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- MakaleYalnız künye2014Relationship between platelet indices and international normalized ratio in patients with non-valvular atrial fibrillation
Arik, Osman Ziya; Özkan, Bugra; Kutlu, Rasim; Karal, Huseyin; Sahin, Durmus Yildiray; Kaypakli, Onur; Özel, Deniz; Çayil, Murat
Atrial fibrillation (AF) is the most common sustained arrhythmia and associated with adverse outcomes and increased risk for thromboembolic events. Warfarin is still the most extensively prescribed oral anticoagulant in AF to prevent ischemic complications. We aimed to determine the differences at platelet indices with warfarin usage layered by International Normalized Ratio (INR). A total of 250 patients with permanent non-valvular AF (mean age 70.2 +/- 9.1; 153 female) were divided into two groups. Group 1 included 125 patients whose INR is between 2.0 and 3.0 (called as effective'') and Group 2 included 125 patients whose INR is <2.0 (called as ineffective''). Also 123 age- and sex-matched individuals in sinus rhythm enrolled as control group (Group 3). After physical and echocardiographic examination, complete blood counts and INR were studied. There was no statistically significant difference in age, sex, co-morbidities and medications, also hemoglobin, white blood cell and platelet counts among the groups. The CHA(2)DS(2)-VASc scores were similar between Groups 1 and 2. The mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) were significantly higher in Group 2 than Groups 1 and 3 and similar between Groups 1 and 3. MPV was positively correlated with PDW and PCT and also inversely correlated with INR value and platelet count. On multivariate logistic regression analysis, MPV, PDW and PCT were independent predictors of ineffectiveness of INR. The results of this study showed that MPV, PDW and PCT are increased in patients with non-valvular AF without effective warfarin treatment. Warfarin usage adjusted by INR is associated with lower values of these platelet indices, even lower as the values of subjects in sinus rhythm. MPV, PDW and PCT are independent predictors of INR ineffectiveness and seem to be useful parameters for monitoring the effectiveness of warfarin treatment.
- BildiriYalnız künye2013Relationship Between Platelet Indices and International Normalized Ratio In Patients With Non-Valvular Atrial Fibrillation
Arik, Osman Ziya; Özkan, Bugra; Kutlu, Rasim; Karal, Huseyin; Memetoglu, Mehmet Erdem; Sahin, Durmus Yildiray; Tekin, Kamuran; Kaypakli, Onur; Uçak, Haci Ali; Çayli, Murat
- MakaleYalnız künye2013Coronary Flow Reserve and Myocardial Performance Index in Newly Diagnosed Diabetic Patients
Kalkan, Gulhan Yuksel; Gür, Mustafa; Sahin, Durmus Yildiray; Baykan, Ahmet Oytun; Elbasan, Zafer; Kuloglu, Osman; Kivrak, Ali; Türkoglu, Caner; Arik, Osman Ziya; Çayli, Murat
BackgroundPatients with diabetes mellitus (DM) are at high risk of left ventricular (LV) dysfunction. A reduction of coronary flow reserve (CFR) has been demonstrated in diabetic patients without coronary artery stenosis. In this study, we investigated the association between LV myocardial diastolic and systolic functions and the CFR in newly diagnosed diabetic patients in the absence of coronary artery disease. MethodWe studied 88 patients (mean age 4910years) with newly diagnosed DM and 40 healthy control subjects (mean age 509years). All subjects underwent transthoracic echocardiography. The myocardial performance index (MPI) was determined by using pulsed-wave Doppler. The CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio. ResultsPatients with diabetes had significantly longer mitral E-wave deceleration time and higher MPI value than control group (P=0.023 and P<0.001, respectively). The mean CFR was lower in diabetic patients compared with controls (P=0.001). The MPI was significantly correlated with CFR (r=-0.371, P<0.001), LV ejection fraction (r=-0.274, P=0.018) E/A ratio (r=-0.244, P=0.024), and glycosylated hemoglobin (HbA1c) (r=0.476, P<0.001). Multivariate regression analysis showed that MPI was independently associated with CFR (=-0.292, P<0.0001) and HbA1c level (=0.372, P<0.0001). ConclusionsThe MPI was independently associated with CFR in newly diagnosed diabetic patients. The decrease in CFR may cause LV systolic and diastolic dysfunction in asymptomatic diabetic patients.
- BildiriYalnız künye2013Automated Functional Imaging in Atrioventricular Delay Time Optimization in Patients with Dual Chamber Pacemakers
Arik, Osman Ziya; Kalkan, Gulhan Yuksel; Sahin, Durmus Yildiray; Elbasan, Zafer; Gür, Mustafa; Kuloglu, Osman; Tekin, Kamuran; Gençaslan, Murat; Türkoglu, Caner; Uçak, Haci Ali