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Baydar, Onur

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Onur

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Baydar

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2019 - 201922020 - 202315

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    Relationship between fasting glucose, HbA1c levels, and the SYNTAX Score 2 in patients with non-ST-elevation myocardial infarction
    (Sage, 2022) N/A; N/A; Kılıç, Alparslan; Baydar, Onur; Doctor; Doctor; N/A; N/A; Koç University Hospital; Koç University Hospital
    We evaluated if admission glycosylated hemoglobin (HbA(1c)) and fasting glucose levels are correlated with the severity of coronary artery disease (CAD) in non-ST-elevation myocardial infarction (NSTEMI), nondiabetic, patients. Coronary artery disease severity, according to the anatomical synergy between percutaneous coronary intervention (PCI) with taxus and cardiac surgery (SYNTAX) score 2 (SSII), was retrospectively evaluated in 359 nondiabetic patients hospitalized with NSTEMI who underwent coronary angiography. Glucose intolerance was assessed by serum fasting glucose and HbA(1c) levels. We stratified patients according to tertiles of SSII (<= 21.5, 21.5-30.6, and >= 30.6). These score ranges were defined as SSII low, SSII mid, and SSII high, respectively. The average age of the patients was 57.1 +/- 10.9 years; 189 (52.1%) patients were males. The average fasting glucose was 114 +/- 52 mg/dL, HbA(1c) was 5.8% +/- 0.9%, and SSII was 18.9 +/- 10.3. A stronger correlation was found between HbA(1c) and SSII than fasting glucose and SSII (r1 = 0.901, P < .001, r2 = 0.378, P < .001, respectively), and HbA(1c) level and hypertension were independent risk factors for SSII high (odds ratio [OR]: 2.2 (95% CI: 0.5-9.0, P < .001; OR: 1.1 (1.0-1.3), P = .007, respectively). In conclusion, in nondiabetic patients with NSTEMI, HbA(1c) levels correlated with CAD severity as measured by the SSII.
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    Relationship between the triglyceride-glucose index and the SYNTAX score 2 in patients with non-ST elevation myocardial infarction
    (Lippincott Williams and Wilkins (LWW), 2023) N/A; Baydar, Onur; Kılıç, Alparslan; Gürsoy, Erol; Doctor; Doctor; Doctor; N/A; N/A; N/A; Koç University Hospital; N/A; N/A; N/A
    Objective: We evaluated if admissiontriglyceride-glucose index (TyG index) correlated with the anatomical synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score 2 in non-ST elevation myocardial infarction (NSTEMI), nondiabetic patients. Methods: SYNTAX score 2 (SSII) was retrospectively evaluated in 260 nondiabetic patients hospitalized with NSTEMI who underwent coronary angiography. The TyG index was calculated using the following equation: log [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. We stratified patients according to tertiles of SSII (≤21.5, 21.5-30.6, and ≥30.6). These score ranges were defined as SSII low, SSII mid, and SSII high, respectively. Results: the average age of the patients was 57.2 ± 10.9 years; 135 patients (52.2%) were males. The average TyG index was 8.68 ± 0.12, and SSII was 18.9 ± 9.9. A moderate correlation was found between TyG index and SSII (r = 0.347; P < 0.001) and TyG index was independent risk factors for SSII high [odds ratio (OR), 6.0; 95% CI, 2.7-17.0; P < 0.001]. Conclusion: in nondiabetic patients with NSTEMI, TyG index correlated with the SSII.
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    The triglyceride-glucose index, a predictor of insulin resistance, is associated with subclinical atherosclerosis
    (Sage, 2021) Okçuoğlu, John; Apaydın, Ziya; Can, Mehmet Mustafa; N/A; Baydar, Onur; Kılıç, Alparslan; Other; Other; N/A; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A
    Insulin resistance is one of the most important risk factors that accelerate atherosclerosis. The goal of this study is to investigate the relationship between the triglyceride glucose (TyG) index and functional vessel disease measured using pulse wave velocity (PWV), in a nondiabetic asymptomatic Turkish population. Nondiabetic, healthy patients (n = 1095) with no previous history of coronary heart disease were enrolled. Functional vessel disease was detected by measuring PWV. The TyG index was calculated using the following equation: log [fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2]. The study population was divided into 2 groups based on their TyG index. The high TyG index group had higher PWV, corrected PWV, left ventricular mass index, body mass index, rates of hypertension, and was predominately male. Age, gender, blood urea nitrogen level, and TyG index were detected as independent risk factors of PWV in linear regression analysis. Triglyceride glucose index and age were also independent risk factors of the corrected PWV in logistic regression analysis. These findings show a relationship between TyG index and subclinical vessel disease, even in patients without a history of atherosclerotic cardiovascular disease or diabetes.
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    Monocyte to high-density lipoprotein ratio and high sensitive c-reactive protein levels in patients with isolated coronary artery ectasia
    (DNT Ortadoğu Yayıncılık, 2020) N/A; N/A; Kılıç, Alparslan; Baydar, Onur; Doctor; Doctor; N/A; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A
    Aim: Isolated coronary artery ectasia (ICAE) is a rare form of coronary artery disease and has almost same mortality and morbidity rate to atherosclerotic coronary artery disease. Monocyte to HDL-cholesterol ratio (MHR) has been entered the literature as a new inflammatory indicator in various cardiovascular disease. In this study we want to investigate relationship between inflammatory and oxidative markers that high sensitive C reactive protein (Hs-Crp), MHR and ICAE. Material and Methods: We retrospectively observed patients who underwent elective coronary angiography. Patients with ICAE and normal coronary arteries included in the study. MHR and Hs-Crp levels were observed just before the coronary angiography procedure. Results: A total of 98 patients (61, 62 % men) patients were included in this study and 28 (28.6%) of them had DM. 68 (69.3%) of patients had ICAE. MHR was significantly higher in patients with ICAE (0.0153 (0.007-0.130)ve 0.0111 (0.005- 0.020), p< 0.001). Hs-Crp was also significantly higher in patients with ICAE (Yd-Crp: 6 (0.2-33)ve 1(0.2-14), p < 0.001). MHR was also significantly correlated with Hs-crp levels (r:0,338, p: 0.001). Additionally; DM, smoking, HT, MHR and Hs-crp were detected as independent risk factors of ICAE in logistic regression analysis. In receiver operating characteristic curve analysis, the area under the curve for predicting CAE was 0.744 (p<0.01, 95% confidence interval [CI] 0.64 to 0.84) and cut- off value was 0.013 (sensitivity 69.1%, specificity 63.3%, ) for the number of MHR. Conclusion: MHO and Hs-Crp are markers of inflammation that can be easily and inexpensively examined and found high in patients with ICAE. These markers may be useful explaining the pathogenesis of ICAE and guiding treatment. / Amaç: Izole koroner arter ektazisi (İKAE), koroner arter hastalığının az görülen bir formu olup, aterosklerotik koroner arter hastalığna benzer mortalite ve morbidite oranına sahiptir. Monosit yüksek dansiteli lipoprotein (HDL) oranı ( MHO) klinikte yeni tanımlanan inflamasyon belirteçlerinden biridir. Çalışamızda MHO ve klinikte inflamasyon belirteci olarak sıkça kullanılan yüksek duyarlıklı C-reaktif protein (Yd-Crp) ile İKAE arasıdaki ilişki araştırılmıştır. Gereç ve Yöntemler: Çalışmamızda retrospektif olarak elektif koroner yapılan hastalar incelenmiştir. Hastaneye başvuruşunda koroner anjiografi hemen öncesinde alınan örneklerden Yd-Crp ve MHO oranı hesaplanmıştır. Bulgular: Toplam 98 (61, %62 erkek ) hasta geriye dönük incelenmiş, 28 (%28.6) hastada Diabetes Mellitus saptamıştır. İKAE hasta sayısı 68 (%69.8) olarak bulunmuştur. MHO ve Yd-Crp ; İKAE grubunda normal koroner arterlere sahip gruba göre anlamlı olarak yüksek saptandı (Sırasıyla; MHO: 0.0153 (0.007-0.130)ve 0.0111 (0.005-0.020), p< 0.001, Yd-Crp: 6 (0.2- 33)ve 1(0.2-14), p < 0.001). Ek olarak MHO ile Yd- Crp değeri arasında pozitif korelasyon saptandı (r:0,338, p: 0.001). Ayrıca; hipertansiyon , Diabetes Mellitus, sigara kullanımı, Yd-Crp ve MHO değerleri İKAE’ nin bağımsız risk faktörleri olarak bulundu. ROC analizinde MHO için eğri altında kalan alan 0.744 (p<0.01, 95% [CI] 0.64 - 0.84) ve cut- off değeri 0.013 (%69.1 sensivite , % 63.3 spesifite ) saptandı. Sonuç: Sonuç olarak MHO ve Hs-Crp basit ve ucuz şekilde bakılabilen inflamasyon belirteçleri olup, İKAE hastalarında yüksek saptanmıştır. Bu beliteçler, İKAE hastalığının patogenezinin aydınlatılmasında ve tedavinin yönlendirilmesinde faydalı olabilir.
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    Evaluation of pulmonary arterial stiffness and comparison with right ventricular functions in patients with cirrhosis preparing for liver transplantation
    (Wiley, 2022) Elçioğlu, Betül Cengiz; Baydar, Onur; Helvacı, Füsun; Karataş, Cihan; Aslan, Gamze; Kılıç, Alparslan; Tefik, Nihal; Demir, Barış; Gürsoy, Erol; Demirci, Yasemin; Ural, Dilek; Kanmaz, Turan; Aytekin, Vedat; Aytekin, Saide; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; Doctor; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; NA; N/A; N/A; 1057; 275799; 140946; N/A
    Objective Pulmonary complications are common in patients with liver cirrhosis. Devolopment of pulmonary hypertension (PH) is associated with a poor prognosis in these patients. Pulmonary arterial stiffness (PAS) is considered an early sign of pulmonary vascular remodeling. The aim of this study is to investigate PAS and compare it with right ventricular (RV) functions in patients with cirrhosis who are scheduled for liver transplantation. Methods The study included 52 cirrhosis patients (mean age 51.01 +/- 12.18 years, male gender 76.9%) who were prepared for liver transplantation and 59 age and sex matched (mean age 51.28 +/- 13.63 years, male gender 62.7%) healthy individuals. Patients with left ventricular ejection fraction (LVEF) less than 55%, ischemic heart disease, more than mild valvular heart disease, chronic pulmonary disease, congenital heart disease, rheumatic disease, moderate to high echocardiographic PH probability, rhythm or conduction disorders on electrocardiography were excluded from the study. In addition to conventional echocardiographic parameters, PAS value, pulmonary vascular resistance (PVR) and RV ejection efficiency was calculated by the related formulas with transthoracic echocardiography (TTE). Results Demographic characteristics and cardiovascular risk factors of the groups were similar. PAS, PVR, and sPAP values were found to be significantly higher in the patient group (20.52 +/- 6.52 and 13.73 +/- 2.05; 1.43 +/- 0.15 and 1.27 +/- 0.14; 27.69 +/- 3.91 and 23.37 +/- 3.81 p < 0.001, respectively). RV FAC and RV Ee were significantly lower and RV MPI was significantly higher in the patient group (45.31 +/- 3.85 and 49.66 +/- 3.62, p < 0.001; 1.69 +/- 0.35 and 1.85 +/- 0.23, p = 0.005; 0.39 +/- 0.07 and 0.33 +/- 0.09, p = 0.001, respectively). PAS was significantly correlated with RV FAC and MPI (r = -0.423, p < 0.001; r = 0.301, p = 0.001, respectively). Conclusions Increased PAS in cirrhosis patients may be associated with early pulmonary vascular involvement. Evaluation of RV functions is important to determine the prognosis in these patients. FAC, MPI, and RV Ee measurements instead of TAPSE or RV S ' may be more useful in demonstrating subclinical dysfunction. The correlation of PAS with RV FAC and MPI may indicate that RV subclinical dysfunction is associated with early pulmonary vascular remodeling in patients with liver cirrhosis.
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    CHA2DS2-VASC score predicts risk of contrasttrast-induced nephropathy in non-st elevation myocardial infarction patients undergoing percutaneous coronary interventions
    (Karger, 2019) N/A; N/A; Baydar, Onur; Kılıç, Alparslan; Doctor; Doctor; N/A; N/A; Koç University Hospital; N/A; N/A
    Backround: The CHA2DS2-VASC score, used for embolic risk stratification in atrial fibrillation, has been reported recently to predict adverse clinical outcomes in patients with coronary artery disease. We investigated the correlation between the CHA2DS2-VASC score and contrast-induced nephropathy (CIN) in patients with non-ST elevation myocardial infarction (NSTEMI) who underwent percutaneous coronary intervention (PCI). Methods: We retrospectively enrolled 363 (191; 52.6% men) NSTEMI patients undergoing PCI. The CHA2 DS2-VASC score was calculated for each patient, and the study population was divided into 2 groups: CHA2DS2-VASC score <2 group (low score; n = 259, 71.3%) and CHA2DS2-VASC score >= 2 group (high score; n = 104, 28.6%). Patients were then reallocated to 2 groups according to the presence or absence of CIN. CIN was defined as a rise in serum creatinine >0.5 mg/dL or >25% increase in baseline within 72 h after PCI. Results: Overall, 56 cases (15.4%) of CIN were diagnosed. When patients with a CHA2DS2-VASC score of <2 were compared with those with a CHA2DS2-VASC score of >= 2, patients with a high score had a higher frequency of CIN (33) 31.7% versus (23) 8.9%; p < 0.001. Also patients with CIN had higher CHADS2 VASC score (3.94 +/- 1.13 vs. 1.68 +/- 0.46, p < 0.001). Additionally, in-hospital mortality, length of hospital stay, major bleeding, requirement of mechanical ventilation, and dialysis were observed significantly higher in patients with CHA2DS2-VASC score of >= 2 (p = 0.001, p = 0.002, p = 0.006, p = 0.001, p = 0.001, respectively). In receiver operating characteristic curve analysis, the area under the curve for predicting CIN was 0.702 (p < 0.001, 95% CI 0.617-0.787) and cutoff value was 2.5 (sensitivity 58.9%, specificity 76.9%) for the number of CHA2DS2-VASC score. Conclusion: In NSTEMI patients undergoing PCI, CHADS2 VASC score is associated with an increased risk for CIN and in-hospital morbidity and mortality. (C) 2019 S. Karger AG, Basel
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    The relationship between diurnal blood pressure abnormalities and target organ damage in normotensive subjects. Which is more important? Increased blood pressure levels or circadian blood pressure abnormalities
    (Taylor and Francis inc, 2020) N/A; N/A; N/A; Kılıç, Alparslan; Baydar, Onur; Doctor; Doctor; N/A; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A
    Objective: Circadian blood pressure (CBP) abnormalities are well-known risk factors for many diseases such as cardiovascular, cerebrovascular, and chronic kidney disease. the object of this study was to evaluate the relationship between abnormalities in CBP rhythm and target organ damage (TOD) in normotensive non-dipper (non-DP) subjects. Methods: the 24-h ambulatory BP monitoring (aBPM) and echocardiography were performed and urinary albumin excretion (UaE) was measured in 127 normotensive dipper (DP) (42 males, 85 females) and 337 (89 males, 248 females) normotensive non-DP subjects. Results: When we compared DP and non-DP subjects; Pulse wave velocity (PWV) (7.12 +/- 1.72 vs 7.57 +/- 1.87 m/s, p = 0.02), the percentile of corrected PWV (cPWV) (7.1 vs. 20.2, p= 0.001) and the percentile of corrected augmentation index (caIx) (23.5 vs. 33.9, p = 0.03), left ventricle mass index (LVMI) (78.00 +/- 23.27 vs. 95.59 +/- 18.29 g/m(2), p = 0.01), relative wall thickness (RWT)(0.36 +/- 0.13 vs 0.46 +/- 0.09, p = 0.01), percentile of proteinuria (8.6 vs 29.2%, p = 0.00) were higher in non-DP group. in the correlation analyses, the PWV, LVMI, RWT were negatively correlated with the rate of systolic fall in nighttime (%)(-0.15, p = 0.01 vs. -0.23, p = 0.02 vs. -0.27, p = 0.00). It was observed that cPWV, caIx, and UaE were independently associated with age and non-DP status (NDS), in logistic regression analysis. Conclusions: Our results suggested that normotensive persons with CBP abnormalities had TOD. in light of the data of this article, non-dipper status is detected in the early period and if the provision of diurnal blood pressure rhythm may reduce the incidence of future adverse events in nondipper normotensive subjects.
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    The triglyceride-glucose index and contrast-induced nephropathy in non-ST elevation myocardial infarction patients undergoing percutaneous coronary intervention
    (Lippincott Williams and Wilkins (LWW), 2023) N/A; N/A; Gürsoy, Erol; Baydar, Onur; Doctor; Doctor; N/A; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A
    The triglyceride glucose (TyG) index is an indicator of insulin resistance and associated with increased risk of diabetes mellitus and cardiovascular events. Our study investigates the correlation between TyG index and contrast induced nephropathy (CIN) in non-diabetic patients with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). 350 non-diabetic NSTEMI patients (183, 52.3% male) undergoing PCI were retrospectively enrolled. The enrolled cohort was divided into 2 groups based on the calculated TyG index, namely values < 8.65 or higher. CIN was defined as an increase in serum creatinine > 25% or 0.5 mg/dL from baseline in the first 48 to 72 hours after PCI. A total of 56 (16%) cases of CIN were diagnosed. In contrast to patients with lower TyG indexes, patients with higher TyG indexes (>= 8.65) had a higher frequency of CIN, 9.5%. versus 20.8% respectively (P .004). Patients with CIN also had higher TyG indexes (8.74 +/- 0.12 vs 8.67 +/- 0.11, P < .001). In addition, TyG index, age, and glomerular filtration rate were identified as independent risk factors for CIN in logistic regression model (OR: 2.5 CI: 1.3-4.6, P .006, OR: 1.0 CI: 1.0-1.1, P < .001, OR: 1.0 KI: 1.03-1.06, P .025). In the ROC analysis, the area under the curve predictive of CIN was 0.666 (P < .001, 95% [CI] 0.58-0.75) with a cutoff value of 8.69 (sensitivity 71,4%, specificity 55.1%) TyG index. Higher TyG indexes are associated with an increased risk of CIN in non-diabetic patients with NSTEMI.
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    Relationship between monocyte to high-density lipoprotein ratioand contrast-induced nephropathy in patients with non-st elevationmyocardial infarction
    (DNT Ortadoğu Yayıncılık, 2020) N/A; N/A; Kılıç, Alparslan; Baydar, Onur; Doctor; Doctor; N/A; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A
    Aim: Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI). Early identification patients with a high risk of CIN are very crucial to improve outcomes. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. We aimed to investigate the MHR had a predictive role for CIN development in patients with NSTEMI. Material and Methods: NSTEMI who underwent percutaneous coronary intervention (PCI) were included in the study. MHR was calculated and CIN was defined as an increase in serum creatinine 25% or 0.5 mg/dl from baseline in the first 48- 72 hours. Results: A total of 370(200, 54.1% men) patients were included in this study and 104 (28.1%) of them had DM. 25 (6.7%) of patients had CIN.MHR was significantly higher in patients with CIN (0.014± 0.004 vs 0.011± 0.006-respectively, p: 0.017). MHR was also significantly correlated with creatinine levels after PCI (r:0,104, p: 0.047). CIN group also experienced a more complicated in-hospital clinical course. Additionally; weight and MHR were detected as independent risk factors of CIN in logistic regression analysis. Conclusion: Preprocedural MHR may be used as cheap, easy and simple marker of CIN. It may help with the early identification of patients with NSTEMIwho are at high risk of CIN. / Amaç: Kontrast madde kullanımına bağlı nefropati (KBN) gelişimi perkutan koroner girişim (PKG) yapılan ST elevasyonu olmayan miyokard enfarktüsü (NON-STEMI) geçiren hastalarda sık görülmekte olup artmış mortalite ve morbidite ile ilişklidir. KBN açısından yüksek riskli hastaların önceden tespiti ve tedavisi, klinik sonuçların iyileşmesinde etkili olacaktır. Monosit yüksek dansiteli lipoprotein (HDL) oranı ( MHO) klinikte yeni tanımlanan inflamasyon belirteçlerinden biridir. Çalışamızda işlem öncesi MHO’ nın PKG yapılmış NON-STMI hastalarında KBN gelişimi arasıdaki ilişki araştırılmıştır. Gereç ve Yöntemler: Çalışmamızda retrospektif olarak NON-STEMI tanısıyla PKG yapılanhastalar incelenmiştir. Hastaneye başvuruşunda alınan örneklerden MHO oranın hesaplanmış ve KBN; işlemden 48-72 saat sonra bakılan serum kreatininde bazal değere göre % 25 ya da 0,5 mg/dl artış olarak tanımlanmıştır. Bulgular: Toplam 370(200, %54.1 erkek ) hasta geriye dönük incelenmiş, 25 (%6.7) hastada KBN geliştiği saptanmıştır. Ayrıca hastaların 104’ünde (%28.1) Diabetes Mellitus (DM) olduğu görülmiştür. MHO; KBN gelilşen grupta gelişmeyen gruba göre anlamlı olarak yüksek saptandı (sırasıyla 0.014± 0.004 ve 0.011± 0.006, p: 0.017). Ek olarak MHO ile PKG sonrası kreatinin değerleri arasında pozitif korelasyon saptandı (r:0,104, p: 0.047). Beklendiği gibi KBN gelişen hastların yatışları sırasında daha çok komplikasyon olduğu görüldü. Ayrıca; kiloveMHO değerleri KBN gelişimi için bağımsız risk faktörleri olarak bulundu. Sonuç: MHO ucuz, basit ve kolay şekilde saptanabilen inflamasyon belirteci olup, PKG yapılan NON-STEMI hastlarında KBN’nin saptanmasında ve tedavinin yönlendirilmesinde faydalı olabilir.
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    Prognostic value of pulmonary artery pulsatility index in chronic heart failure patients with reduced ejection fraction
    (Taylor & Francis Ltd, 2022) Yıldız, Ömer; Baydar, Onur; Doctor; Koç University Hospital; N/A
    Background The co-existence of right ventricular dysfunction (RVD) in heart failure patient with reduced ejection fraction (HFrEF) is an independent maker of poor prognosis. A novel right ventricular hemodynamic composite measure is the pulmonary artery pulsatility index (PAPi), which is the pulmonary artery pressure gradient ratio. It is a strong predictor of RVD in patients with acute inferior myocardial infarction and patients undergoing left ventricular assist device (LVAD) implantation. However, little is known about its prognostic value in patients with HFrEF. Methods Between September 2010 and July 2013, 172 patients with HFrEF admitted to the tertiary hospital were included in this analysis. We carried out a cardiac catheterisation for each patient, at baseline. Subsequently, we evaluated both PAPi and the other hemodynamic parameters with longitudinal follow-up of adverse outcomes such as cardiac mortality, LVAD, and heart transplantation (HTx). Results During a median follow-up period of 52 months we observed 50 cardiac deaths, 12 LVAD implantations and 10 HTx. A threshold for PAPi value of 2.82 was ascertained (Area: 0.76, p < 0.001, CI: 0.67-0.85, sensitivity 67%, specificity 69%). After dividing the study population into two groups, PAPi <= 2.82 and PAPi >2.82, no significant difference was demonstrated with respect to the aetiology of heart failure (ischaemic HFrEF p = 0.29 and non-ischaemic HFrEF p = 0.29). In Cox regression survival analysis, PAPi was an independent predictor of cardiac death (hazard ratio 0.73 [95% confidence interval 0.53-0.99], p = 0.045). Conclusion In patients with HFrEF, a low PAPi value (<2.82) was associated with increased cardiac mortality risk.