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OP-046 CONGENITAL VASCULAR MALFORMATIONS AND MULTIDISCIPLINARY TEAM WORK
9th Int. Congr. Update Cardiology & Cardiovascular Surgery, Oral Presentations / International Journal of Cardiology 163S1 (2013) S1–S79
OP-045 PATIENTS WITH PERIPHERAL ARTERIAL DISEASE ARE AT INCREASED RISK OF DEPRESSIVE SYMPTOMS E. Gok, O.A. Sayin, M. Kanber, O.S. Goksel, U. Alpagut, E. Dayioglu. Department of Cardiovascular Surgery, Istanbul University, Istanbul, Turkey Objectives: Peripheral artery disease (PAD), which comprises atherosclerosis of the abdominal aorta, iliac, and lower-extremity arteries, is underdiagnosed, undertreated, and poorly understood by the medical community. Patients with PAD may experience a multitude of problems, such as claudication, ischemic rest pain, ischemic ulcerations, repeated hospitalizations, revascularizations, and limb loss. This may lead to a poor quality of life and a high rate of depression. To assess the quality of life (QoL) of peripheral arterial disease (PAD) patients who have undergone one or more surgical revascularizations. Methods: 60 peripheral arterial disease patient (mean age 67.8, SD 10.4 yrs; range 43–91, 62% men), in 2006–2012, and their age- and gender-matched controls were studied. A postal questionnaire study in which a case-control methodology was applied. The mean time since the last revascularization for operated patients 3.5, SD 1.8 yrs. Ankle-brachial pressure index (ABI) was obtained. QoL was assessed using 15D Health-related QoL instrument, SF-36 (Short Form for QoL) and Beck’s Depression questionnaire. Results: Patients after surgical revascularization (most with ABIs 0.5–0.89 and without cognitive impairment), had similarly lower QoL, indicated more depression than their controls. Conclusion: Significant depressive symptoms are more common in younger women with PAD than in other gender-age groups. Poor QoL and depression should be thoroughly considered, alongside proper follow-up and ABI-measurements. OP-046 CONGENITAL VASCULAR MALFORMATIONS AND MULTIDISCIPLINARY TEAM WORK 1 ¨ U. Bengisun1 , A. Demirkan1 , O.A. Cetinkaya ¸ , Y. Yıldız2 , S. Fitoz ¨ 3, 3 4 1 ˙ 1 1 U. Sanlıdilek , M. Kır , H. Uncu , I. Alacayır ¸ , C. Koksoy ¨ , E. Anadol1 . 1 Department of Peripheral Vascular Surgery, 2 Department of Orthopedic Surgery, 3 Department of Radiology, 4 Department of Nuclear Medicine, Ankara, Turkey Congenital vascular malformation (CVM) of peripheral circulatory system is a challenging topic. Unfortunately, patients with CVM often wander around from one doctor to another in search of someone with interest and expertise in their disease. In the past, catastrophic outcomes after CVM treatment were relatively common due to limited knowledge and ill-planned approaches. First of all, the need for appropriate definitions and the correct classification of CVMs is crucial to clear any misunderstandings that may lead the physican to a dead end. For example, hemangioma is a misnomer used to decribe venous malformations. A feasible new classification system, advances in technology and multidisciplinary team-work has opened a new era for diagnosis and treatment of CVM. Since CVM affects different tissues and organs, the diagnostic work up, treatment and follow up of such challenging conditions should be undertaken by dedicated multidisciplinary centres. Our multidisciplinary CVM team at the Medical Faculty of Ankara University comprises experts from 15 different departments. The aim of our study is to underline the importance of problems accompanying CVM and how we came up with solutions for therapy. Keywords: Vascular malformation,multidisciplinary team
March 21, 2013, Thursday
S19
10:30–12:00
New Perspectives in Antiplatelet Therapy in Coronary Disease OP-047 AWARENESS AND APPROACH OF TURKISH DENTISTS FOR CORONARY STENTING AND DUAL ANTIPLATELET THERAPY I˙ .F. Akturk ¨ 1 , N. Ca˘ ¸ glar2 , G. Durmus¸ 3 , K. Keskin4 , A.A. Yalcın ¸ 1, 1 1 ¨ Celik ¨ Ozyılmaz ¨ I˙ .M. Ca˘ ¸ glar5 , I˙ . Bıyık6 , O. ¸ , F. Uzun1 , M. Erturk ¨ 1 , S.O. . 1 Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, ˙ Turkey; 2 Department of Cardiology, Istanbul Training and Research Hospital, Istanbul, Turkey; 3 Department of Cardiology, Arnavutk¨ oy ˙ State Hospital, Istanbul, Turkey; 4 Department of Cardiology, Private 29 ˙ Mayıs Hospital Istanbul, Turkey; 5 Department of Cardiology, Bakırk¨ oy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey; 6 Department of Cardiology, Private Fuar Hospital, Afyonkarahisar, Turkey Objective: As rest of the prevalance of coronary artery disease is increasing in our aging country, percutenous interventions and number of coronary stent implantations are increasing. Long-time dual antiplatelet therapy is recommended by different cardiology societies after coronary stenting. During this long theraphy period patients may face with dental problems and need invasive dental procedures. Especially in patients with drug eluting stents withdrawal of antiplatelet therapy may cause stent thrombosis and death. We planned to investigate this frequently observed problem from a different point of view and evaluated the awareness of dental healt care proffesionals and their proffesional approach for such patients using antiplatelet therapy. Methods: We performed a questionnaire consisted of 13 questions to randomly selected 88 dentists working within the boundaries of the city of Isanbul. We asked questions such as what is a coronary stent, why dual antiplatelet therapy should not be interrupted, what are the complications of interrupting the therapy and how often they consult a cardiologist. Results: 89% of the participants knew about coronary stents and 92% was consulting a cardiologist before dental procedures. However knowledge about clopidogrel was only 8%. Only 1 participant had an idea about stent thrombosis. While 76 of participants said they were interrupting aspirin treatment, only 6 participants were interrupting clopidogrel tratment before the procedure. Finally the awareness of international guidelines among the participants were 20%. Conclusion: Although most of the turkish dentist were aware of coronary stents, they were not familiar about the differences between stents, clopidogrel therapy and the complications of interrupting the therapy. Most of them consult a cardiologist before performing dental procedures to patients with cardiovascular disease. Increasing the knowledge and sensitivity of dentists about this issue may be effective in preventing possible complications. OP-048 ELEVATED SERUM OSTEOPROTEGERIN LEVELS PREDICT IN-HOSPITAL MACE IN PATIENTS WITH STEMI 1 , M.E. Durako˘glugil2 , T. Erdo˘gan2 , A. Kırbas¸ 3 , A. Yılmaz3 , A. Canga ¸ 1 Y. Ci ¸ cek ¸ 2 , E. Ergul ¨ 1 , M. Cetin ¸ , S.A. Kocaman1 . 1 Department of Cardiology, Rize Education and Research Hospital, Rize, Turkey; 2 Department of Cardiology, Recep Tayyip Erdo˘gan University, Rize, Turkey; 3 Department of Biochemistry, Recep Tayyip Erdo˘gan University, Rize, Turkey Objective: The aim of our study is to investigate whether osteoprotegerin (OPG) is related to in-hospital major adverse cardiac events (MACE) and reperfusion parameters in patients with ST elevation myocardial infarction (STEMI). Osteoprotegerin (OPG)/ Receptor activator of nuclear factor-úB (RANK)/RANK ligand (RANKL) pathway has recently been associated with atherosclerosis.
OP-045 PATIENTS WITH PERIPHERAL ARTERIAL DISEASE ARE AT INCREASED RISK OF DEPRESSIVE SYMPTOMS E. Gok, O.A. Sayin, M. Kanber, O.S. Goksel, U. Alpagut, E. Dayioglu. Department of Cardiovascular Surgery, Istanbul University, Istanbul, Turkey Objectives: Peripheral artery disease (PAD), which comprises atherosclerosis of the abdominal aorta, iliac, and lower-extremity arteries, is underdiagnosed, undertreated, and poorly understood by the medical community. Patients with PAD may experience a multitude of problems, such as claudication, ischemic rest pain, ischemic ulcerations, repeated hospitalizations, revascularizations, and limb loss. This may lead to a poor quality of life and a high rate of depression. To assess the quality of life (QoL) of peripheral arterial disease (PAD) patients who have undergone one or more surgical revascularizations. Methods: 60 peripheral arterial disease patient (mean age 67.8, SD 10.4 yrs; range 43–91, 62% men), in 2006–2012, and their age- and gender-matched controls were studied. A postal questionnaire study in which a case-control methodology was applied. The mean time since the last revascularization for operated patients 3.5, SD 1.8 yrs. Ankle-brachial pressure index (ABI) was obtained. QoL was assessed using 15D Health-related QoL instrument, SF-36 (Short Form for QoL) and Beck’s Depression questionnaire. Results: Patients after surgical revascularization (most with ABIs 0.5–0.89 and without cognitive impairment), had similarly lower QoL, indicated more depression than their controls. Conclusion: Significant depressive symptoms are more common in younger women with PAD than in other gender-age groups. Poor QoL and depression should be thoroughly considered, alongside proper follow-up and ABI-measurements. OP-046 CONGENITAL VASCULAR MALFORMATIONS AND MULTIDISCIPLINARY TEAM WORK 1 ¨ U. Bengisun1 , A. Demirkan1 , O.A. Cetinkaya ¸ , Y. Yıldız2 , S. Fitoz ¨ 3, 3 4 1 ˙ 1 1 U. Sanlıdilek , M. Kır , H. Uncu , I. Alacayır ¸ , C. Koksoy ¨ , E. Anadol1 . 1 Department of Peripheral Vascular Surgery, 2 Department of Orthopedic Surgery, 3 Department of Radiology, 4 Department of Nuclear Medicine, Ankara, Turkey Congenital vascular malformation (CVM) of peripheral circulatory system is a challenging topic. Unfortunately, patients with CVM often wander around from one doctor to another in search of someone with interest and expertise in their disease. In the past, catastrophic outcomes after CVM treatment were relatively common due to limited knowledge and ill-planned approaches. First of all, the need for appropriate definitions and the correct classification of CVMs is crucial to clear any misunderstandings that may lead the physican to a dead end. For example, hemangioma is a misnomer used to decribe venous malformations. A feasible new classification system, advances in technology and multidisciplinary team-work has opened a new era for diagnosis and treatment of CVM. Since CVM affects different tissues and organs, the diagnostic work up, treatment and follow up of such challenging conditions should be undertaken by dedicated multidisciplinary centres. Our multidisciplinary CVM team at the Medical Faculty of Ankara University comprises experts from 15 different departments. The aim of our study is to underline the importance of problems accompanying CVM and how we came up with solutions for therapy. Keywords: Vascular malformation,multidisciplinary team
March 21, 2013, Thursday
S19
10:30–12:00
New Perspectives in Antiplatelet Therapy in Coronary Disease OP-047 AWARENESS AND APPROACH OF TURKISH DENTISTS FOR CORONARY STENTING AND DUAL ANTIPLATELET THERAPY I˙ .F. Akturk ¨ 1 , N. Ca˘ ¸ glar2 , G. Durmus¸ 3 , K. Keskin4 , A.A. Yalcın ¸ 1, 1 1 ¨ Celik ¨ Ozyılmaz ¨ I˙ .M. Ca˘ ¸ glar5 , I˙ . Bıyık6 , O. ¸ , F. Uzun1 , M. Erturk ¨ 1 , S.O. . 1 Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, ˙ Turkey; 2 Department of Cardiology, Istanbul Training and Research Hospital, Istanbul, Turkey; 3 Department of Cardiology, Arnavutk¨ oy ˙ State Hospital, Istanbul, Turkey; 4 Department of Cardiology, Private 29 ˙ Mayıs Hospital Istanbul, Turkey; 5 Department of Cardiology, Bakırk¨ oy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey; 6 Department of Cardiology, Private Fuar Hospital, Afyonkarahisar, Turkey Objective: As rest of the prevalance of coronary artery disease is increasing in our aging country, percutenous interventions and number of coronary stent implantations are increasing. Long-time dual antiplatelet therapy is recommended by different cardiology societies after coronary stenting. During this long theraphy period patients may face with dental problems and need invasive dental procedures. Especially in patients with drug eluting stents withdrawal of antiplatelet therapy may cause stent thrombosis and death. We planned to investigate this frequently observed problem from a different point of view and evaluated the awareness of dental healt care proffesionals and their proffesional approach for such patients using antiplatelet therapy. Methods: We performed a questionnaire consisted of 13 questions to randomly selected 88 dentists working within the boundaries of the city of Isanbul. We asked questions such as what is a coronary stent, why dual antiplatelet therapy should not be interrupted, what are the complications of interrupting the therapy and how often they consult a cardiologist. Results: 89% of the participants knew about coronary stents and 92% was consulting a cardiologist before dental procedures. However knowledge about clopidogrel was only 8%. Only 1 participant had an idea about stent thrombosis. While 76 of participants said they were interrupting aspirin treatment, only 6 participants were interrupting clopidogrel tratment before the procedure. Finally the awareness of international guidelines among the participants were 20%. Conclusion: Although most of the turkish dentist were aware of coronary stents, they were not familiar about the differences between stents, clopidogrel therapy and the complications of interrupting the therapy. Most of them consult a cardiologist before performing dental procedures to patients with cardiovascular disease. Increasing the knowledge and sensitivity of dentists about this issue may be effective in preventing possible complications. OP-048 ELEVATED SERUM OSTEOPROTEGERIN LEVELS PREDICT IN-HOSPITAL MACE IN PATIENTS WITH STEMI 1 , M.E. Durako˘glugil2 , T. Erdo˘gan2 , A. Kırbas¸ 3 , A. Yılmaz3 , A. Canga ¸ 1 Y. Ci ¸ cek ¸ 2 , E. Ergul ¨ 1 , M. Cetin ¸ , S.A. Kocaman1 . 1 Department of Cardiology, Rize Education and Research Hospital, Rize, Turkey; 2 Department of Cardiology, Recep Tayyip Erdo˘gan University, Rize, Turkey; 3 Department of Biochemistry, Recep Tayyip Erdo˘gan University, Rize, Turkey Objective: The aim of our study is to investigate whether osteoprotegerin (OPG) is related to in-hospital major adverse cardiac events (MACE) and reperfusion parameters in patients with ST elevation myocardial infarction (STEMI). Osteoprotegerin (OPG)/ Receptor activator of nuclear factor-úB (RANK)/RANK ligand (RANKL) pathway has recently been associated with atherosclerosis.