ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 24 (1)
Volume: 24  Issue: 1 - July 2020
1.New editors, COVID-19, TURKMI, ATA study, and more
Çetin Erol
PMID: 32628150  doi: 10.14744/AnatolJCardiol.2020.7  Page 1
Abstract |Full Text PDF

2.The ISCHEMIA trial: Implications for non-invasive imaging
Amina Rakisheva, Mohamed Marwan, Stephan Achenbach
PMID: 32628146  doi: 10.14744/AnatolJCardiol.2020.82428  Pages 2 - 6
Coronary artery disease (CAD) is highly prevalent and constitutes the single most common cause of death worldwide. However, the diagnosis of CAD remains challenging. There are two ways to approach the diagnosis of CAD, namely (1) by a functional non-invasive stress test to detect ischemia (stress echocardiography, stress cardiovascular magnetic resonance, single-photon emission computed tomography, positron emission tomography) or (2) by imaging for stenosis visualization (coronary computed tomography angiography or invasive coronary angiography). There are also two approaches for treatment: medical treatment and revascularization. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial investigated the outcome differences of patients who had moderate to severe ischemia on stress testing and who, after CT angiography, had ruled out left main stenosis and demonstrated at least 1 coronary artery stenosis exceeding 50%. The patients were randomized to an initially conservative treatment versus immediate revascularization. No difference in hard outcomes was found, but angina relief was more effective in the revascularization group. In this article, we explore the implications of the ISCHEMIA trial for non-invasive testing in suspected CAD.

3.Emerging mechanisms for the new coronavirus-related myocardial injury and ischemia: A review of the literature
Farbod Hatami, Niloufar Valizadeh, Mohammad Mostafa Ansari Ramandi
doi: 10.14744/AnatolJCardiol.2020.68166  Pages 7 - 12
A history of cardiovascular comorbidity or experiencing acute cardiac injury during the coronavirus disease 2019 is accompanied by a poor prognosis. Also, it seems myocardial ischemia (or infarction) accounts for a major part of the cardiac involvement observed in this disease. Therefore, particular consideration is needed to protect the cardiovascular system during this pandemic. The gaps highlighted in this review are an issue to be explored through future research.

4.Evaluation and follow-up of pediatric COVID-19 in terms of cardiac involvement: A scientific statement from the Association of Turkish Pediatric Cardiology and Pediatric Cardiac Surgery
Gülendam Koçak, Yakup Ergul, Kemal Nişli, Ali Can Hatemi, Ercan Tutar, Niyazi Kürşad Tokel, Ahmet Celebi
PMID: 32628134  doi: 10.14744/AnatolJCardiol.2020.36559  Pages 13 - 18
Abstract |Full Text PDF

5.Blocking angiotensin earlier with RAS blockers, statins, and heparin in high-risk COVID-19 patients: Is the remedy here?
Imdat Eroğlu, Burcu Çelik Eroğlu, Oğuz Abdullah Uyaroğlu, Gülay Sain Güven
PMID: 32628145  doi: 10.14744/AnatolJCardiol.2020.73232  Pages 19 - 20
Abstract |Full Text PDF

6.Association between chronic ACE inhibitor exposure and decreased odds of severe disease in patients with COVID-19
Naci Şenkal, Rasimcan Meral, Alpay Medetalibeyoğlu, Hilal Konyaoğlu, Murat Kose, Tufan Tukek
PMID: 32628137  doi: 10.14744/AnatolJCardiol.2020.57431  Pages 21 - 29
Objective: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Renin-angiotensin-aldosterone-system (RAAS) inhibitors may increase the expression of angiotensin-converting enzyme 2, which is the receptor for SARSCoV-2 Spike protein. The consequences of using angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) during the COVID-19 pandemic are unknown.
Methods: A retrospective cohort study aiming to identify the odds of severe disease (defined as either hospitalization of ≥14 days, admission to the intensive care unit, or death) associated with exposure to ACEi or ARB was conducted. Adult patients (age ≥18 years) with COVID-19 admitted to the İstanbul Faculty of Medicine Corona Center between March 9 and May 11, 2020, were included. Chronic users of ACEi, ARB, or other antihypertensive drugs were matched according to age, sex, sick days before hospitalization, comorbidities, smoking, number of antihypertensive regimens, doxazosin use, furosemide use, and serum creatinine level. Odds ratios (OR) of having severe disease were calculated.
Results: In total, 611 patients were admitted with COVID-19, confirmed by either reverse-transcriptase polymerase chain reaction or computed tomography (CT). There were 363 males, and the age ranged from 18 to 98 years, with an average age of 57±15 years. Of these, 165 participants had severe disease (53 deaths, case fatality rate: 8.7%). Among those with hypertension (n=249), ARB exposure was compatible with decreased odds (OR=0.60, 95% CI: 0.27–1.36, p=0.31) of severe disease though not statistically significant, while ACEi exposure significantly reduced the risk of severe disease (OR=0.37, 95% CI: 0.15–0.87, p=0.03). ACEi exposure was associated with milder infiltrations seen on baseline CT, lower C-reactive protein and ferritin, higher monocytes, shorter hospitalization, and less requirement for specific empirical treatments (favipiravir and meropenem).
Conclusion: Our data suggest that exposure to ACEi drugs may have favorable effects in the context of COVID-19 pneumonia.

7.Renin–angiotensin system inhibition in COVID-19 patients: Friend or foe?
Bilgehan Karadağ
PMID: 32628135  doi: 10.14744/AnatolJCardiol.2020.40771  Pages 30 - 31
Abstract |Full Text PDF

8.Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction: The ATA study
Umut Kocabaş, Tarık Kıvrak, Gülsüm Meral Yılmaz Öztekin, Veysel Ozan Tanık, Ibrahim Halil Özdemir, Ersin Kaya, Elif Ilkay Yüce, Fulya Avcı Demir, Mustafa Doğduş, Meltem Altınsoy, Songül Üstündağ, Ferhat Özyurtlu, Uğur Karagöz, Alper Karakuş, Örsan Deniz Urgun, Ümit Yaşar Sinan, Inan Mutlu, Taner Şen, Mehmet Ali Astarcıoğlu, Mustafa Kınık, Özge Özden Tok, Begüm Uygur, Mehtap Yeni, Bahadır Alan, Onur Dalgıç, Çağla Sarıtürk, Hakan Altay, Seçkin Pehlivanoğlu
PMID: 32628147  doi: 10.14744/AnatolJCardiol.2020.91771  Pages 32 - 40
Objective: Despite recommendations from heart failure guidelines on the use of pharmacologic and device therapy in patients with heart failure with reduced ejection fraction (HFrEF), important inconsistencies in guideline adherence persist in practice. The aim of this study was to assess adherence to guideline-directed medical and device therapy for the treatment of patients with chronic HFrEF (left ventricular ejection fraction ≤40%).
Methods: The Adherence to guideline-directed medical and device Therapy in outpAtients with HFrEF (ATA) study is a prospective, multicenter, observational study conducted in 24 centers from January 2019 to June 2019.
Results: The study included 1462 outpatients (male: 70.1%, mean age: 67±11 years, mean LVEF: 30%±6%) with chronic HFrEF. Renin–angiotensin system (RAS) inhibitors, beta-blockers, mineralocorticoid receptor antagonists (MRAs), and ivabradin were used in 78.2%, 90.2%, 55.4%, and 12.1% of patients, respectively. The proportion of patients receiving target doses of medical treatments was 24.6% for RAS inhibitors, 9.9% for beta-blockers, and 10.5% for MRAs. Among patients who met the criteria for implantable cardioverter–defibrillator (ICD) and cardiac resynchronization therapy (CRT), only 16.9% of patients received an ICD (167 of 983) and 34% (95 of 279) of patients underwent CRT (95 of 279).
Conclusion: The ATA study shows that most HFrEF outpatients receive RAS inhibitors and beta-blockers but not MRAs or ivabradin when the medical reasons for nonuse, such as drug intolerance or contraindications, are taken into account. In addition, most eligible patients with HFrEF do not receive target doses of pharmacological treatments or guideline-recommended device therapy.

9.Heart failure guidelines implementation: Lifting barriers using registries and networks
Kalliopi Keramida, Gerasimos Filippatos
PMID: 32628142  doi: 10.14744/AnatolJCardiol.2020.62747  Pages 41 - 42
Abstract |Full Text PDF

10.Baseline clinical characteristics and patient profile of the TURKMI registry: Results of a nation-wide acute myocardial infarction registry in Turkey
Mustafa Kemal Erol, Meral Kayıkçıoğlu, Mustafa Kılıçkap, Can Baba Arın, Ibrahim Halil Kurt, Ibrahim Aktaş, Yılmaz Güneş, Eyüp Özkan, Taner Şen, Orhan Ince, Ender Örnek, Ramazan Asoğlu, Nesim Aladağ, Utku Zeybey, Ümit Yaşar Sinan, Muhammet Dural, Haşim Tüner, Arda Doğan, Mustafa Yenerçağ, Mehmet Akboğa, Onur Sinan Deveci, Mustafa Umut Somuncu
PMID: 32628144  doi: 10.14744/AnatolJCardiol.2020.69696  Pages 43 - 53
Objective: The TURKMI registry is designed to provide insight into the characteristics, management from symptom onset to hospital discharge, and outcome of patients with acute myocardial infarction (MI) in Turkey. We report the baseline and clinical characteristics of the TURKMI population.
Methods: The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of percutaneous coronary intervention selected from each EuroStat NUTS region in Turkey according to population sampling weight, prioritized by the number of hospitals in each region. All consecutive patients with acute MI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018 and November 16, 2018.
Results: A total of 1930 consecutive patients (mean age, 62.0±13.2 years; 26.1% female) with a diagnosis of acute MI were prospectively enrolled. More than half of the patients were diagnosed with non-ST elevation MI (61.9%), and 38.1% were diagnosed with ST elevation MI. Coronary angiography was performed in 93.7% and, percutaneous coronary intervention was performed in 73.2% of the study population. Fibrinolytic therapy was administered to 13 patients (0.018%). Aspirin was prescribed in 99.3% of the patients, and 94% were on dual antiplatelet therapy at the time of discharge. Beta blockers were prescribed in 85.0%, anti-lipid drugs in 96.3%, angiotensin converting enzyme inhibitors in 58.4%, and angiotensin receptor blockers in 7.9%. Comparison with European countries revealed that TURKMI patients experienced MI at younger ages compared with patients in France, Switzerland, and the United Kingdom. The most prevalent risk factors in the TURKMI population were hypercholesterolemia (60.2%), hypertension (49.5%), smoking (48.8%), and diabetes (37.9%).
Conclusion: The nation-wide TURKMI registry revealed that hypercholesterolemia, hypertension, and smoking were the most prevalent risk factors. TURKMI patients were younger compared with patients in European Countries. The TURKMI registry also confirmed that current treatment guidelines are largely adopted into clinical cardiology practice in Turkey in terms of antiplatelet, anti-ischemic, and anti-lipid therapy.

11.Percutaneous closure of pseudoaneurysm of the descending thoracic aorta with septal device occlusion technique
Omer Celik, Ahmet Anil Sahin, Mehmet Erturk
PMID: 32628139  doi: 10.14744/AnatolJCardiol.2020.59251  Pages 54 - 56
Abstract |Full Text PDF

12.A novel technique for treating visceral artery pseudoaneurysm: Selective arterial embolization with cut-inflateddeflated balloon
Yusuf Can, İbrahim Kocayiğit
PMID: 32628140  doi: 10.14744/AnatolJCardiol.2020.59507  Pages 56 - 59
Abstract |Full Text PDF | Video

13.An unusual case of cardiac lymphoma diagnosed using computed tomographyguided percutaneous transthoracic biopsy
Gokhan Yuce, Ali Coskun
PMID: 32628149  doi: 10.14744/AnatolJCardiol.2020.95079  Pages 59 - 61
Abstract |Full Text PDF

14.Prognostic value of carotid intima-media thickness
Aykun Hakgor, Berhan Keskin, Seda Tanyeri, Ozgur Yasar Akbal, Ali Karagöz
PMID: 32628133  doi: 10.14744/AnatolJCardiol.2020.31777  Page 62
Abstract |Full Text PDF

15.Author`s Reply
Ali Elitok, Samim Emet
PMID: 32628151  Pages 62 - 63
Abstract |Full Text PDF

16.Response to: Percutaneous closure of a secundum atrial septal defect through femoral approach in an adult patient with interrupted inferior vena cava and azygos continuation
Umberto Geremia Rossi, Anna Maria Ierardi, Maurizio Cariati
PMID: 32628141  doi: 10.14744/AnatolJCardiol.2020.61168  Pages 63 - 64
Abstract |Full Text PDF

17.Author`s Reply
Elnur Alizade, Ahmet Karaduman, İsmail Balaban, Berhan Keskin, Semih Kalkan
PMID: 32628152  Pages 64 - 65
Abstract |Full Text PDF

18.Multimodality imaging of asymptomatic huge floating thrombus in the thoracic aorta
Murat Akcay, İlkay Camlıdag
PMID: 32628136  doi: 10.14744/AnatolJCardiol.2020.56581  Page E1
Abstract |Full Text PDF | Video

19.Rapid growth of right sinus Valsalva aneurysm dissecting into interventricular septum
Hsiao Chun Chen, Ming Hsiung, I-Chen Chen, Jeng Wei
PMID: 32628148  doi: 10.14744/AnatolJCardiol.2020.92566  Pages E2 - E3
Abstract |Full Text PDF | Video

20.Lung carcinoma extended to the left atrium through the right inferior pulmonary vein
Manying Xie, Wenqian Wu, Qing LV, Yu Wang
PMID: 32628138  doi: 10.14744/AnatolJCardiol.2020.58019  Pages E3 - E4
Abstract |Full Text PDF | Video

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