Researcher: Çelik, Yeliz
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Çelik, Yeliz
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Publication Metadata only CPAP may promote an endothelial inflammatory milieu in sleep apnoea after coronary revascularization(Elsevier B.V., 2024) Behboudi, Afrouz; Redline, Susan; Lyu, Jing; Wei, Ying; Gottlieb, Daniel J.; Jelic, Sanja; Peker, Yüksel; Çelik, Yeliz; School of MedicineBackground: Continuous positive airway pressure (CPAP) has failed to reduce cardiovascular risk in obstructive sleep apnoea (OSA) in randomized trials. CPAP increases angiopoietin-2, a lung distension-responsive endothelial proinflammatory marker associated with increased cardiovascular risk. We investigated whether CPAP has unanticipated proinflammatory effects in patients with OSA and cardiovascular disease. Methods: Patients with OSA (apnoea-hypopnea index [AHI] ≥15 events/h without excessive sleepiness) in the Randomized Intervention with CPAP in Coronary Artery Disease and OSA study were randomized to CPAP or usual care following coronary revascularization. Changes in plasma levels of biomarkers of endothelial (angiopoietin-2, Tie-2, E-selectin, vascular endothelial growth factor [VEGF-A]) and lung epithelial (soluble receptor of advanced glycation end-products [sRAGE]) function from baseline to 12-month follow-up were compared across groups and associations with cardiovascular morbidity and mortality assessed. Findings: Patients with OSA (n = 189; 84% men; age 66 ± 8 years, BMI 28 ± 3.5 kg/m2, AHI 41 ± 23 events/h) and 91 patients without OSA participated. Angiopoietin-2 remained elevated whereas VEGF-A declined significantly over 12 months in the CPAP group (n = 91). In contrast, angiopoietin-2 significantly declined whereas VEGF-A remained elevated in the usual care (n = 98) and OSA-free groups. The changes in angiopoietin-2 and VEGF-A were significantly different between CPAP and usual care, whereas Tie-2, sRAGE and E-selectin were similar. Greater 12-month levels of angiopoietin-2 were associated with greater mortality. Greater CPAP levels were associated with worse cardiovascular outcomes. Interpretation: Greater CPAP levels increase proinflammatory, lung distension-responsive angiopoietin-2 and reduce cardioprotective angiogenic factor VEGF-A compared to usual care, which may counteract the expected cardiovascular benefits of treating OSA. Funding: National Institutes of Health/ National Heart, Lung, and Blood Institute; Swedish Research Council; Swedish Heart-Lung Foundation; ResMed Foundation.Publication Metadata only Association of visual-based signals with electroencephalography patterns in enhancing the drowsiness detection in drivers with obstructive sleep apnea(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Peker, Nur Yasin; Hakkoz, Mustafa Abdullah; Erdem, Ciğdem Eroğlu; Department of Electrical and Electronics Engineering; Department of Electrical and Electronics Engineering; Minhas, Riaz; Arbatlı, Semih; Çelik, Yeliz; Gürsoy, Beren Semiz; Peker, Yüksel; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); Graduate School of Sciences and Engineering; Graduate School of Health Sciences; School of Medicine; College of EngineeringIndividuals with obstructive sleep apnea (OSA) face increased accident risks due to excessive daytime sleepiness. PERCLOS, a recognized drowsiness detection method, encounters challenges from image quality, eyewear interference, and lighting variations, impacting its performance, and requiring validation through physiological signals. We propose visual-based scoring using adaptive thresholding for eye aspect ratio with OpenCV for face detection and Dlib for eye detection from video recordings. This technique identified 453 drowsiness (PERCLOS ≥ 0.3Publication Metadata only The power of mechanical ventilation may predict mortality in critically ill patients(Edizioni Minerva Medica, 2023) Cukurova, Zafer; Asar, Sinan; Şentürk, Evren; Uğur, Semra; Çelik, Yeliz; Çakar, Nahit; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Koc University Hospital;Animal LaboratoryBackground: Mechanical power (MP) is the amount of energy transferred from the ventilator to the patient within a unit of time. It has been emphasized in ventilation-induced lung injury (VILI) and mortality. However, its measure-ment and use in clinical practice are challenging. "Electronic recording systems (ERS)" using mechanical ventilation parameters provided by the ventilator can be helpful to measure and record the MP. The MP (J/minutes) formula is 0.098 x tidal volume x respiratory rate x (Ppeak - '/z increment P), in which increment P is the driving pressure and Ppeak is the peak pressure. We aimed to define the association between MP values and ICU mortality, mechanical ventilation days, and intensive care unit length of stay (ICU-LOS). The secondary outcome was to determine the most potent or essential component of power in the equation that has a role in mortality. Methods: This retrospective study was performed in two centers (VKV American Hospital and Bakirkoy Sadi Konuk Hospital ICUs) that used ERS (Metavision IMDsoft) between 2014 and 2018. We uploaded the power formula (MP (J/ minutes)=0.098xVTxRRx(Ppeak - '/z increment P) to ERS (METAvision, iMDsoft, and Consult Orion Health) and calculated the MP value by using MV parameters automatically sent from the ventilator. ( increment P; driving pressure, VT; tidal volume, RR; respiratory rate and Ppeak; peak pressure). Results: A total of 3042 patients were included in the study. The median value of MP was 11.3 J/min. Mortality in MP<11.3 J/min was 35.4%, and 49.1% in MP>11.3J/min.; P<0.001. Mechanical ventilation days and ICU-LOS were also statistically longer in the MVP>11.3 J/min group. Conclusions: The first 24 h MP maybe a predictive value for the ICU patients' prognosis. This implies that MP may be used as a decision-making system to define the clinical approach and as a scoring system to predict patient prognosis.Publication Metadata only Association of TNF-α (-308 G/A) gene polymorphism with the changes in circulating TNF-a levels over 12 months in response to CPAP treatment in the RICCADSA cohort(American Thoracic Society, 2023) Yucel-Lindberg, T.; Behboudi, A.; Peker, Yüksel; Çelik, Yeliz; School of Medicine; Graduate School of Health SciencesPublication Metadata only Impact of continuous positive airway pressure on serum angiopoietin-2 following coronary revascularization in patients with obstructive sleep apnea: the RICCADSA study(American Thoracic Society, 2023) Behboudi, A.; Redline, S. S.; Jelic, S.; Gottlieb, D. J.; Peker, Yüksel; Çelik, Yeliz; School of Medicine; Graduate School of Health SciencesCritical care medicine;Respiratory systemPublication Metadata only Determinants of age-adjusted higher nt-pro-bnp values in adults with coronary artery disease and obstructive sleep apnea in the RICCADSA cohort(Elsevier, 2019) Glantz, H.; Thunstrom, E.; N/A; Peker, Yüksel; Aslan, Gamze; Çelik, Yeliz; Ural, Dilek; Faculty Member; Doctor; Researcher; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; N/A; N/A; School of Medicine; N/A; N/A; Koç University Hospital; N/A; 234103; N/A; N/A; 1057N/APublication Metadata only Effect of CPAP treatment on adhesion molecules in coronary artery disease with nonsleepy obstructive sleep apnoea: The RICCADSA randomized controlled trial(2020) Zou, Ding; Lindberg, Tülay; Thunstrom, Erik; N/A; N/A; Çelik, Yeliz; Peker, Yüksel; Researcher; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); N/A; School of Medicine; N/A; 234103Background: Enhanced levels of vascular adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) have been associated with obstructive sleep apnoea (OSA). Impact of continuous positive airway pressure (CPAP) treatment on VCAM-1 and ICAM-1 levels in coronary artery disease (CAD) patients with OSA is unclear. Aims and Objectives: We aimed to evaluate whether CPAP therapy would reduce VCAM-1 and ICAM-1 after one year in a revascularized CAD cohort. Methods: This was one of the secondary outcomes of the RICCADSA trial, conducted in Sweden between 2005 and 2013. In all, 210 adults with nonsleepy OSA (apnea-hypopnea index ≥15/h, and Epworth Sleepiness Scale <10) were included. Participants were randomized to CPAP (n=104), or no-CPAP (n=106). Circulating levels of the adhesion molecules were assessed at baseline and after one year. Results: Median VCAM-1 decreased from 1055 to 979 ng/ml (p=0.02) in CPAP group, and from 1062 to 1034 ng/ml (p=0.95) in no-CPAP group. Similarly, median ICAM-1 reduced from 152 to 115 ng/ml (p<0.001) in CPAP group, and from 146 to 127 ng/ml (p=0.001) in no-CPAP group. Change from baseline in median values did not differ significantly between the groups. In a multivariate linear backward regression model, CPAP use (hrs/night) was associated with the decline in VCAM-1 (β=0.16 [95% CI 5.10-88.14], p=0.028), and tended to be significant with the decrease in the ICAM-1 (p=0.08). Conclusions: There was a natural decrease in the VCAM-1 and ICAM-1 values after one year in this CAD cohort with OSA. The magnitude of the decline was associated with increasing CPAP usage.Publication Metadata only Association of TNF-ALPHA (-308g/a) gene polymorphism with circulating TNF-ALPHA levels and excessive daytime sleepiness in adults with coronary artery disease and concomitant obstructive sleep apnea(Amer Thoracic Soc, 2021) Thelander, T.; Yucel-Lindberg, T.; Thunstrom, E.; Behboudi, A.; N/A; N/A; N/A; Peker, Yüksel; Yazıcı, Duygu; Çelik, Yeliz; Faculty Member; PhD Student; Researcher; N/A; N/A; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Graduate School of Health Sciences; N/A; 234103; N/A; N/APublication Metadata only CPAP treatment increases anxiety in coronary artery disease patients with nonsleepy obstructive sleep apnoea: the RICCADSA randomized controlled trial(2020) Thunstrom, Erik; Strollo, Patrick J.; Peker, Yüksel; N/A; Çelik, Yeliz; Researcher; N/A; N/ABackground: Revascularization is related with increased anxiety in coronary artery disease (CAD). Impact of obstructive sleep apnoea (OSA) as well as treatment with continuous positive airway pressure (CPAP) on anxiety in cardiac cohorts is unknown. Aims and Objective: We explored the state of anxiety after CPAP therapy in CAD patients with nonsleepy OSA. Methods: This was one of the secondary outcomes of the RICCADSA randomized controlled trial, conducted in Sweden between 2005 and 2013. In all, 237 adults with nonsleepy OSA (apnea-hypopnea index ≥15/h, and Epworth Sleepiness Scale <10) who filled the Zung Self-rating Anxiety Scale (SAS) were included. Participants were assigned to CPAP (n=119), or no-CPAP (n=118). Between-group difference in absolute change on the SAS scores after 3- and 12 months of CPAP therapy was examined. Results: Intention-to-treat analysis showed no significant difference between the CPAP and no-CPAP groups. Notwithstanding, there was an increase in the median score (+3.75 points) after 3 months in the group using the device at least 3 hrs/night, while there was a decline (-1.25 points) in the non-adherent/no-CPAP group (p=0.01). The increase in the SAS score (+1.25 points) in the adherent group and the decline (-1.25 points) in the non-adherent/no-CPAP group remained significant after one year (p=0.04). In a multivariate linear regression model, there was an association between the increase in the SAS scores and CPAP hrs/night (β coefficient =0.14 [95% CI 0.00-0.69], p=0.05). Conclusions: CPAP treatment increases anxiety in revascularized CAD patients with nonsleepy OSA.Publication Metadata only Cardiovascular outcomes in adults with coronary artery disease and obstructive sleep apnea with versus without excessive daytime sleepiness in the RICCADSA clinical trial(American Thoracic Society (ATS), 2023) Eulenburg Christine; Redline, Susan; Thunström, Erik; Glantz, Helena; J Strollo Jr, Patrick; N/A; N/A; Çelik, Yeliz; Peker, Yüksel; Researcher; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); N/A; School of Medicine; N/A; 234103Rationale: recent randomized controlled trials did not show cardiovascular benefits of continuous positive airway pressure (CPAP) in adults with coronary artery disease (CAD) and obstructive sleep apnea (OSA) in intention-to-treat analyses. It has been argued that exclusion of patients with OSA with excessive daytime sleepiness (EDS), who may be most likely to benefit from CPAP treatment, may be a reason for the null results. Objectives: we addressed 1) the effect of concomitant EDS on adverse outcomes in patients with CAD and OSA; and 2) whether the cardiovascular benefit of CPAP adherence differs between individuals with versus without EDS. Methods: this was a secondary analysis of the RICCADSA (Randomized Intervention with CPAP in CAD and Obstructive Sleep Apnea) trial, conducted in Sweden between 2005 and 2013. Data were analyzed from 155 patients with CAD with OSA (apnea-hypopnea index ⩾ 15/h) and EDS (Epworth Sleepiness Scale score ⩾ 10), who were allocated to CPAP and 244 patients without EDS (ESS < 10), who were randomized to CPAP or no CPAP. Patients who were allocated to no CPAP or were nonadherent (CPAP usage < 4 h/night) were compared with adherent patients (CPAP usage ⩾ 4 h/night) at 1-year follow-up. Inverse probability of treatment weighting was applied to mimic randomization of EDS. The primary endpoint was the first event of repeat revascularization, myocardial infarction, stroke, or cardiovascular mortality. Results: the median follow-up was 52.2 months. The incidence of the primary endpoint did not differ significantly between the EDS versus no-EDS groups in the entire cohort. Within the adherent group, patients without EDS had a significantly decreased risk compared with patients with EDS (adjusted hazard ratio, 0.41; 95% confidence interval, 0.20-0.85; P = 0.02). Conclusions: adverse cardiovascular outcomes did not differ by degrees of EDS for patients with CAD with OSA who were untreated or nonadherent to treatment. CPAP use, at least 4 h/night, was associated with reduced adverse outcomes in participants without EDS.
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