Browsing by Author "Engin, Mesut"
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Publication Investigation of the effects of stress hyperglycemia ratio and preoperative computed tomographic angiography on the occurrence of acute kidney injury in diabetic patients following surgical thromboembolectomy(MDPI, 2023-02-01) Güvenç, Orhan; Engin, Mesut; Ata, Filiz; Yavuz, Şenol; GÜVENÇ, ORHAN; Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı; 0000-0003-1072-1269; ACJ-3462-2022Acute lower extremity ischemia (ALI) is a cardiovascular emergency resulting from embolic and thrombotic causes. Although endovascular techniques have advanced, surgical thromboembolectomy is still the gold standard. Emergency thromboembolectomy surgery involves an ischemia-reperfusion injury, which also poses a risk for acute renal injury (AKI). The stress hyperglycemia rate (SHR) has recently emerged as an important prognostic value in emergency cardiovascular events. In the present study, we aimed to analyze the impact of preoperative contrast-enhanced tomographic angiography (CTA) and the SHR value on postoperative AKI in emergency thromboembolectomy procedures in patients with insulin-dependent diabetes mellitus (DM). In this retrospective analysis, patients with DM who received emergency surgical thromboembolectomy after being hospitalized at our hospital with ALI between 20 October 2015, and 10 September 2022, were included. Patients were classified into two groups: Group 1 (N = 159), who did not develop AKI, and Group 2 (N = 45), who did. The 45 patients in Group 2 and the 159 patients in Group 1 had median ages of 59 (39-90) and 66 (37-93), respectively (p = 0.008). The percentage of patients in Group 2 with Rutherford class IIB and admission times longer than 6 h was higher (p = 0.003, p = 0.027, respectively). To determine the variables affecting AKI after surgical embolectomy procedures, multivariate logistic regression analysis was used. In multivariate analysis Model 1, age > 65 years (odds ratio [OR]: 1.425, 95% confidence interval [CI]: 1.230-1.980, p < 0.001), preoperative high creatinine (OR: 4.194, 95% CI: 2.890-6.156, p = 0.003), and Rutherford class (OR: 0.874, 95% CI: 0.692-0.990, p = 0.036) were determined as independent predictors for AKI. In Model 2, age > 65 years (OR: 1.224 CI: 1.090-1.679, p = 0.014), preoperative high creatinine (OR: 3.975, 95% CI: 2.660-5.486, p = 0.007), and SHR (OR: 2.142, CI: 1.134-3.968, p = 0.003), were determined as independent predictors for amputation. In conclusion, when an emergency thromboembolectomy operation is planned in insulin-dependent DM patients, renal risky groups can be identified, and renal protective measures can be taken. In addition, to reduce the renal risk, according to the suitability of the clinical conditions of the patients, the decision to perform a CTA with contrast can be taken by looking at the SHR value.Item Investigation of the predictive values of triglyceride/HDL cholesterol ratio and whole blood viscosity with regard to severe peripheral or carotid artery disease in patients scheduled for coronary bypass(Forum Multimedia Publishing, 2020-04-21) Engin, Mesut; Güvenç, Orhan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; CRT-9383-2022; 57215931601Background: The incidence of atherosclerotic cardiovascular diseases, which constitute an important disease group, is expected to rise with increasing life expectancy. The aim of this study was to investigate the predictive values of triglyceride/HDL cholesterol (TG/HDL-C) ratio and whole blood viscosity on possible severe carotid or peripheral arterial disease in patients who were admitted to our clinic and scheduled for coronary artery bypass graft (CABG) surgery. Methods: This study retrospectively examined 299 patients who were admitted to our clinic and scheduled for CABG between August 1, 2015, and August 1, 2019. Patients with severe carotid or peripheral arterial disease were included in group 2; those in whom peripheral arterial disease and stenosis were not detected were included in group 1. Results: Group 1 consisted of 255 patients, mean (+/- standard deviation) age 58.1 +/- 8.9 years; the 44 patients in group 2 had a mean age of 64.1 +/- 10.6 years (P = .018). The incidence of diabetes mellitus and tobacco use were significantly higher in group 2 (P < .001 and P = .034, respectively). Triglyceride values, TG/HDL-C, and whole blood viscosity at high and low shear rates were significantly higher in group 2 (P = .017, P < .001, P < .001, and P < .001, respectively). Receiver operator characteristic analysis revealed that the cutoff value of TG/HDL-C was 3.2 with 77% sensitivity and 72% specificity; that of high-shear-rate viscosity was 16.1 with 73% sensitivity and 69% specificity; and that of low-shear-rate viscosity was 59.2 with 70% sensitivity and 63% specificity. Conclusion: It is possible to predict severe additional arterial diseases in patients scheduled for CABG with whole blood viscosity and TG/HDL-C ratios, both of which can be obtained with simple blood tests.Item Is it possible to predict the complexity of peripheral artery disease with atherogenic index?(Sage Publications, 2020-10) Engin, Mesut; Aydın, Cihan; Güvenç, Orhan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı.; 0000-0003-4809-6139; GRY-5535-2022; 57216829797Objectives: Lower extremity peripheral artery disease develops mainly due to atherosclerosis and occurs as a result of the systemic atherosclerotic process. Increased triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C) values increase atherosclerosis risk. With regard to this information, TG/HDL-C ratio is used as the atherogenic index. The aim of the present study was to evaluate the role of TG/HDL-C ratio to predict the complexity of disease in patients with peripheral artery disease. Methods: Patients who were diagnosed with peripheral artery disease and admitted to our clinic between August 2013 and August 2019 were included in this study retrospectively. Patients were divided into two groups based on angiographic evaluations with TransAtlantic Inter-Society Consensus-II classification. Those with TASC A-B lesions were included in Group 1 and those with TASC C-D lesions constituted Group 2. Results: The mean ages of Group 1 (n = 314) and Group 2 (n = 98) patients were 56.1 ± 9.3 and 58.4.1 ± 8.1 years, respectively. The frequency of male gender and coronary artery disease was significantly higher in Group 2 (p = 0.043, p = 0.001, respectively). In Group 2, triglyceride and TG/HDL-C ratios were significantly high, while HDL-C was significantly low (p = 0.022, p < 0.001, p = 0.010, respectively). The multivariate logistic regression analysis performed to evaluate the parameters in predicting the angiographic complexity of peripheral artery disease showed that coronary artery disease (OR: 1.009 CI 95%: 1.003–1.021 p = 0.016) and TG/HDL-C ratio (OR: 5.385 CI 95%: 2.553–9.357 p = 0.001) were independent predictors for complexity. ROC analysis revealed that the cut-off value of TG/HDL-C was 2.9 (AUC = 0.670, p < 0.001) with 75.5% sensitivity and 56.7% specificity. Conclusions: It is possible to predict the angiographic complexity of peripheral artery disease with TG/HDL-C ratio, also known as atherogenic index, which is easily obtained by routine biochemical parameters.Publication Predictive value of hatch scoring and waist-to-height ratio in atrial fibrillation following coronary artery bypass operations performed with cardiopulmonary bypass(Digital Commons Bepress, 2021-01-01) Savran, Muhammed; Engin, Mesut; Güvenç, Orhan; Yüksek, Hasan F.; Sunbül, Sadık Ahmet; Türk, Tamer; Ata, Yusuf; Aydın, Ufuk; Özyazıcıoğlu, Ahmet F.; GÜVENÇ, ORHAN; Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı; ACJ-3462-2022Objectives: Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations.Methods: Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively.Results: A total of 255 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 196, mean age = 58.9 +/- 9.4 years), and those who did were included in Group 2 (n = 59, mean age = 61.1 +/- 12 years). There were no statistically significant differences between the two groups in terms of age, gender, presence of hypertension and hyperlipidemia. Rates of chronic obstructive pulmonary disease and previous percutaneous coronary interventions, waist circumference, waist to height ratio and HATCH score values were significantly higher in Group 2 compared to Group 1 (p values: 0.019, 0.034, 0.001, <0.001, <0.001, respectively). In multivariate analysis, WHR (Odds ratio: 1.068, Confidence interval: 1.032-1.105, p < 0.001) and HATCH score (Odds ratio: 2.590, Confidence interval: 1.850-3.625, p < 0.001) were independent predictors of PoAF.Conclusions: With this current prospective study, we showed that calculating WHR and HATCH score in the preoperative period can help us predict PoAF.Publication Spontaneous regression of the abdominal aortic aneurysm in a middle age female patient(Sage Publications, 2020-03-25) Engin, Mesut; Güvenç, Orhan; Göncü, Mehmet Tuğrul; GÜVENÇ, ORHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı.; ACJ-3462-2022IntroductionAbdominal aortic aneurysm is an important cardiovascular disease affecting especially the elderly. Early diagnosis of this disease is particularly important for treatment success. Spontaneous regression of aneurysms has rarely been reported in the literature.MethodsA 63-year-old female patient was admitted to the internal medicine outpatient clinic with abdominal pain three years ago. A urinary ultrasonography was requested, which revealed no urinary pathology, but an abdominal aortic aneurysm of 5 cm. There were no pathological findings in routine blood tests and physical examination of the patient. Contrast-enhanced computed tomographic angiography showed an infrarenal Abdominal aortic aneurysm of approximately 4.30 x 3.24 cm. Three years later, the patient had come to the hospital for check-up with no complaints. In control computed tomographic angiography, the aneurysm was found to have regressed almost completely (2 x 2.15 cm).Results and ConclusionIn this case report, to the best of our knowledge, we aimed to share the first spontaneous regression of an abdominal aortic aneurysm in a patient without any systemic disease or use of immunosuppressive medication.Publication The importance of prognostic nutritional index in predicting acute renal failure after on-pump coronary artery bypass operations in patients with insulin-dependent diabetes mellitus(Forum Multimedia Publishing, 2021-02-05) Gücü, Arif; Özlük, Özlem Arıcan; Güvenç, Orhan; Sünbül, Sadık Ahmet; Engin, Mesut; GÜVENÇ, ORHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalları.; ACJ-3462-2022Background: After coronary artery bypass graft (CABG) operations, acute kidney injury (AKI) appears at 5-30% rates, and this rate increases even more in patients with diabetes mellitus (DM). Prognostic nutritional index (PNI) is known as a valuable parameter that affects cardiovascular surgery outcomes. In this current study, we aimed to investigate the importance of PNI value in predicting AKI after on-pump CABG operations in insulin-dependent diabetic patients.Methods: A total of 254 consecutive patients with insulin-dependent diabetes who underwent on-pump CABG in our clinic between January 2016 and January 2020 retrospectively were included in this study. In the postoperative period, patients were registered as the renal failure group (Group 1), and those who did not develop renal failure were registered as Group 2.Results: A total of 255 patients with DM were included in the study. There were 82 patients in Group 1 and 173 patients in Group 2. There was no difference between the groups, in terms of age, gender, smoking, and hyperlipidemia rates. Hypertension rate significantly was higher in Group 2 (P = .001). In multivariate logistic regression analysis, hypertension (OR: 1.226, 95% CI: 1.114-2.459, P = .026), need for inotropic support (OR: 1.128, 95% CI: 1.070-1.784, P = .033), increased blood product use (OR: 1.291, 95% CI: 1.112-2.156, P =.021) preoperative high creatinine (OR: 3.563, 95% CI: 2.497-5.559, P < .001), and PNI (OR: 1.327, 95% CI: 1.118-2.785, P = .012) were independent predictors of AKI.Conclusion: In our study, we determined PNI value as an independent predictor in predicting acute renal injury occurring after on-pump CABG operations in patients with insulin-dependent DM.Publication The roles of liver fibrosis scores and modified stress hyperglycemia ratio values in predicting contrast-induced nephropathy after elective endovascular infrarenal abdominal aortic aneurysm repair(Mdpi, 2023-03-01) Engin, Mesut; Ata, Filiz; Yavuz, Şenol; Güvenç, Orhan; GÜVENÇ, ORHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; 0000-0003-1072-1269; ACJ-3462-2022Endovascular aortic repair (EVAR) methods are higher preferred for the treatment of patients with abdominal aortic aneurysms (AAAs). Various markers, including the neutrophil-lymphocyte ratio, have been used to predict the risk of contrast-induced nephropathy (CIN). In this study, we aimed to investigate the role of fibrosis-4 score (FIB-4), aspartate transaminase to platelet ratio index (APRI), and modified stress hyperglycemia ratio (mSHR) values in predicting CIN. Patients who had undergone elective endovascular infrarenal abdominal aortic aneurysm repair in our clinic between January 2015 and January 2022 were included in this retrospective study. Patients who did not develop contrast-induced nephropathy after the procedure were identified as Group 1, and those who did were referred to as Group 2. A total of 276 patients were included in the study. The two groups were similar in terms of age, gender, body mass index, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, hyperlipidemia, and left ventricular ejection fraction. In Group 2, the FIB-4 score, APRI, and mSHR values were significantly higher (p = 0.008, p < 0.001, and p < 0.001, respectively). In Group 2, the contrast volume and number of packed blood products used (median 1 (1-4) vs. 2 (1-5)) were significantly higher (p = 0.003 and p = 0.012, respectively). In this study, we demonstrated that we may predict the risk of CIN development with preoperatively calculated, noninvasive liver fibrosis scores and mSHR.Publication Visceral adiposity index and prognostic nutritional index in predicting atrial fibrillation after on-pump coronary artery bypass operations: A prospective study(Soc Brasil Cirurgia Cardiovasc, 2021-01-01) Engin, Mesut; Özşin, Kadir Kaan; Savran, Muhammed; Güvenç, Orhan; Yavuz, Şenol; Özyazıcıoğlu, Ahmet Fatih; GÜVENÇ, ORHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı.; ACJ-3462-2022Introduction: Rhythm problems are the most observed complications following coronary artery bypass grafting (CABG), the most common being postoperative atrial fibrillation (PoAF), with an incidence reaching 50% of the patients. In this study, we aimed to investigate the predictive importance of prognostic nutritional index (PNI) and visceral adiposity index (VAI) in predicting PoAF, which occurs after CABG accompanied by cardiopulmonary bypass.Methods: Patients who underwent isolated CABG with cardiopulmonary bypass between June 15 and October 15, 2019, were prospectively included in the study. Patients who did not develop in-hospital PoAF were identified as Group 1, and those who did constituted Group 2.Results: PoAF developed in 55 (27.6%) patients (Group 2). The mean age of the 144 patients included in Group 1 and 55 patients in Group 2 were 56.9 +/- 8.7 and 64.3 +/- 10.2 years, respectively (P<0.001). In multivariate analysis Model 1, age (odds ratio [OR]: 1.084, confidence interval [CI]: 1.010-1.176, P=0.009), chronic obstructive pulmonary disease (OR: 0.798, CI: 0.664-0.928, P=0.048), and PM (OR: 1.052, CI: 1.015-1.379, P=0.011) were determined as independent predictors for PoAF. In Model 2, age (OR: 1.078, CI: 1.008-1.194, P=0.012), lymphocyte counts (OR: 0.412, CI: 0.374-0.778, P=0.032), and VAI (OR: 1.516, CI: 1.314-2.154, P<0.001) were determined as independent predictors for PoAF.Conclusion: In this study, we determined that low PNI, a simply calculable and cheap parameter, along with high VAI were risk factors for PoAF.