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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| Journal | Count |
|---|---|
| Aging Clinical and Experimental Research | 2 |
| Dicle Tıp Dergisi | 2 |
| Journal of Electrocardiology | 2 |
| ANGIOLOGY | 1 |
| Thrombosis Research | 1 |
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Now showing 1 - 10 of 12
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: 2Citation - Scopus: 2The 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: 3The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome(ELSEVIER, 2023) Günlü, Serhat; Arpa, Abdulkadir; Kayan, Fethullah; Güzel, Tuncay; Kılıç, Raif; Aktan, Adem; Bernas, Altıntaş; Karahan, Mehmet ZülkifBackground: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited. Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS. Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02–5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45–0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01–1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61–3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69–5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001). Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.Article Citation - WoS: 2Citation - Scopus: 2Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement(Sage Journals, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Kılıç, Raif; Günlü, Serhat; Demir, Muhammed; Ertaş, FarukAlthough 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.Article Sistemik İmmün İnflamasyon İndeksi Koroner Arter Hastalığının Yükünü Tahmin Edebilir(2024) Kaya, Ahmet Ferhat; Kılıç, Raif; Aktan, AdemArkaplan: Koroner arter hastalığının patofizyolojisinde ateroskleroz önemli bir yer almaktadır. Aterosklerozun çok yönlü etkileri göz önüne alındığında tam kan sayımıyla kolayca hesaplanabilen sistemik immün inflamatuar indeks (SII) inflamasyon dengesini tanımlamak için kullanılabilmektedir. Amaç: Biz çalışmamızda 166 hastada değerlendirilen bu biyobelirteç ile inflamasyon şiddetinin,koroner anjiografi ile değerlendirilen koroner arter hastalığı şiddeti ile ilişkisini incelemeyi amaçladık. Yöntem: Çalışmamıza Akut koroner sendrom nedeni ile koroner anjiografisi yapılan 166 hasta dahil edildi. Hastaların SYNTAX skoru web sitesindeki uygulama üzerinden hesaplandı. (http://www.SYNTAXcore.com.) SYNTAX puanı 3 gruba ayrılmaktadır: 0-22, düşük; 23-32, orta; 33 ve üzeri, yüksek. Biz çalışmamızda SYNTAX puanını iki gruba ayırarak inceledik: 0-22 düşük, 23 ve üzeri orta -yüksek olarak tanımladık. SII ile düşük ve orta-yüksek grup arasındaki ilişkiyi inceledik. Bulgular: Akut koroner sendrom ile başvuran hastalarda sistemik immun inflamatuar indeks (SII) ile SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) skoru ile değerlendirilen koroner arter hastalığı yaygınlığı arasında istatiksel olarak anlamlı sonuç tespit edildi.(p=0,022) Sonuç: SII klinik olarak pratik bir yöntem olup akut koroner sendrom yaygınlığı ile ilgili biz klinisyenlere tedavi yaklaşımı açısından önemli ipuçları verebilir, ve bulduğumuz sonucun hasta tedavi yaklaşımına katkı sağlayacağı inancındayız. Yine de SII için daha derinlemesine ve iyi düzenlenmiş araştırmalara gereksinme duyulmaktadır.Article Ürik Asit-Albumin Oranı ile Kontrast Kaynaklı Nefropati ve Mortalite Arasındaki İlişki: Kronik Total Oklüzyon Olgularında Bir Değerlendirme(2025) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Özbek, Mehmet; Kılıç, Raif; Altunova, Mehmet; Evsen, AliAmaç: Koroner anjiyografi (CAG) uygulanan bireyler arasında, kronik koroner total oklüzyon (CTO) sık görülen bir lezyon tipini temsil etmekte olup genellikle perkütan koroner girişim (PCI) ile tedavi gerektirmektedir. PCI sonrasında, kontrast kaynaklı nefropati (CIN) sık rastlanan bir komplikasyon olup artmış morbidite ve mortaliteye katkıda bulunmaktadır. Ürik asit-albumin oranı (UAR), son dönemde olumsuz klinik sonuçlarla ilişkili yeni bir biyobelirteç olarak tanımlanmıştır. Bu çalışma, CTO hastalarında UAR’ın CIN ve uzun dönem mortalite açısından prognostik önemini belirlemeyi amaçlamıştır. Yöntemler: Bir veya daha fazla CTO lezyonu nedeniyle PCI uygulanan toplam 169 hasta retrospektif olarak değerlendirildi. Hastalar, CIN gelişimine göre iki gruba ayrıldı: CIN-pozitif (n = 27) ve CIN-negatif (n = 142). Bulgular: CIN (+) grubu, CIN (−) grupla karşılaştırıldığında anlamlı şekilde daha yüksek serum ürik asit düzeyleri, daha yüksek UAR değerleri ve artmış mortalite oranları gösterdi (tümü p < 0,001). Ayrıca, çok değişkenli regresyon analizi UAR’ı CIN için bağımsız bir prognostik gösterge olarak ortaya koydu (p = 0,012). UAR için 1,77 kesme değeri CIN’i %66,7 duyarlılık ve %62 özgüllük ile öngörürken, 1,90 kesme değeri uzun dönem mortaliteyi %64,5 duyarlılık ve %73,9 özgüllük ile tahmin etti. Kaplan–Meier sağkalım eğrilerine göre, CIN-pozitif gruptaki bireyler uzun dönem sağkalım açısından belirgin şekilde daha düşük ve tüm nedenlere bağlı ölüm sıklığı açısından daha yüksek bulundu (log-rank, p < 0,001). Sonuç: Artmış UAR, CTO hastalarında hem CIN’i hem de uzun dönem mortaliteyi bağımsız olarak öngörmüş olup, bu yüksek riskli popülasyonda prognostik önemini vurgulamaktadır.Article Citation - WoS: 2Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement(SAGE, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Kılıç, Raif; Günlü, Serhat; Demir, Muhammed; Ertaş, FarukAlthough 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.Article Citation - WoS: 3Citation - Scopus: 3The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome(ScienceDirect, 2023) Günlü, Serhat; Arpa, Abdulkadir; Kayan, Fethullah; Güzel, Tuncay; Kılıç, Raif; Aktan, Adem; Altintaş, Bernas; Karahan, Mehmet ZülkifBackground: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited. Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS. Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02-5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45-0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01-1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61-3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69-5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001). Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.
