ACR) and serum cystatin C levels were compared with the levels of these variables measured at the end of 6-month follow-up period. After 6 months of treatment with olmesartan medoxomil, there was a significant reduction in systolic and diastolic blood pressure (p < 0.001) and in urine ACR (p = 0.04). Mean serum cystatin C levels decreased from 1.61 +/- 0.24 mg/l to 1.31 +/- 0.29 mg/l (p < 0.001). Olmesartan medoxomil treatment also reduced left ventricular mass index (p < 0.001) and LVH (p < 0.001). Our findings indicate that olmesartan medoxomil decreases serum cystatin C levels, urine ACR and reduces LVH in patients with hypertension. To our knowledge, this study is the first to show that olmesartan medoxomil decreases serum cystatin C levels, indicating that in patients with essential hypertension it may counteract end organ damage.
Effect of spironolactone therapy in patients with impaired diastolic function
(Elsevier Science Bv, 2007) Özhan, Hakan; Balaban, Yakup; Albayrak, S.; Kaya, A.; Ordu, Serkan; Sözen, Serhat Bahadır; Yazıcı, M.
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Effects of ivabradine therapy on heart failure biomarkers
(Via Medica, 2015) Ordu, Serkan; Yıldız, Bekir Serhat; Alihanoğlu, Yusuf İzzettin; Özsoy, Aybars; Tosun, Mehmet; Evrengül, Harun; Özhan, Hakan
Background: Heart rate (HR) reduction is associated with improved outcomes in patients with heart failure (HF) and biomarkers can be a valuable diagnostic tool in HF management. The primary aim of our study was to evaluate the short-term (6 months) effect of ivabradine on N-terminal pro B-type natriuretic peptide (NT-proBNP), CA-125, and cystatin-C values in systolic HF outpatients, and secondary aim was to determine the relationship between baseline HR and the NT-proBNP, CA-125, cystatin-C, and clinical status variation with ivabradine therapy. Methods: Ninety-eight patients (mean age: 65.81 +/- 10.20 years; 33 men), left ventricular ejection fraction < 35% with Simpson method, New York Heart Association (NYHA) class II-III, sinus rhythm and resting HR > 70/min, optimally treated before the study were included. Among them, two matched groups were formed: the ivabradine group and the control group. Patients received ivabradine with an average (range of 10-15) mg/day during 6 months of follow-up. Blood samples for NT-proBNP, CA-125, and cystatin-C were taken at baseline and at the end of a 6-month follow-up in both groups. Results: There was a significant decrease in NYHA class in the ivabradine group (2.67 +/- +/- 0.47 vs. 1.85 +/- 0.61, p < 0.001). When ivabradine and control groups were compared, a significant difference was also found in NHYA class 6 months later (p = 0.013). A significant decrease was found in HR in the ivabradine and control groups (84.10 +/- 8.76 vs. 68.36 +/- +/- 8.32 bpm, p = 0.001; 84.51 +/- 10 vs. 80.40 +/- 8.3 bpm, p = 0.001). When both groups were compared, a significant difference was also found in HR after 6 months (p = 0.001). A significant decrease was found in cystatin-C (2.10 +/- 0.73 vs. 1.50 +/- 0.44 mg/L, p < 0.001), CA-125 (30.09 +/- 21.08 vs. 13.22 +/- 8.51 U/mL, p < 0.001), and NT-proBNP (1,353.02 +/- 1,453.77 vs. 717.81 +/- 834.76 pg/mL, p < 0.001) in the ivabradine group. When ivabradine and control groups were compared after 6 months, a significant decrease was found in all HF parameters (respectively; cystatin-C: p = 0.001, CA-125: p = 0.001, NT-proBNP: p = 0.001). Creatinine level was significantly decreased and glomerular filtration rate (GFR) was significantly increased in the ivabradine group (1.02 +/- 0.26 vs. 0.86 +/- 0.17, creatinine: p = 0.001; 79.26 +/- +/- 18.58 vs. 92.48 +/- 19.88, GFR: p = 0.001). There was no significant correlation between NYHA classes (before and after ivabradine therapy) and biochemical markers, or HR. Conclusions: In the outpatients with systolic HF, persistent resting HF > 70/min with optimal medical therapy, the NT-proBNP, CA-125, and cystatin-C reductions were obtained with ivabradine treatment. Measurement of NT-proBNP, CA-125, and cystatin-C may prove to be useful in biomarker panels evaluating ivabradine therapy response in HF patients.
Efficacy of Nebivolol on Flow-Mediated Dilation in Patients With Slow Coronary Flow
(Int Heart Journal Assoc, 2009) Albayrak, Sinan; Ordu, Serkan; Yüksel, Hatice; Özhan, Hakan; Yazgan, Ömer; Yazıcı, Mehmet
Slow coronary flow (SCF) is the phenomenon of slow progression of angiographic contrast in the coronary arteries in the absence of stenosis in the epicardial vessels in some patients presenting with chest pain. There are no definite treatment modalities for patients with SCF. Our aim was to investigate the efficacy of nebivolol in patients with slow coronary flow by monitoring its effects on endothelial function and different markets of inflammation. Forty-two patients (16 females, 26 males mean age, 55 10) with slow coronary flow (SCF) were included in the study. After baseline assessment, the patients were administered nebivolol 5 mg once daily. After 12 weeks of nebivolol therapy, the biochemical and ultrasonographic examinations were repeated. Chest pain relief wits detected in 38 patients after treatment (90%). Systolic and diastolic blood pressure and high sensitive CRP were significantly decreased after nebivolol therapy. Among brachial artery dilation variables that reflect endothelial function, basal resistive index (RI), post-flow mediated dilation RI, and post-nitrate mediated dilation RI were significantly decreased after therapy. Nebivolol is effective at improving endothelial function in patients with SCF. It controls chest pain, decreases CRP, and has favorable effects on brachial artery dilation variables in patients with coronary slow flow. (Int Heart J 2009; 50: 545-553)
Efficacy of olmesartan therapy on fibrinolytic capacity in patients with hypertension
(Lippincott Williams & Wilkins, 2011) Bulur, Serkan; Özhan, Hakan; Erden, İsmail; Alemdar, Recai; Aydın, Mesut; Çağlar, Onur; Ordu, Serkan
The efficacy of olmesartan on fibrinolytic capacity has not been studied yet. Therefore, the aim of the present study was to investigate the efficacy of olmesartan on hemostatic/fibrinolytic status by measuring plasma level of plasminogen activator inhibitor-1 (PAI-1) and soluble thrombomodulin levels in patients with hypertension. Forty-two consecutive, newly diagnosed (25 women and 17 men with a mean age of 48 +/- 8 years) patients with untreated essential hypertension were included in the study. Olmesartan medoxomil (20 mg/day) was started and the patients were followed up for 6 months. Baseline biochemical variables, thrombomodulin, and PAI-1 levels were compared with the levels of these variables measured at the end of the 6-month follow-up period. After 6 months of treatment with olmesartan medoxomil, there was a significant reduction in systolic and diastolic blood pressure (from 159.5 +/- 10.9 to 134.6 +/- 12.7 mmHg and from 98.0 +/- 6.3 to 83.9 +/- 7.0 mmHg, respectively). Mean plasma PAI-1 and thrombomodulin levels were also significantly decreased (59.73 +/- 41.91 vs. 48.60 +/- 33.65 ng/ml, P=0.001 and 8.09 +/- 2.29 vs. 6.92 +/- 1.42 mu g/l, P<0.001, respectively). Olmesartan medoxomil decreased plasma PAI-1 and thrombomodulin levels after 6 months of therapy, indicating a favorable effect on fibrinolytic capacity in patients with essential hypertension. Blood Coagul Fibrinolysis 22:29-33 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
Efficacy of Short-Term High-Dose Atorvastatin for Prevention of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography
(Sage Publications Inc, 2010) Özhan, Hakan; Erden, İsmail; Ordu, Serkan; Aydın, Mesut; Çağlar, Onur; Başar, Cengiz; Alemdar, Recai
Contrast-induced nephropathy (CIN) is associated with increased morbidity, extended hospital stay, and higher costs. We compared an atorvastatin plus N-acetylcysteine (NAC) regimen with NAC alone in patients undergoing coronary angiography. A total of 130 patients (mean age 54 +/- 10; 77 men) undergoing coronary angiography were studied. Seven CIN cases occurred in the NAC group and 2 in the atorvastatin + NAC group; this difference was not significant. Baseline mean creatinine and estimated glomerular filtration rate (eGFR) were similar between the 2 groups, whereas after the procedure there was a significant creatinine decrease and eGFR increase in the atorvastatin + NAC group. Change in creatinine (baseline creatinine-creatinine after the procedure) was also significantly higher in patients taking statin plus NAC. Atorvastatin may be effective in protecting patients undergoing coronary angiography from CIN.

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