Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p<0.0001, p=0.02 respectively). TYPE 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative top re-pandemic group (10 vs 0 p=0.003). Post procedural TIMI flow grade was lower in pandemic group and distal embolization and TIMI thrombus score were significantly higher in the pandemic group compared top re-pandemic group (, p=0.001, p=0.02 ,p=0.002 respectively). However; there was no statistically significant difference in hospital mortality and short –term all cause mortality, among groups (p>0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.
To evaluate the role of serum lipoprotein-a (Lp-a) levels on the success of thrombolytic therapy (TT) in patients with acute myocardial infarction (MI).56 patients randomly allocated into 2 groups (A and B) with an approximately 1 to 2 ratio. Group A consisted of 18 patients who received 1,5 million IU streptokinase. Group B: 38 patients receiving 100 mg t-PA totally and Group C: 22 patients who did not received any TT as controls. All patients had undergone coronary angiography in the first 7 days and the degree of TIMI flow was determined in the infarct related artery with TIMI-0 and I being considered as unsuccessful perfusion, whereas TIMI-II and III as successful. Lp-a level gs;30 mg/dl was considered as high Lp-a level.Patency rates were similar in Group A and B, in cases with high or low Lp-a levels (p>0.05 for both). In Group C patency rate was found significantly higher in patients with high Lp-a level compared to patients with low Lp-a (p<0.01). Lp-a level in Group C was similar with Group A and B (p>0.05). The time interval for coronary angiography was similar in all groups (p>0.05 for all).Lp-a level does not effect the reperfusion outcome of TT in patients with MI. However in those patients who not received TT, spontaneous reperfusion rate was found significantly higher in patients with low Lp-a level compared to those with high Lp-a level.
Abstract Purpose: Left ventricular hypertrophy (LVH) is a common condition in the population and potentially modifiable cardiovascular (CV) risk factor often overlooked in clinical practice. Early diagnosis and treatment-related regression of LVH reduces adverse CV events and improves survival. For this reason, we planned to LVH-TR trial to determine the etiological causes of LVH, the symptoms that patients present with, and the effects of demographic characteristics of patients on LVH. Methods: Our study is a multicenter, national, observational study and included 886 patients who applied to the cardiology clinics in 23 centers between February 2020 and August 2021. In the initial evaluation, the Fabry and amyloidosis algorithm was followed in patients whose traditional etiologic cause(s) could not be identified (LVH of unknown origin). Results: The mean age of the patients was 58.92 years, and 60.3% of them were male. More than 90% of the patients were NYHA class I & II patients. The most common etiological causes of LVH in our study were hypertension with a rate of 69.7%, heart valve disease with 10.2%, and hypertrophic cardiomyopathy with 9.2%. Athlete's heart was detected in 8 patients, LV non-compaction was detected in 4 patients.The rate of LVH of unknown cause was 18.8%. Fabry disease was suspected in 143 patients, and Amilodose disease was suspected in 16 patients. There were 43 (4.85%) patients with low α-Galactosidase A enzyme levels in patients who requested enzyme testing. GLA gene mutation analysis was positive in 1.58% of all patients, and these patients were diagnosed with Fabry, and 15 (1.69%) patients were diagnosed with amyloidosis by endomyocardial biopsy method. Conclusion: In the etiology of left ventricular hypertrophy, the rate of LVH of unknown cause was high. Fabry Disease and Amyloidosis should be considered primarily in this patient group. Early diagnosis of the disease by following the schemes leading to Fabry and Amyloidosis was essential in starting treatment before the progression of the disease.
Background and Aim: Lifestyles and behavoiral patterns of patients must be known to improve public health and to prevent cardiovascular diseases (CVD). In this study, we aimed to provide insights into the lifestyles and behavioral patterns of patients applied to outpatient cardiology clinics in Turkey. Materials and Methods: The participants completed a self-administered questionnaire about awareness of cardiovascular (CV) risk factors and individual CV risk levels, lifestyles, and medications. Results: A total of 2793 patients, 52.1% of females with a mean age of 57.0 ± 14.0 years were included. The most common risk factor was hypertension. The most common CVD was coronary artery disease. The calculated CV risk level of 1041 patients (37.3%) was high, while only 20.4% of all participants identified themselves as high risk. Participants were aware that hypertension, smoking, hyperlipidemia, diabetes, sedentary, family history, and aging were risk factors for CVD. About 44% of the patients reported that they used additional salt and the majority reported that they did not consume fast food. The most commonly prescribed CV drug was beta-blockers (44.9%) and 22.4% of patients were taking minimum of 5 drugs daily. Conclusion: The awareness of CV risk factors and risk levels is low in the study population. Guideline recommended medications and lifestyle changes are not sufficiently implemented.