Browsing by Author "Akar, Ahmet Ruchan"
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Item Effects of preoperative short term use of atorvastatin on endothelial progenitor cells after coronary surgery: A randomized, controlled trial(Humana Press, 2012-09) Baran, Çağdaş; Durdu, Serkan; Dalva, Klara; Zaim, Çağın; Doğan, Arin; Gürman, Günhan; Arslan, Önder; Akar, Ahmet Ruchan; Ocakoğlu, Gökhan; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; AAH-5180-2021; 15832295800We investigated the effects of short-term use of atorvastatin on CD34+/VEGF-R2+/CD133+/CD45- endothelial progenitor cell (EPC) count after on-pump coronary artery bypass surgery (CABG). Between Feb-2010 and May-2010, we randomly assigned, in a placebo-controlled, double-blind study, 60 consecutive patients who underwent isolated, first-time CABG to receive either 14-day atorvastatin (40 mg/day) or placebo preoperatively. Urgent CABG and recent myocardial infarction were excluded. EPCs were quantified (cells/mu l) by flow cytometric phenotyping obtained from venous blood samples collected preoperatively (T-1), 6-hours (T-2), and on the 5th day postoperatively (T-3). Levels of markers of inflammation and serum cardiac troponin I were also measured preoperatively and daily until day-5 after surgery. There were no differences in baseline risk factors including cholesterol profiles, and EuroSCORES between the groups. The composite primary end-point, favored statin group with higher amount of circulating, early EPC count (cells/mu l) at all time points compared with placebo (T-1, 2.30 +/- 0.02 versus 1.58 +/- 0.03, p < 0.001; T-2, 5.00 +/- 0.06 versus 2.19 +/- 0.06, p < 0.001; T-3, 3.03 +/- 0.08 versus 1.78 +/- 0.02, p < 0.001). Postoperative hsCRP rise were inversely correlated with EPC count, and were significantly lower in the statin group (T-1, 0.8 +/- 0.1 versus 2.2 +/- 1.5, p < 0.001; T-2, 72.9 +/- 3.2 versus 96.0 +/- 3.6, p < 0.001; T-3, 4.3 +/- 1.2 versus 11.4 +/- 4.1, p < 0.001). Furthermore, the incidence of postoperative atrial fibrillation was significantly lower in the statin group compared to placebo (3.3% versus 23%, p = 0.02). Short-term atorvastatin use increases circulating early EPCs both pre- and post-operatively and is associated with better preservation of sinus rhythm and reduced hsCRP levels.Publication Raising the bar to ultradisciplinary collaborations in management of chronic thromboembolic pulmonary hypertension(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2021-07-01) Akay, Tankut; Kaymaz, Cihangir; Akar, Ahmet Ruchan; Orhan, Gokcen; Yanartas, Mehmed; Gultekin, Bahadir; Sirlak, Mustafa; Kervan, Umit; Tas, Serpil Gezer; Yagdi, Tahir; Ispir, Selim; Dogan, Riza; Bicer, Murat; BİÇER, MURAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyovasküler Cerrahi.Chronic thromboembolic pulmonary hypertension is an underdiagnosed and potentially fatal subgroup of pulmonary hypertension, if left untreated. Clinical signs include exertional dyspnea and non-specific symptoms. Diagnosis requires multimodality imaging and heart catheterization. Pulmonary endarterectomy, an open heart surgery, is the gold standard treatment of choice in selected patients in specialized centers. Targeted medical therapy and balloon pulmonary angioplasty can be effective in high-risk patients with significant comorbidities, distal pulmonary vascular obstructions, or recurrent/persistent pulmonary hypertension after pulmonary endarterectomy. Currently, there is a limited number of data regarding novel coronavirus-2019 infection in patients with chronic thromboembolic pulmonary hypertension and the changing spectrum of the disease during the pandemic. Challenging times during this outbreak due to healthcare crisis and relatively higher case-fatality rates require convergence; that is an ultradisciplinary collaboration, which crosses disciplinary and sectorial boundaries to develop integrated knowledge and new paradigms. Management strategies for the "new normal" such as virtual care, preparedness for further threats, redesigned standards and working conditions, reevaluation of specific recommendations, and online collaborations for optimal decisions for chronic thromboembolic pulmonary hypertension patients may change the poor outcomes.