Bozbeyoğlu, E. | Aslanger, E. | Yıldırımtürk, Ö. | Şimşek, B. | Karabay, C.Y. | Şimşek, M.A. | Kozan, Ö.

Article | 2018 | Annals of Noninvasive Electrocardiology23 ( 6 )

Background: It may sometimes be difficult to differentiate subtle ST-segment elevation (STE) due to anterior myocardial infarction (MI) from benign variant (BV) STE. Recently, two related formulas were proposed for this purpose. However, they have never been tested in an external population. Materials and methods: Consecutive patients from May 2017 to January 2018, who were admitted with the diagnosis of acute anterior STEMI, were enrolled. Electrocardiograms were systematically reviewed and only subtle ones were included. First 200 consecutive patients with noncardiac chest pain were also enrolled as a control group. Relevant elect . . .rocardiographic parameters were measured. Results: A total of 379 anterior MI and 200 BV-STE cases were enrolled during study period. A total of 241 patients in STEMI group were excluded for not matching subtleness criteria, four patients in control group were also excluded because of prior left-anterior descending artery intervention. The three-variable formula, with recommended cut-point of 23.5, had a sensitivity, specificity, and diagnostic accuracy of 73.9%, 86.7%, and 81.4%, respectively. The four-variable formula, with the published cut-point of 18.2, had a sensitivity, specificity, and diagnostic accuracy of 83.3%, 87.7%, and 85.9%, respectively. Conclusion: Three- and four-variable formulas with recommended cutoffs have a reasonable sensitivity, specificity, and diagnostic accuracy in differentiating subtle STEMI with BV-STE. Although both perform well, the four-variable formula has a higher sensitivity, specificity, and diagnostic accuracy and should be preferred. © 2018 Wiley Periodicals, Inc Daha fazlası Daha az

Bozbeyoğlu, E. | Aslanger, E. | Yıldırımtürk, Ö. | Şimşek, B. | Karabay, C.Y. | Türer, A. | Değertekin, M.

Article | 2018 | Journal of Electrocardiology51 ( 6 ) , pp.1055 - 1060

Background: In a minority of the patients presenting with ST-segment elevation (STE) myocardial infarction (MI), electrocardiogram (ECG) may show a balanced STE in both anterior and inferior lead groups and may cause diagnostic confusion about involved myocardial territory. In this study, we sought ECG clues which may facilitate discriminating (1) MI location and then (2) culprit artery in patients with difficult-to-discern ECGs. Material and methods: Consecutive patients with the diagnosis of STEMI were scanned and patients with ECGs displaying both anterior and inferior STE were enrolled. ECGs with obvious ST elevation in either l . . .ead group and reciprocal ST-segment depression were excluded. Predictive power of several ECG variables has been analyzed and an algorithm has been constructed. Results: A total of 959 STEMI cases were scanned, the final study population was consisted of 114 patients. Our algorithm for locating MI territory had a sensitivity, specificity, positive and negative predictive value of 72.1%, 92.5%, 91.7% and 74.2% for inferior versus anterior location, respectively (P < 0.001, ? = 0.652). As anterior MI was strictly reserved for left anterior descending (LAD) artery occlusion, these diagnostic values were also valid for discriminating circumflex artery [Cx]/right coronary artery [RCA] versus LAD as the culprit artery. In patients classified as having inferior MI, an STE in lead III greater than STE in lead II favored RCA over Cx as the culprit artery with a sensitivity, specificity, positive and negative predictive value of 97%, 46.6%, 80% and 87.5%, respectively (P < 0.001; ? = 0.544). Conclusion: Our algorithm can be used in difficult-to-discern ECGs for defining involved myocardial territory and culprit artery. © 2018 Elsevier Inc Daha fazlası Daha az

Simsek, M.A. | Degertekin, M. | Turer Cabbar, A. | Aslanger, E. | Ozveren, O. | Aydin, S. | Erol, C.

Article | 2018 | Biomarkers in Medicine12 ( 10 ) , pp.1073 - 1081

Aim: We investigated the relationship between NT-ProBNP and mortality in a general population-based cohort. Methods & Results: A total of 2021 out of 4650 participants from previously published HAPPY study were included. Mean follow-up was 84.5 ± 10.4 months. After adjusting for risk factors, high levels of LogNT-proBNP predicted all-cause death (HR: 3.23; 95% CI: 2.20-4.75; p < 0.001) and cardiovascular death (HR: 3.85; 95% CI: 2.37-6.26; p < 0.001). Regression analysis revealed that LogNT-proBNP was an independent predictor of all-cause death (HR: 2.85; 95% CI: 1.91-4.24; p < 0.001) and cardiovascular death (HR: 3.02; 95% CI: 1.84 . . .-4.95; p < 0.001). Conclusion: Our study showed that in long term follow-up, NT-proBNP is associated with increased all-cause and cardiovascular mortalit. © 2018 2018 Future Medicine Ltd Daha fazlası Daha az

Aslanger, E. | Yıldırımtürk, Ö. | Bozbeyoğlu, E. | Şimşek, B. | Karabay, C.Y. | Türer Cabbar, A. | Değertekin, M.

Article | 2018 | American Journal of Cardiology122 ( 8 ) , pp.1303 - 1309

Benign variant (BV) ST-segment elevation (STE) is present in anterior chest leads in most individuals and may cause diagnostic confusion in patients presenting with chest pain. Recently, 2 regression formulas were proposed for differentiation of BV-STE from anterior ST-elevation myocardial infarction (MI) on the electrocardiogram, computation of which is heavily device-dependent. We hypothesized that a simpler visual-assessment-based formula, namely (R-wave amplitude in lead V4 + QRS amplitude in V2) – (QT interval in millimeters + STE60 in V3), will be noninferior to these formulas. Consecutive cases of proven left anterior descend . . .ing occlusion were reviewed, and those with obvious ST elevation MI were excluded. First 200 consecutive patients with noncardiac chest pain and BV-STE were also enrolled as a control group. Relevant electrocardiographic parameters were measured. There were 138 anterior MI and 196 BV-STE cases. Our simple formula was superior to the 3- and noninferior to the 4-variable formulas. This new practical formula had an excellent area-under curve of 0.963 (95% confidence interval, 0.946 to 0.980, Daha fazlası Daha az