Browsing by Author "Demir, Muhammed"

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Citation - WoS: 2
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(ELSEVIER, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥75 years) than in younger (<75 years) patients. Methods This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically signifcant hematoma (CSH), pericardial efusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results The overall sample included 1923 patients (1419<75 years and 504 aged≥75 years). There was no diference between the groups in terms of cumulative events defned as primary outcome (3.5% vs. 4.4%, p=0.393). Infection related to device system was signifcantly higher in the≥75 age group (1.8% vs. 3.4%, p=0.034). There was no signifcant diference between the groups in terms of clinically signifcant hematoma and pneumothorax (0.7% vs. 0.4%, p=0.451, 1.4% vs. 1.0%, p=0.477, respectively). In multivariate model analysis, no association was found between age≥75 years and infection related to the device system. Conclusion Infection rates were relatively higher in the patient group aged≥75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Citation - WoS: 2
Citation - Scopus: 2
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Citation - WoS: 1
Citation - Scopus: 1
Comparison of Evolut-R 34 Mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors
(Kare Publ, 2024) Aktan, Adem; Kilic, Raif; Kılıç, Raif; Guzel, Tuncay; Aktan, Adem; Günlü, Serhat; Demir, Muhammed; Gunlu, Serhat; Arslan, Bayram; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Objective: The main purpose of this study was to evaluate and compare the in -hospital, 1 -month and 1 -year post -procedure outcomes of patients treated with Evolut-R 34 mm and Evolut-R 23/26/29 mm devices. Additionally, the study aimed to identify factors that could predict the occurrence of >= mild paravalvular leaks (PVL). Methods: Between April 2015 and May 2022, 269 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with Evolut-R 34 mm (n = 66, 24.5%) and Evolut-R 23/26/29 mm (n = 203, 75.5%) devices in a single center were retrospectively analyzed. Results: Patients in the Evolut-R 34 mm group had a lower female sex ratio (16.7% vs. 66.5%, P < .001, respectively), ejection fraction (50.7 +/- 10.1% vs. 54.5 +/- 9.3%, P = .016, respectively), and mean aortic gradient (7.4 +/- 3.3 vs. 9.2 +/- 5.0, P = .026, respectively) compared to the Evolut-R 23/26/29 mm group. The groups did not exhibit any statistically significant distinctions with regard to technical success, the need for a permanent pacemaker, occurrences of stroke, major vascular complications, PVL, major adverse cardiovascular and cerebrovascular events, or mortality. Peak velocity was confirmed as a significant pre- dictor of >= mild PVL in both patient groups in the receiver operating characteristic curve analysis. In logistic regression analysis; In patients with Evolut-R 34 mm valve, pre-TAVI aortic valve peak velocity (odds ratio (OR) = 23.202; P = .019) and calcium volume 800 Hounsfield Units (mm(3)) (OR = 1.017; P < .001) were independent predictors of >= mild PVL. Conclusion: The Evolut-R 34 mm valve has shown comparable in -hospital results with smaller valve sizes. Pre-TAVI aortic valve peak velocity and calcium volume predicted >= mild PVL in Evolut-R 34 mm patients.
Citation - WoS: 2
Citation - Scopus: 2
The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement
(Soc Brasil Cirurgia Cardiovasc, 2024) Aktan, Adem; Demir, Muhammed; Guzel, Tuncay; Karahan, Mehmet Zulkuf; Aslan, Burhan; Kilic, Raif; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Introduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in -hospital complications as well as mortality of patients undergoing Evolut (TM) R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium -3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in -hospital mortality. Patients were divided into two groups, AA <= 48(degrees) and AA > 48(degrees), based on the mean AA measurement (48.3 +/- 8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted.
Citation - WoS: 1
Citation - Scopus: 1
The effect of body mass index on complications in cardiac implantable electronic device surgery
(WILEY, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Kılıç, Raif; Arslan, Bayram; Günlü, Serhat; Altıntaş, Bernas; Karahan, Mehmet Zülkif; Özbek, Mehmet; Aslan, Burhan; Arpa, Abdulkadir; Coşkun, Mehmet Sait; Altunbaş, Mahsum; Tüzün, Rohat; Akgümüş, Alkame; Karadeniz, Muhammed; Aydın, Saadet; Güzel, Hamdullah; Aslan, Selen Filiz; Söner, Serdar; Taş, Ahmet; Ertaş, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background: Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications. Methods: 1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obese (BMI ≥ 30 kg/m2). The primary endpoint was accepted as cumulative events, including the composite ofclinically significant hematoma (CSH), pericardial effusion or tamponade, pneumoth- orax, and infection related to the device system. Secondary outcomes included each component of cumulative events. Results: The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156–3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470–9.204, p < .001), BMI (OR:1.069, 95%CI:1.012–1.129, p = .01) were independent predictors of cumulative events rates. Conclusions: Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.
Citation - WoS: 2
Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement
(SAGE, 2023) Günlü, Serhat; Karahan, Mehmet Zülkif; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Demir, Muhammed; Ertaş, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Although transcatheter aortic valve replacement (TAVR) is safe and effective, mortality and bleeding events post procedure are important. The present study investigated the changes in hematologic parameters to evaluate whether they predict mortality or major bleeding. We enrolled 248 consecutive patients (44.8% male; mean age 79.0 ± 6.4 years) undergoing TAVR. In addition to demographic and clinical examination, blood parameters were recorded before TAVR, at discharge, 1 month and 1 year. Hemoglobin levels before TAVR 12.1 ± 1.8 g/dL, 10.8 ± 1.7 g/dL at discharge, 11.7 ± 1.7 g/dL at first month, 11.8 ± 1.4 g/dL at first year (Hemoglobin values compared with pre-TAVR, P < .001, P = .019, P = .047, respectively). Mean platelet volume (MPV) before TAVR 8.72 ± 1.71 fL, 8.16 ± 1.46 fL at discharge, 8.09 ± 1.44 fL at first month, 7.94 ± 1.18 fL at first year (MPV values compared with pre-TAVR, P < .001, P < .001, P < .001, respectively). Other hematologic parameters were also evaluated. Hemoglobin, platelet count, MPV, and red cell distribution width before the procedure, at discharge, and at the first year did not predict mortality and major bleeding in receiver operating characteristic analysis. After multivariate Cox regression analysis, hematologic parameters were not independent predictors of in-hospital mortality, major bleeding, and death at 1 year after TAVR.
Citation - WoS: 2
Citation - Scopus: 2
Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement
(Sage Journals, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Günlü, Serhat; Demir, Muhammed; Ertaş, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Although transcatheter aortic valve replacement (TAVR) is safe and effective, mortality and bleeding events post procedure are important. The present study investigated the changes in hematologic parameters to evaluate whether they predict mortality or major bleeding. We enrolled 248 consecutive patients (44.8% male; mean age 79.0 ± 6.4 years) undergoing TAVR. In addition to demographic and clinical examination, blood parameters were recorded before TAVR, at discharge, 1 month and 1 year. Hemoglobin levels before TAVR 12.1 ± 1.8 g/dL, 10.8 ± 1.7 g/dL at discharge, 11.7 ± 1.7 g/dL at first month, 11.8 ± 1.4 g/dL at first year (Hemoglobin values compared with pre-TAVR, P < .001, P = .019, P = .047, respectively). Mean platelet volume (MPV) before TAVR 8.72 ± 1.71 fL, 8.16 ± 1.46 fL at discharge, 8.09 ± 1.44 fL at first month, 7.94 ± 1.18 fL at first year (MPV values compared with pre-TAVR, P < .001, P < .001, P < .001, respectively). Other hematologic parameters were also evaluated. Hemoglobin, platelet count, MPV, and red cell distribution width before the procedure, at discharge, and at the first year did not predict mortality and major bleeding in receiver operating characteristic analysis. After multivariate Cox regression analysis, hematologic parameters were not independent predictors of in-hospital mortality, major bleeding, and death at 1 year after TAVR.
Citation - WoS: 1
Citation - Scopus: 1
Predictive Value of Nutritional Scores in Non-Valvular Atrial Fibrillation Patients: Insights From the After-2 Study
(Elsevier Sci Ltd, 2025) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Arslan, Bayram; Demir, Muhammed; Ertas, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background and aim: Many scoring systems are used to evaluate malnutrition, but there is no consensus on which scoring system would be more appropriate. We aimed to investigate the effect of malnutrition in patients with non-valvular atrial fibrillation (NVAF) and to compare three scoring systems. Methods and results: A total of 2592 patients with non-valvular AF from 35 different centers in Turkey were included in this prospective study. All participants were divided into two groups: 761 patients who died and 1831 patients who were alive. The malnutrition status of all participants was evaluated with three scoring systems. The primary outcome was all-cause mortality. The mean age of the population was 68.7 +/- 11.1 years, and 55.5 % were female. According to Cox regression analysis, the geriatric nutritional risk index (GNRI) (HR = 0.989, 95 % CI: 0.982-0.997, p = 0.007), controlling nutritional status (CONUT) score (HR = 1.121, 95 % CI: 1.060-1.185, p < 0.001), and prognostic nutritional index (PNI) (HR = 0.980, 95 % CI: 0.962-0.999, p = 0.036) were found to be significant mortality predictors. ROC curve analysis indicated GNRI (AUC = 0.568), CONUT (AUC = 0.572), and PNI (AUC = 0.547) had moderate predictive values. Kaplan-Meier analysis showed that increasing the risk class based on GNRI (p < 0.001) and CONUT (p < 0.001) was associated with decreased survival, while PNI staging had no statistically significant effect (p = 0.266). Conclusions: Malnutrition, determined by three scoring systems, was found to be an independent predictor of all-cause mortality in NVAF patients. Nutritional examination may provide useful information for prognosis and risk stratification in patients with NVAF.
Prognostic Value of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) Scores in Patients With Non-Valvular Atrial Fibrillation: Insights From the After-2 Study
(BMC, 2025) Soner, Serdar; Guzel, Tuncay; Aktan, Adem; Kilic, Raif; Soner, Hulya Tosun; Demir, Muhammed; Ertas, Faruk
Objectives: The relationship between hemoglobin, albumin, lymphocyte, platelet (HALP) score, and various cancers and cardiovascular diseases has been tested previously. However, the relationship between HALP score and non-valvular atrial fibrillation (NVAF) has not been adequately tested. Therefore, our study aimed to investigate the relationship between HALP score and mortality in patients with NVAF. Methods: This study included 2,592 NVAF patients from 35 centers in Turkey. Patients were divided into two groups: those with HALP scores <= 58.96 (low HALP score group, 1,296 patients) and > 58.96 (high HALP score group, 1,296 patients). The primary outcome measured was all-cause mortality. Results: The mean HALP score was 66 +/- 33. Patients in the low HALP score group had higher 1- and 5-year all-cause mortality rates (1-year: 12.9% vs. 5.4%, p < 0.001; 5-year: 38.5% vs. 20.2%, p < 0.001). Cox regression analysis identified the HALP score as an independent predictor of mortality (1-year: HR = 0.987, 95% CI = 0.981-0.992, p < 0.001; 5-year: HR = 0.990, 95% CI = 0.987-0.993, p < 0.001). ROC analysis determined a HALP score 52.3 predicted 1-year mortality with 62.9% sensitivity and 62% specificity (AUC = 0.680); a score of 55 predicted 5-year mortality with 60.3% sensitivity and 62.2% specificity (AUC = 0.657). Kaplan-Meier analysis revealed increasing mortality over time in the low HALP score group (log-rank tests, 1-year = 44.86, p < 0.001; 5-year = 108.54, p < 0.001). Conclusions: The HALP score is a simple, accessible measure, and our findings suggest that lower HALP scores are associated with increased 1-year and 5-year mortality in NVAF patients. This provides a reference for clinicians assessing risk in this vulnerable population.