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Yayın Distribution of risk factors and prophylactic drug usage in Turkish patients with angiographically established coronary artery disease(Sage Journals, 2002) Sönmez, Kenan; Akçay, Ahmet; Akçakoyun, Mustafa; Demir, Durmuş; Elönü, Orhan Hakan; Pala, Selçuk; Ekşi Duran, Nilüfer; Gençbay, Murat; Değertekin, Muzaffer; Turan, FikretBackground: Coronary artery disease (CAD) is the leading cause of adult deaths in our country. In clinical practice, an adequate level of secondary prevention towards CAD primarily requires full recognition of the distribution of risk factors. The aim of our study was to determine the prevalence of coronary risk factors and the use of prophylactic drugs among patients who have an angiographically proven CAD in our centre, and to compare it with those of the EUROASPIRE I and II studies. Design: Cross-sectional, observational study. Methods: Our patients comprise 617 subjects (516 male, mean age 57.2 +/- 10.8 years) who underwent an angiography between January 2000 and May 2000 for the first time and in whom significant coronary lesions were detected. Age, gender, family history of premature CAD (FH), diabetes mellitus (DM), hypertension (HT), lipid profile, smoking, body mass index, waist circumference, hip circumference and physical activity data were recorded prior to angiography. The medical treatments received by these cases at discharge from hospital were investigated. Data thus obtained were compared with the results of the EUROASPIRE I and II trials, which studied the frequency of existing risk factors and prophylactic drug use among CAD patients in European countries. Results: Hyperlipidaemia, FH, DM, HT, smoking, obesity, central obesity were found in 52, 26, 20, 41, 65, 18 and 29% of patients, respectively. The use of antiplatelets, beta-blockers, ACE inhibitors, statins and calcium antagonists were 99, 86, 40, 63 and 16%, respectively. Conclusion: Upon comparison of the risk factors, prevalence of obesity and DM was found to be similar to the average of nine European countries among our subjects. Smoking was found to be considerably higher, whereas HT, hyperlipidaemia and family history of premature CAD were lower than the European average within our subjects. In our cases the frequency of prophylactic drug usage at discharge was higher than the European means.Yayın İleri mitral yetersizliğinde atriyal fibrilasyonun sıklığı ve öngördürücüleri(Türk Kardiyoloji Derneği, 2003) Ekşi Duran, Nilüfer; Duran, İbrahim; Sönmez, Kenan; Gençbay, Murat; Akçay, Ahmet; Turan, FikretÇalışmamızın amacı, ileri mitral yetersizliği (MY) bulunan hastalarda atriyal fibrilasyonun (AF) sıklığını ve AF'ye neden olan öngördürücü faktörleri tespit etmektir.Yayın Koroner arter hastalığı bulunan olgularda obezite derecelerinin diğer risk faktörleriyle ilişkisi(Türk Kardiyoloji Derneği, 2002) Sönmez, Kenan; Akçakoyun, Mustafa; Demir, Durmuş; Akçay, Ahmet; Pala, Selçuk; Ekşi Duran, Nilüfer; Bakal, Ruken Bengi; Gençbay, Murat; Değertekin, Muzaffer; Turan, FikretDünya Sağlık Örgütü ve uluslararası kılavuz komitelerince kabul edilmiş beden kitle indeksi (BKİ) ve bel çevresi sınırlarına göre yapılan obezite sınıflamasında, farklı obezite gruplarında yer alan koroner arter hastalığı (KAH 9 olgularında, diğer koroner risk faktörlerinin dağılımını karşılaştırmak, böylece bu sınır değerlerinin diğer koroner risk faktörlerinin dağılımını ne ölçüde belirlediğini incelemektedir.Yayın Prevalence and predictors of significant coronary artery disease in Turkish patients who undergo heart valve surgery(National Library of Medicine, 2002) Sönmez, Kenan; Gençbay, Murat; Akçay, Ahmet; Yılmaz, Ahmet; Pala, Selçuk; Onat, Özgür; Ekşi Duran, Nilüfer; Değertekin, Muzaffer; Turan, FikretBackground and aims of the study: The presence of significant atherosclerotic coronary artery disease (CAD) in patients with valvular heart disease is an important predictor of perioperative mortality. The prevalence of CAD in patients undergoing valvular heart surgery is 20-40% in industrialized countries. The study aim was to determine CAD prevalence in Turkish patients undergoing valvular heart surgery, and to identify predictors of its presence. Methods: A total of 760 patients (357 males, 403 females; mean age 54.4+/-18.1 years) who underwent coronary angiography before valvular surgery between 1995 and 2000 was enrolled retrospectively. Single- and multi-valve involvement was present in 46% and 54% of patients, respectively. Patients with ischemic mitral regurgitation were excluded from the study. Significant CAD was defined as the presence of > or =50% diameter stenosis anyone of the coronary arteries. The presence of angina pectoris, and of risk factors (e.g. hypertension, smoking, diabetes mellitus (DM), hyperlipidemia, family history of CAD) were sought in all patients. Predictors of CAD were identified by logistic regression analysis. Results: Significant CAD was present in 15.8% of patients (24% males, 9% females) (p <0.001); the highest prevalence was in those with aortic stenosis (p <0.05). CAD was not seen in young patients (aged <45 years) with none of the above-mentioned risk factors. The highest correlation between CAD and risk factors was family history of CAD, followed by DM, hyperlipidemia, hypertension and smoking, in decreasing order. Conclusion: The study results showed that CAD in patients with valvular heart disease was less prevalent in Turkey than in industrialized countries. The incidence of coronary lesions rises notably from the age of 50 years in both males and females. Coronary angiography before valvular heart surgery could be omitted in young patients (age <45 years) with none of the coronary risk factors, or without angina.
