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    Dynamic Changes in Perioperative Cellular Inflammation and Acute Kidney Injury after Coronary Artery Bypass Grafting
    (Soc Brasil Cirurgia Cardiovasc, 2021) Parlar, Hakan; Arikan, Ali Ahmet; Onmez, Attila
    Introduction: This study investigated the role of the neutrophillymphocyte ratio (NLR), the perioperative changes in NLR (deltaNLR), the platelet-lymphocyte ratio (PLR), and the platelet count in predicting acute kidney injury (AKI) following coronary artery bypass grafting (CABG) during hospital stay. Methods: The records of 396 patients with preoperative creatinine < 1.5 mg/dl undergoing isolated CABG between October 2015 and October 2019 were reviewed retrospectively. Diagnosis of AKI was based on the Kidney Disease Improving Global Outcomes definition. Demographic data, operative data, inhospital mortality, preoperative NLR, PLR, and platelet counts were compared between patients with (AKI group) and without (nonAKI group) postoperative AKI. Additionally, NLR, delta-NLR, and PLR values were calculated daily for the first four postoperative days. A subsequent AKI group was formed for the first four postoperative days by excluding patients diagnosed with AKI. The daily and overall predictivity of the markers for AKI are investigated. Results: AKI was present in 86 patients during the postoperative period, while 310 patients had normal postoperative renal functions. NLR, delta-NLR, and PLR on the first four postoperative days (P<0.001 for all) were significantly associated with the development of AKI in subsequent days. Multivariate analysis identified postoperative NLR (odds ratio 1.17, 95% confidence interval 1.11-1.23; P<0.001) as an independent predictor of AKI. PLR lost its significant association with AKI at the values measured at discharge from hospital (P>0.05). Conclusion: NLR values measured on the first four days postoperatively are a useful tool in predicting AKI during hospital stay following CABG.
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    Short Term Outcomes of Endarterectomy to Asymptomatic Extracranial Carotid Artery Disease
    (2020) Kalender, Mehmet; Uğur, Oğuz; Gökmengil, Hayat; Baysal, Ahmet Nihat; Düzyol, İpek Yakın; Parlar, Hakan; Karaca, Okay Güven
    Aim: Recently published papers regarding the treatment of carotid artery stenosis are incontradiction with previous trials. Some experts have argued that this evidence supports aconservative approach to carotid revascularization (carotid endarterectomy or carotid stenting)in asymptomatic patients. The objective of this study is to evaluate outcomes of carotidendarterectomy based on preoperative symptom status.Material and Methods: This retrospective study included patients underwent carotidendarterectomy to internal carotid artery between August 2008 and August 2015. Patients weredivided into two groups according to preoperative symptoms. Asymptomatic group consistedof 41 patients with no preoperative neurological symptoms, and symptomatic group of 62patients with preoperative neurological symptoms (vertigo, amaurosis fugax, transientischemic attack and ischemic stroke). Postoperatively, all patients received standard therapy inline with the recommendation of the guidelines.Results: One hundred and three patients were enrolled in this study. The mean age of patientswas 68.20±9.79 (range, 41-86) years, and 27 (26.2%) of them were female. There were nostatistically significant difference in terms of demographic characteristics between the groupsexcept risk groups; asymptomatic group had more high risk grouped patients (p=0.001).Asymptomatic group was associated with statistically significantly more postoperativemortality compared with symptomatic group (p=0.028). None of the preoperative variableswere related to postoperative stroke. In symptomatic group, postoperative stroke was seen inthe patients who had preoperative transient ischemic attack and major stroke.Conclusion: Time of surgical treatment in asymptomatic carotid artery disease should beplanned according to patients’ cardiac risk factors.