Kılıç, Raif
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Dr. Öğr. Üyesi
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raifkilic@artuklu.edu.tr
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Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü
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3GOOD HEALTH AND WELL-BEING
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4QUALITY EDUCATION
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37
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123
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33
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1.94
Scopus Citations per Publication
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| Journal | Count |
|---|---|
| Annals of Vascular Surgery | 2 |
| Journal of Electrocardiology | 2 |
| BMC Cardiovascular Disorders | 2 |
| Coronary Artery Disease | 2 |
| Dicle Tıp Dergisi | 2 |
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Now showing 1 - 10 of 33
Article Citation - WoS: 1Citation - Scopus: 1A Novel Determinant of Prognosis in Acute Pulmonary Edema: Intermountain Risk Score(Kare Publ, 2024) Kilic, Raif; Aktan, Adem; Guzel, Tuncay; Kaya, Ahmet Ferhat; Guzel, Hamdullah; Arslan, Bayram; Cankaya, Yusuf; Işık, Mehmet AliObjective: The Intermountain Risk Score (IMRS), calculated using age, gender, complete blood count (CBC), and simple laboratory analyses, is an easy-to-use and cost-effective tool developed to predict mortality. In our study, we aimed to determine whether the IMRS could predict mortality in patients admitted to the hospital with a diagnosis of acute pulmonary edema. Methods: A total of 371 patients who were admitted with a diagnosis of pulmonary edema, were included in our study. The IMRS of the patients was determined using a calculation tool, and the patients were divided into three groups based on the determined value: low, moderate, and high IMRS. Results: The patients included in our study comprised 208 women and 163 men, with an average age of 68.7 years. There was a statistically significant difference between the patient groups concerning both 1-month and 1-year mortality rates. Additionally, there was a significant difference in IMRS between patients who developed in-hospital, 1-month, and 1-year mortality and those who survived. In the Receiver Operating Characteristic (ROC) analysis, a cutoff value of 15.5 for the IMRS predicted both 1-year and 1-month mortality. In the Kaplan-Meier analysis, the highest mortality risk was observed in the high IMRS group and the lowest mortality risk in the low IMRS group. Conclusion: Our research results show that the IMRS strongly predicts both short-term and long-term mortality in patients hospitalized with a diagnosis of acute pulmonary edema.Article Citation - WoS: 3Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?(ELSEVIER, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, MuhammedBackground 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.Article Citation - WoS: 3Citation - Scopus: 3Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?(Springer, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, MuhammedBackground: 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.Article Citation - WoS: 12Citation - Scopus: 12Comparison of Pain Levels of Traditional Radial, Distal Radial, and Transfemoral Coronary Catheterization(Assoc Medica Brasileira, 2023) Aslan, Muzaffer; Gunlu, Serhat; Karahan, Mehmet Zulkuf; Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Arslan, BayramOBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale.METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7 & PLUSMN;1.6, traditional radial artery: 3.9 & PLUSMN;1.9, and distal radial artery: 4.9 & PLUSMN;2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724-0.815, p<0.0001)].CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain.Article Impact of 5-and 6-Fr Sheaths on Hemostasis Duration and Access Site Complications in Distal Transradial Approach(Wiley, 2025) Aktan, Adem; Kilic, Raif; Guzel, Tuncay; Evsen, Ali; Acun, Baris; Tanircan, Muhammed Rasit; Karahan, Mehmet ZulkufBackground: The distal transradial approach (dTRA) is increasingly preferred for coronary angiography (CAG) and/or per-cutaneous coronary intervention (PCI) because of its advantages in patient comfort and vascular access. However, the effect of sheath size on these outcomes remains unclear.
Aim: To compare the effects of 5-French (Fr) and 6-Fr sheaths in dTRA on vascular complications, hemostasis duration, and patient comfort.
Methods: A retrospective analysis was conducted on patients who underwent dTRA for CAG between January 2020 and October 2023. Participants were categorized into two groups based on sheath size (5- vs. 6-Fr). Data on procedural details, complications, hemostasis duration, and patient discomfort were collected.
Result: A total of 228 patients were included, with 72 in the 5-Fr group and 156 in the 6-Fr group. The study found no significant difference in vascular complications between the two groups (p = 0.18). However, hemostasis duration was significantly shorter in the 5-Fr group compared to the 6-Fr group (97.8 +/- 27.6 vs. 122.0 +/- 24.9 min; p < 0.001). Severe pain was more frequent in the 6-Fr group (p = 0.036). Regression analysis showed that severe pain, puncture time, and the use of P2Y12 receptor antagonists (P2Y12 inhibitors) were significantly associated with vascular complications (p < 0.05).
Conclusion: In our study, sheath size-specifically the comparison between 5- and 6-Fr-did not significantly affect vascular complications in the dTRA. However, using a 5-Fr sheath may reduce hemostasis time and patient discomfort compared to a 6-Fr sheath. Procedural factors such as puncture time and severe pain, as well as P2Y12 inhibitor use, should be carefully considered to minimize complications. These findings support the safe application of the dTRA with sheath size tailored to individual patient characteristics.Article Citation - WoS: 11Citation - Scopus: 12The Effectiveness of HALP Score in Predicting Mortality in Non-ST Myocardial Infarction Patients(Lippincott Williams and Wilkins, 2025) Kiliç, R.; Guzel, T.; Aktan, A.; Güzel, H.; Kaya, A.F.; Çankaya, Y.Background: The HALP score, measured based on hemoglobin, albumin, lymphocyte, and platelet levels, is regarded as a novel scoring system that indicates the status of systemic inflammation and nutritional health. Our study aimed to evaluate the relationship between HALP score and prognosis in non-ST-elevation myocardial infarction (NSTEMI) patients. Methods Between 1 January 2020 and 1 January 2022, 568 consecutive patients diagnosed with NSTEMI from a single center were included in the study retrospectively. The patients were divided into two equal groups according to the median HALP cutoff value of 44.05. Patients were followed for at least 1 year from the date of admission. Results The average age of the patients was 62.3±10.6 years and 43.7% were female. In-hospital and 1-year mortality were found to be significantly higher in the group with low HALP scores (6.0 vs. 2.1%, P=0.019 and 22.5 vs. 9.9%, P<0.001, respectively). In receiver operating characteristic curve analysis, a cutoff level of 34.6 of the HALP score predicted 1-year mortality with 71% sensitivity and 65% specificity (area under the curve: 0.707, 95% confidence interval: 0.651-0.762, P<0.001). In Kaplan-Meier analysis, higher mortality rates were observed over time in the group with lower HALP scores (log-rank test=16.767, P<0.001). In Cox regression analysis, the HALP score was found to be an independent predictor of 1-year mortality (odds ratio: 0.969, 95% confidence interval: 0.958-0.981, P<0.001). Conclusion We found that a low HALP score could predict in-hospital and 1-year mortality in patients admitted to the hospital with a diagnosis of NSTEMI. © © 2024 Wolters Kluwer Health, Inc. All rights reserved.Article Citation - WoS: 2Citation - Scopus: 3The effect of body mass index on complications in cardiac implantable electronic device surgery(WILEY, 2023) Güzel, Tuncay; Demir, Muhammed; Aktan, Adem; 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, FarukBackground: 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.Article Citation - Scopus: 7The effect of coronary slow flow on ventricular repolarization parameters(ScienceDirect, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Günlü, Serhat; Kılıç, RaifIntroduction: Ischemia due to microvascular dysfunction may be responsible for the heterogeneity of ventricular repolarization in coronary slow flow. To our knowledge, there is no study in which QT interval, Tp-Te interval, index of cardiac-electrophysiological balance (iCEB), and frontal QRS-T angle were evaluated together in patients with CSF. In this study, we examined for the first time the relationship between all these myocardial repolarization parameters and CSF. Materials and methods: The study group included 178 patients (99 female, mean age: 50.6 ± 8.6 years) with isolated CSF without stenotic lesions and with angiographically proven normal coronary arteries. The control group included 120 patients (71 female, mean age: 49.3 ± 9.4 years) with normal coronary angiography. QRS duration, QT interval, QTc interval, Tp-Te interval, Tp-Te/QT, Tp- Te/QTc, iCEB score, and frontal QRS-T angle were calculated from 12‑lead ECGs. Results: There was no significant difference in demographic parameters between the two groups. Compared with the control group, patients with CSF had significantly longer QTmax duration, QT dispersion, Tp-Te interval, and higher iCEB score, wider frontal QRS-T angle. Conclusion: In our study, we found that many of the ventricular repolarization parameters were adversely affected in patients with CSF. Impaired parameters may be associated with the risk of malignant ventricular arrhythmias.Article Citation - WoS: 2Citation - Scopus: 2The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement(Soc Brasil Cirurgia Cardiovasc, 2024) Aktan, Adem; Demir, Muhammed; Aslan, Burhan; Guzel, Tuncay; Karahan, Mehmet Zulkuf; Kilic, Raif; Ertas, FarukIntroduction: 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.Article Response to Comment Letter: The Effectiveness of HALP Score in Predicting Mortality in Non-ST Myocardial Infarction Patients(Lippincott Williams & Wilkins, 2025) Kiliç, R.; Aktan, A.; Guzel, T.
