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Öğe Cut-off value for interleukin-34 as an additional potential inflammatory biomarker for estimation of slow coronary flow risk(Bmc, 2024) Karasu, Mehdi; Bolayir, Hasan AtaBackground Inflammatory markers may provide insights into the underlying mechanisms of slow coronary flow (SCF), including subclinical atherosclerosis and endothelial dysfunction. Interleukin-34 (IL-34), known for its role in immuno-inflammatory diseases, might hold significance in SCF. We aimed to explore the potential association between IL-34 and SCF in patients undergoing diagnostic elective coronary angiography.Methods This observational, cross-sectional study enrolled 256 participants: 124 with SCF and 132 with normal coronary flow (NCF). All participants had undergone outpatient coronary angiography for suspected coronary artery disease. SCF assessment employed the TIMI frame count (TFC) for quantifying coronary flow rate.Results SCF patients exhibited significantly elevated TFC in all three major coronary arteries compared to controls (p < 0.05). IL-34 displayed a noteworthy positive correlation with average TFC [for all participants: r = 0.514, p < 0.001; for SCF patients: r = 0.526, p < 0.001; for normal controls: r = -0.288, p > 0.05]. Similarly, high-sensitivity C-reactive protein (hsCRP) showed a significant and positive relationship with average TFC [for all participants: r = 0.504, p < 0.001; for SCF patients: r = 0.558, p < 0.001; for normal controls: r = -0.148, p > 0.05]. SCF patients presented coronary arteries of larger size compared to controls.Conclusion Mean coronary diameter and IL-34 emerged as independent predictors of SCF. Additionally, hsCRP, mean coronary diameter, and IL-34 exhibited a positive correlation with mean TFC values. IL-34 appears to be a more effective indicator than hsCRP in SCF patients.Öğe Inflammatory and cardiac biomarkers in pulmonary arterial hypertension: The prognostic role of IL-34(Elsevier Inc., 2025) Bolayır, Hasan Ata; Karasu, Mehdi; Gelen, Mehmet Ali; Akın, Yusuf; Çeçen, Erkan; Küçük, Uğur; Bulu, AykutBackground: Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary artery pressure with significant morbidity and mortality. Inflammatory processes are crucial in PAH pathogenesis, with inflammatory cells and mediators present early in disease progression. IL-34 involvement in inflammatory pathways suggests that IL-34 could be an important player in the progression of PAH, influencing both pulmonary pressures and vascular changes. Objective: The purpose of this study was to investigate the correlation between IL-34 levels and pulmonary arterial hypertension (PAH), aiming to enhance the understanding of the molecular mechanisms underlying PAH and explore IL-34′s potential as a biomarker. Methods: Consecutive PAH patients diagnosed via right-heart catheterization at Malatya Turgut Ozal Eğitim ve Araştırma Hastanesi (Dec 2022 - Apr 2024) were enrolled. Patients were classified into low-risk and high-risk groups based on comprehensive risk assessments that included clinical parameters, hemodynamic measurements and biomarkers, in-line with ESC/ERS guidelines. Serum IL-34, hs-CRP, and NT-proBNP levels were measured and compared with those of healthy controls. Echocardiographic assessments and statistical analyses, including ROC analysis, were conducted to evaluate biomarker significance and predictive capabilities. Results: The mean age of low-risk and high-risk PAH patients was 42 ± 7.2 years and 45 ± 5.5 years, respectively. The mean age of the control group was 40 ± 6.4 years. Males comprised 54.29 % of the low-risk group, 56 % of the high-risk group, and 53.3 % of the control group. IL-34 and hs-CRP levels were significantly elevated in PAH patients compared to controls. IL-34 correlated positively with systolic pulmonary artery pressure, RA area, and NT-proBNP levels. Multivariate analysis revealed that IL-34 and hs-CRP were independent predictors of PAH. IL-34 levels>29.8 pg/mL predicted PAH with 78 % sensitivity and 69 % specificity, while levels >44.4 pg/mL predicted high-risk PAH with 84 % sensitivity and 77 % specificity. Conclusion: Elevated IL-34 and hs-CRP levels are associated with PAH severity and right ventricular dysfunction, suggesting IL-34′s potential as a diagnostic and prognostic biomarker. Further research is needed to validate these findings and explore IL-34-targeted therapies in pH management. © 2024 Elsevier Inc.Öğe Interleukin-34 as a Robust Predictor of No-Reflow Phenomenon in ST-Elevation Myocardial Infarction: Insights into Inflammatory Mechanisms and Clinical Implications(Galenos Publ House, 2024) Karasu, Mehdi; Bolayir, Hasan Ata; Aktas, IbrahimObjective: ST-elevation myocardial infarction (STEMI) poses a significant challenge despite advances in reperfusion strategies. The no-reflow phenomenon, characterized by inadequate microvascular blood flow restoration following successful revascularization, remains poorly understood. Inflammation, particularly interleukin-34 (IL-34), is implicated in cardiovascular disease, prompting investigation into its role in no-reflow. Methods: This observational study included 182 patients with STEMI (32 with no-reflow, 150 without) and 100 controls. Clinical and angiographic data were analyzed, and IL-34 levels were measured. Logistic regression and receiver operating characteristic (ROC) analysis assessed IL-34's predictive value for no-reflow. Results: Patients with no reflow exhibited elevated IL-34 levels compared with controls and those without no-reflow. Logistic regression identified IL-34 as an independent predictor of no-reflow (odds ratio: 1,020, p<0.001). ROC analysis showed IL-34's significant predictive value (area under the curve: 0.972, p<0.001). Conclusion: IL-34 emerges as a robust predictor of no-reflow in STEMI, potentially reflecting its role in macrophage activation and the inflammatory response. These findings suggest a novel avenue for understanding and mitigating no-reflow in STEMI, paving the way for targeted therapies. Early identification of high-risk patients could inform tailored interventions, ultimately improving STEMI outcomes. Further research is warranted to elucidate IL-34's mechanistic involvement and validate its predictive value in larger cohorts.Öğe Neutrophil Percentage-to-Albumin Ratio as a Predictor of Collateral Circulation in Chronic Total Occlusion(Kare Publ, 2025) Aktas, Ibrahim; Bolayir, Hasan Ata; Karasu, MehdiBackground: This study aimed to investigate the relationship between neutrophil percentage-to-albumin ratio (NPAR) and collateral circulation in patientswith chronictotal occlusion (CTO). Chronic total occlusion is an advanced stage of coronary artery disease (CAD) and is characterized by complete occlusion of the coronary arteries. Collateral circulation provides alternative routes that supply blood flow instead of occluded arteries and may affect the prognosis of CTO patients. Neutrophil percentage-to-albumin ratio is recognized as an indicator of inflammation and can be used to predict the prognosis of various diseases. Methods: In this retrospective study, 320 patients with CAD who were diagnosed with CTO by coronary angiography were included. Demographic characteristics, clinical findings, and laboratory test results were recorded. The degree of coronary collateral circulation was classified according to the Cohen-Rentrop method. Neutrophil percentage-to-albumin ratio and other inflammatory parameters were measured. The relationship between NPAR and collateral circulation was evaluated using multivariate analysis. Results: Neutrophil percentage-to-albumin ratio levels were significantly associated with poor collateral circulation. Neutrophil percentage-to-albumin ratio, together with other inflammatory parameters (white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein), was identified as an independent marker of poor collateral circulation in CTO patients. Fasting blood glucose levels and diabetes mellitus were also associated with poor collateral circulation. Conclusion: Neutrophil percentage-to-albumin ratio is emerging as a simple and effective inflammatory marker that can be used to predict the quality of collateral circulation in CTO patients. This is important for predicting the prognosis of CTO patients and the success of percutaneous revascularization. However, more extensive studies are needed.Öğe Predictive value of the systemic immune inflammatory index in cardiac syndrome x(Bmc, 2023) Akin, Yusuf; Karasu, Mehdi; Deniz, Abdulmelik; Mirzaoglu, Cetin; Bolayir, Hasan AtaIntroductionPatients with normal coronary arteries in whom increased vasospasm cannot be detected with the stress test should be evaluated in terms of cardiac syndrome x (CSX). Inflammatory systems are effective in endothelial activation and dysfunction in CSX. The systemic immune inflammation index (SII) is thought to be an important factor in determining the course of diseases, especially in infectious diseases or other diseases, as an indicator of the inflammation process. The aim of this study is to determine the role of SII levels in the diagnosis of CSX disease.MethodsThe study group included 80 patients who applied to the cardiology department of Firat University with typical anginal complaints between October 2021 and April 2022, and were diagnosed with ischemia after the myocardial perfusion scan, and then coronary angiography was performed and normal coronary arteries were observed.ResultsWhen the study and control groups were examined according to age, gender and body mass index, hypertension, smoking, diabetes mellitus, dyslipidemia and family history, no statistical significant difference was observed between the groups. It was observed that there was a significant difference between the high sensitive C- reactive protin levels of the individuals in the study and control groups (p = 0.028). SII levels measured in samples taken from patients were significantly higher than control subjects (p = 0.003). SII cutoff at admission was 582 with 82% sensitivity and 84% specificity (area under the curve 0.972; 95% CI:0.95-0.98;p < 0.001).ConclusionIt has been demonstrated that systemic SII parameters, which can be simply calculated with the data obtained from the complete blood count and do not require additional costs, can contribute to the prediction of CSX disease.Öğe Reply to Letter to the Editor: Neutrophil Percentage-to-Albumin Ratio and Coronary Collaterals: A True Predictor or an Overstated Association?(Kare Publ, 2025) Aktas, Ibrahim; Bolayir, Hasan Ata; Karasu, Mehdi[Abstract Not Available]
