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    The Association between Platelet/Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients
    (Korean Soc Cardiology, 2016) Ucar, Fatih Mehmet; Acar, Burak; Gul, Murat; Ozeke, Ozcan; Aydogdu, Sinan
    Background and Objectives: Coronary angiography (CAG) is generally needed in the setting of systolic heart failure (HF) with an unidentified etiology as a part of diagnostic strategy. On the other hand, the clinical value of this invasive strategy is largely unknown. Platelet-lymphocyte ratio (PLR) has recently emerged as a novel inflammatory index that may serve as an important predictor of inflammatory state and overall mortality. The present study aimed to search the predictive value of PLR in determining the extent of coronary atherosclerosis in asymptomatic low ejection fraction (EF) patients. Subjects and Methods: 156 asymptomatic heart failure (HF) subjects (without angina or HF symptoms, mean age: 58 years; to male: 71.2% were enrolled, and thereafter a CAG was performed. Gensini Score was used to determine the severity of coronary artery disease (CAD) on CAG. According to this scoring system, the overall study group was categorized into three distinct subgroups: control group with the score 0, mild atherosclerosis group with the score 0 to 20 and severe atherosclerosis group with the score of >20. Thereafter, a comparison was made among groups with regard to mean values of PLR. Results:The severe atherosclerosis group had a substantially higher level of mean PLR in comparison to other groups (p<0.001). Pre-CAG PLR levels as well as a variety of clinical variables including age, low density lipoprotein (LDL)-cholesterol demonstrated an independent correlation with Gensini score through a multivariate analysis. Conclusion: These findings suggest the potential association of high PLR levels with severe atherosclerosis in the setting of asymptomatic systolic HF. A simple measurement of PLR helps to identify the severity of coronary atherosclerosis prior to conducting coronary angiography.
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    Gamma-glutamyl transferase predicts recurrences of atrial fibrillation after catheter ablation
    (Taylor & Francis Ltd, 2016) Ucar, Fatih Mehmet; Ipek, Esra Gucuk; Acar, Burak; Gul, Murat; Tuncez, Abdullah; Ozeke, Ozcan; Geyik, Bilal
    Background Catheter ablation is a popular therapy of atrial fibrillation (AF). Gamma-glutamyl transferase (GGT) is known as a marker of oxidative stress. The objective of this study was to ascertain the relationship between levels of GGT and recurrence of AF after catheter ablation. Methods A total of 102 paroxysmal AF patients who underwent cryoballoon catheter ablation were enrolled. Serum samples were obtained to evaluate GGT levels before catheter ablation. Cox regression analysis was used to estimate the predictors of AF recurrence. Results Mean age of the cohort was 49.9 +/- 11.7 and 63% of the patients were male. After a mean follow-up of 20 months, 19 (23%) patients had AF recurrences. The baseline GGT levels were significantly higher in patients who had AF recurrence [27 U/L (17-36) vs 18 U/L (13-22), P=0.0021.The optimal cut-off value of GGT to predict AF recurrence was 23.5 U/L according to receiver operating characteristic curve analysis (area under the curve 0.72, P=0.002). In the multivariable Cox regression analysis, baseline GGT > 23.5 was the only independent predictor of AF recurrence (hazard ratio (HR) 4.47, 95% confidence interval [1.66-12.09], P=0.003). Conclusions Our results indicate that elevated GGT is associated with AF recurrence. A simple measurement of GGT may help us to identify high-risk patients undergoing catheter ablation for AF.
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    Monocyte-to-HDL-cholesterol ratio is associated with Ascending Aorta Dilatation in Patients with Bicuspid Aortic Valve
    (Makerere Univ, Fac Med, 2021) Acar, Burak; Yayla, Cagri; Gul, Murat; Karanfil, Mustafa; Unal, Sefa; Ucar, Fatih; Kuyumcu, Serdar Mevlut
    Background: The importance of monocyte count-to-HDL-cholesterol ratio (MHR) in cardio-vascular diseases has been shown in various studies. Ascending aortic dilatation (AAD) is a common complication in the patients with bicuspid aortic valve. In this study, we aimed to investigate the relationship between MHR and the presence of aortic dilatation in the patients with bicuspid aortic valve. Methods: The study population included totally 347 patients with bicuspid aortic valve.169 patients with aortic dilatation (ascending aorta diameter >= 4.0 cm) and 178 patients with no aortic dilatation. Echocardiographic and laboratory measurement was done and compared between groups. Results: The mean age of the participants was 44.7 +/- 15.4 years and average ascending aorta diameter was 3.2 +/- 0.3 cm in dilatation negative group and 4.4 +/- 0.4 cm in positive group. MHR was significantly increased in in patients with aortic dilatation. MHR and uric acid level was independently associated with the presence of aortic dilatation in the patients with bicuspid aortic valve. Conclusion: We found a significant relationship between MHR and aortic dilatation in the patients with bicuspid aortic valve.
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    Neutrophil to lymphocyte ratio predicts appropriate therapy in idiopathic dilated cardiomyopathy patients with primary prevention implantable cardioverter defibrillator
    (Saudi Med J, 2017) Ucar, Fatih M.; Acar, Burak
    Objectives: To investigate whether an inflammatory marker of neutrophil to lymphocyte ratio (NLR) predicts appropriate implantable cardioverter defibrillator (ICD) therapy (shock or anti tachycardia pacing) in idiopathic dilated cardiomyopathy (IDC) patients. Methods: We retrospectively examined IDC patients (mean age: 58.3 +/- 11.8 years, 81.5% male) with ICD who admitted to outpatient clinic for pacemaker control at 2 tertiary care hospitals in Ankara and Edirne, Turkey from January 2013-2015. All ICDs were implanted for primary prevention. Hematological and biochemical parameters were measured prior procedure. Results: Over a median follow-up period of 43 months (Range 7-125), 68 (33.1%) patients experienced appropriate ICD therapy. The NLR was increased in patients that received appropriate therapy (4.39 +/- 2.94 versus 2.96 +/- 1.97, p<0.001). To identify independent risk factors for appropriate therapy, a multivariate linear regression model was conducted and age (beta=0.163, p=0.013), fasting glucose (beta=0.158, p=0.017), C-reactive protein (CRP) (beta=0.289, p<0.001) and NLR (beta=0.212, p<0.008) were found to be independent risk factors for appropriate ICD therapy. Conclusions: Before ICD implantation by using NLR and CRP, arrhythmic episodes may be predictable and better antiarrhythmic medical therapy optimization may protect these IDC patients from unwanted events.