- Email: [email protected]
OP-193 King is Naked
MARCH 26e29, 2015 Table Comparison of the groups according to socio-demographic characteristics, and anxiety, depression, and SF-36 quality of life scales score
Age Education Beck Depression Inventory Beck Anxiety Inventory Physical Functioning Physical Role Limitation Bodily Pain General Health Energy Social Functioning Emotional Role Limitation Mental Health Physical Quality of Life Mental Quality of Life
NCA (n¼87) Median (Min-Max)
CAD (n¼31) Median (Min-Max)
p
51(30-72) 5(5-15) 17(3-40) 24(5-50) 25(11-30) 4(4-8) 6.1(3-11) 12.5(5-22) 10(5-23) 7(3-10) 4(3-6) 14(7-28) 47(29-69) 35(19-63)
60(43-81) 5(5-15) 16(5-36) 17(5-32) 23(14-30) 4(4-8) 7(2-11) 15(5-22) 10(5-17) 8(2-10) 6(3-6) 16(7-25) 51(32-70) 38(17-56)
0.000 0.140 0.704 0.000 0.660 0.383 0.036 0.048 0.794 0.001 0.059 0.441 0.168 0.103
p: Kruscal Wallis test (p < 0.05) pGroup1&2, pGroup1&3, pGroup2&3: Post-hoc Mann Whitney U test (p0.017 bonferoni correction) NCA: Normal coronary arteries, CAD: Coronary Artery Diseases.
Materials-Methods: Eighty-seven patients with normal coronary angiography and thirty-one patients with coronary artery disease (CAD) were included to the study. The socio-demographic characteristics, co morbid disorders, Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), and Health Related Quality of Life (HRQoL) scale scores were compared between groups. It was estimated using the short form (SF)-36 questionnaires for total HRQoL and its two dimensions for physical and mental health. Results: There were significant differences in age, gender, employment and psychiatric disorders history in family between two groups (Table 1). Anxiety scores were significantly higher level in NCA group. No difference was found in terms of depression between the NCA and CAD groups. There were significant differences in pain, general health and social function subgroups of SF-36 in NCA group. Physical and mental health was not differences between two groups. Psychiatric co morbidities were found in 82.8 % (n¼72) of the patients with normal angiographic findings and 54.8 % (n¼ 17) of the patients with angiographic coronary disease. Discussion: Our study suggests that impairment of the mental and physical health related quality of life is similar in normal and coronary artery disease patients. We found that Normal coronary arteries patients have been feel pain and social function and general health impairment to be more than CAD patients. Psychiatric co morbidity may conclude a risk factor to impairment of quality of life in normal coronary angiography patients.
- OP-192 The Relationship of The Healthy Lifestyle Behaviors and Cardiovascular Disease Risk Factors Knowledge Level of Patients with Cardiovascular Disease and Their Relatives. Sevda Korkut Bayındır1, Gulsum Nihal Guleser1, Abdurrahman Oguzhan2. 1Faculty of Health Sciences, Erciyes University, Kayseri, Turkey; 2Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Objectives: The aim of this study is to determine relationship of cardiovascular disease risk factors knowledge level and healthy life style behaviors of patient having cardiovascular disease and their relatives. Methods: This descriptive study was conducted between January 2014 and September 2014 in 126 patients with cardiovascular disease and 109 relatives. Data were collected by the researcher using questionnaire form, Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale and Healthy Living Style Behaviors Scale-II (HLSBS-II). Descriptive statistics and correlation analysis were used to evaluate the data. Results: It has been determined that the average age of patients and their relatives were 59.713.1 and 44.314.8, respectively. Total CARRF-KL and HLSBS-II score average of patients and their relatives were 18.74.1, 19.35.8 and 117.919.1, 119.723.2, respectively. There was a significant, positive correlation between CARRF-KL and HLSBS-II score patients and relatives (r¼0.551, p¼0.00), (r ¼0.398, p¼0.00), respectively. The relationship significant positive side was determined between CARRF-KL and physical activity (r¼0.381, p¼0.00), health responsibility (r¼0.484, p¼0.00), spiritual growth (r¼0.513, p¼0.00), interpersonal relationships (r¼0.321, p¼0.00), nutrition (r¼0.374, p¼0.00) and stress management (r¼0.495, p¼0.00) score patients. The relationship significant positive side was determined between CARRF-KL and physical activity (r¼0.244, p¼0.01), health responsibility (r¼0.395, p¼0.00), spiritual growth (r¼0.302, p¼0.00), interpersonal relationships (r¼0.299, p¼0.00), nutrition (r¼0.343, p¼0.00) and stress management (r¼0.324, p¼0.00) score relatives. It has been determined that as the score of CARRF-KL increases, scores of HLSBS-II, physical activity, health responsibility, spiritual growth, interpersonal relationships, nutrition, and stress management increase. Conclusion: It is recommended that nurses should be given education about cardiovascular disease risk factors, prevention and management to patients and their relatives.
- OP-193 King is Naked. Aytekin Oguz, Ozge Telci Caklili. Istanbul Medeniyet University, Faculty of Medicine, Department of Internal Medicine. Objective: The University Group Diabetes Program (UGDP) study showed sulfonylureas may bring more harm than benefit to diabetic patients. Since then there has been no strong evidence proving sulfonylureas can prevent mortality or major cardiovascular clinical events. But sulfonylureas are still widely used in diabetes treatment. ORIGIN study has shown that insulin treatment which was considered as the most effective and natural remedy of diabetes for many years, had no beneficial effect on mortality and complications of diabetes. Is it reasonable to treat a disease with hyperinsulinemia and insulin resistance with insulin or insulin secretagogues. In this study we aimed to evaluate the type 2 diabetes treatment perception of doctors practicing in internal medicine. Method: A survey about type 2 diabetes treatment and relevant complications were conducted on 29 doctors practicing internal medicine. A questionnaire about their choices in treatment of type 2 diabetes and how much they have faith in those drugs was filled by participants. Results: Metformin was the most preferred agent as first line therapy. Sixty-five percent of the participants found it unnecessary to use insulin for treating a disease characterized with hyperinsulinemia however 73% claimed preferring insulin treatment frequently.
The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S87
O R A L A B S T R A C T S
MARCH 26e29, 2015
O R A L A B S T R A C T S
Sulfonylureas were not used at all by 45 %. Concerns about safety of GLP-1 analogues and DPP-4 inhibitors were expressed by 65% and 50% respectively. Fifty-nine percent of the doctors found available type 2 diabetic treatments partially beneficial. Conclusions: Results of the study show a significant change in doctors’ view of type 2 diabetes treatment. Sulfonylureas, the most common prescribed drug class of our country for many years seemed to be abandoned in recent years. In a sulphonylurea based study (ADVANCE) which was concluded as positive study, there was no macrovascular or microvascular protection with sulfonylurea treatment except for a reduction in proteinuria which had no beneficial effect on renal outcomes. Various meta-analysis results proved significant increase in cardiovascular risk with sulfonylurea treatment. Action to Control Cardiovascular Risk in Diabetes (ACCORD) study showed worsened outcomes as diabetic drugs were used more intensively. Among new agents DPP4 inhibitors are found to be “non-inferior to placebo(!)” on cardiovascular outcomes. Truth to be said medical world has failed in treatment of type 2 diabetes unlike the miraculous discovery of insulin to cure type 1 diabetes. We would like to ask if it is the time to open our eyes and say “the king is naked”.
- OP-194 Frequencies of Cardiovascular Diseases Detected in a Pretest Screening Examination of Apparently Healthy Young Subjects. Mustafa Aparci1, Cengiz Ozturk2, Sevket Balta3, Sercan Okutucu4, Mehmet Karaduman5, Ugur Kucuk6. 1Dept.of Cardiology Kasimpasa Military Hospital, Istanbul, Turkey; 2Dept. of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 3Eskis¸ehir Military Hospital, Dept. of Cardiology and Aviation Medicine; 4Dept. of Cardiology, Memorial Hospital, Ankara, Turkey; 5Dept. of Internal Medicine, Etimesgut Military Hospital, Ankara, Turkey; 6Dept. of Cardiology, Haydarpasa Training Hospital, Istanbul. Aim: Although the clinical significance of screening tests is still controversial for the professional sportsmen and elite athletes or special occupational status e.g. military, aviation, altitude climbers we claim that it may give more vital data than expected. Detection of various type of aortic or valvular disease could prevent the progression of current status while detection of congenital heart disease could prevent the actual disease to consequence with heart failure or sudden cardiac/ arrhythmic deaths. We aimed to present the spectrum of cardiovascular disease which could further be related significant cardiovascular events unless they were not detected in a large population (n¼2969) of young healthy adolescents. Material-Method: We retrospectively analyzed the medical recording of healthy young subjects (ranging between 19-24 years old) and echocardiographic diagnosis of subjects. Echocardiographic examination was performed by standard parasternal long axis and short axis view and from the apical four/five chamber view and when necessary from the suprasternal view. Results: Total prevalence of the disease was 2.2%.Trivial valvular regurgitations (n¼12) were the most frequent pathologies which were not potentially related with any hemodynamic abnormality while rheumatic mitral diseases (n¼9) and mitral valve prolapse with significant mitral regurgitation (n¼7) were the other frequent disorders. Atrial septal defects (n¼3) or patent foramen ovales (n¼3) were less frequent but with potential to progress to right sided heart failure or
Figure. Frequencies of the cardiovascular diseases detected during the pretest screening echocardiographic examination of apparently healthy young subjects.
thromboembolic disease unless they were detected until adult age. Aortic aneurysm/dilatation either alone (n¼7) or coexisting with Bicuspid aortic valve (n¼6) were detected at a frequency which could not be ignored in this study population. Conclusion: In our country echocardiography is a cardiac imaging modality which could not be priced. So screening tests for young subjects including echocardiography examination could be inexpensive but a wealthy way of imaging cardiac status. Especially avoidance of young patients with those abovementioned cardiovascular diseases from the isometric type of exercises e.g. straining, weight lifting, scuba diving, special occupations e.g. military, security, and high altitude could prevent too many cardiac disorders which could be irreversibly progressed or requiring surgical correction. Single echoardiographic examination during adolescent age (15-18) or young age (19-24 years old) could provide the data of subjects that should be followed up for 3-5 years period. Medically archiving of those data will reduce too many unnecessary echocardiographic examinations in future life period of subjects.
- OP-195 The Relationship of Coronary Artery Disease with Alleles of Chromosome 9p21 in Turkish Population. Çagrı Yayla1, Kaan Okyay2, Akın Yılmaz3, Asife Sahinarslan1, Atiye Seda3, Azmi Eyiol1, Ata Bolayır1, Burak Sezenöz1, Sevda Menevs¸e3, Atiye Çengel1. 1 Department of Cardiology, Gazi University, Ankara, Turkey; 2 Department of Cardiology, Baskent University, Ankara, Turkey; 3Department of Biology and Genetics, Gazi University, Ankara, Turkey. Background: Genetic predisposition is an important risk factor for coronary artery disease. Genetic studies showed that single nucleotide polymorphisms on chromosome 9p21 are related to coronary atherosclerosis and myocardial infraction in different populations. In this study we aimed to evaluate the impact of polymorphisms on chromosome 9p21 on presence and severity of CAD in Turkish population.
S88 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
Age Education Beck Depression Inventory Beck Anxiety Inventory Physical Functioning Physical Role Limitation Bodily Pain General Health Energy Social Functioning Emotional Role Limitation Mental Health Physical Quality of Life Mental Quality of Life
NCA (n¼87) Median (Min-Max)
CAD (n¼31) Median (Min-Max)
p
51(30-72) 5(5-15) 17(3-40) 24(5-50) 25(11-30) 4(4-8) 6.1(3-11) 12.5(5-22) 10(5-23) 7(3-10) 4(3-6) 14(7-28) 47(29-69) 35(19-63)
60(43-81) 5(5-15) 16(5-36) 17(5-32) 23(14-30) 4(4-8) 7(2-11) 15(5-22) 10(5-17) 8(2-10) 6(3-6) 16(7-25) 51(32-70) 38(17-56)
0.000 0.140 0.704 0.000 0.660 0.383 0.036 0.048 0.794 0.001 0.059 0.441 0.168 0.103
p: Kruscal Wallis test (p < 0.05) pGroup1&2, pGroup1&3, pGroup2&3: Post-hoc Mann Whitney U test (p0.017 bonferoni correction) NCA: Normal coronary arteries, CAD: Coronary Artery Diseases.
Materials-Methods: Eighty-seven patients with normal coronary angiography and thirty-one patients with coronary artery disease (CAD) were included to the study. The socio-demographic characteristics, co morbid disorders, Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), and Health Related Quality of Life (HRQoL) scale scores were compared between groups. It was estimated using the short form (SF)-36 questionnaires for total HRQoL and its two dimensions for physical and mental health. Results: There were significant differences in age, gender, employment and psychiatric disorders history in family between two groups (Table 1). Anxiety scores were significantly higher level in NCA group. No difference was found in terms of depression between the NCA and CAD groups. There were significant differences in pain, general health and social function subgroups of SF-36 in NCA group. Physical and mental health was not differences between two groups. Psychiatric co morbidities were found in 82.8 % (n¼72) of the patients with normal angiographic findings and 54.8 % (n¼ 17) of the patients with angiographic coronary disease. Discussion: Our study suggests that impairment of the mental and physical health related quality of life is similar in normal and coronary artery disease patients. We found that Normal coronary arteries patients have been feel pain and social function and general health impairment to be more than CAD patients. Psychiatric co morbidity may conclude a risk factor to impairment of quality of life in normal coronary angiography patients.
- OP-192 The Relationship of The Healthy Lifestyle Behaviors and Cardiovascular Disease Risk Factors Knowledge Level of Patients with Cardiovascular Disease and Their Relatives. Sevda Korkut Bayındır1, Gulsum Nihal Guleser1, Abdurrahman Oguzhan2. 1Faculty of Health Sciences, Erciyes University, Kayseri, Turkey; 2Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Objectives: The aim of this study is to determine relationship of cardiovascular disease risk factors knowledge level and healthy life style behaviors of patient having cardiovascular disease and their relatives. Methods: This descriptive study was conducted between January 2014 and September 2014 in 126 patients with cardiovascular disease and 109 relatives. Data were collected by the researcher using questionnaire form, Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale and Healthy Living Style Behaviors Scale-II (HLSBS-II). Descriptive statistics and correlation analysis were used to evaluate the data. Results: It has been determined that the average age of patients and their relatives were 59.713.1 and 44.314.8, respectively. Total CARRF-KL and HLSBS-II score average of patients and their relatives were 18.74.1, 19.35.8 and 117.919.1, 119.723.2, respectively. There was a significant, positive correlation between CARRF-KL and HLSBS-II score patients and relatives (r¼0.551, p¼0.00), (r ¼0.398, p¼0.00), respectively. The relationship significant positive side was determined between CARRF-KL and physical activity (r¼0.381, p¼0.00), health responsibility (r¼0.484, p¼0.00), spiritual growth (r¼0.513, p¼0.00), interpersonal relationships (r¼0.321, p¼0.00), nutrition (r¼0.374, p¼0.00) and stress management (r¼0.495, p¼0.00) score patients. The relationship significant positive side was determined between CARRF-KL and physical activity (r¼0.244, p¼0.01), health responsibility (r¼0.395, p¼0.00), spiritual growth (r¼0.302, p¼0.00), interpersonal relationships (r¼0.299, p¼0.00), nutrition (r¼0.343, p¼0.00) and stress management (r¼0.324, p¼0.00) score relatives. It has been determined that as the score of CARRF-KL increases, scores of HLSBS-II, physical activity, health responsibility, spiritual growth, interpersonal relationships, nutrition, and stress management increase. Conclusion: It is recommended that nurses should be given education about cardiovascular disease risk factors, prevention and management to patients and their relatives.
- OP-193 King is Naked. Aytekin Oguz, Ozge Telci Caklili. Istanbul Medeniyet University, Faculty of Medicine, Department of Internal Medicine. Objective: The University Group Diabetes Program (UGDP) study showed sulfonylureas may bring more harm than benefit to diabetic patients. Since then there has been no strong evidence proving sulfonylureas can prevent mortality or major cardiovascular clinical events. But sulfonylureas are still widely used in diabetes treatment. ORIGIN study has shown that insulin treatment which was considered as the most effective and natural remedy of diabetes for many years, had no beneficial effect on mortality and complications of diabetes. Is it reasonable to treat a disease with hyperinsulinemia and insulin resistance with insulin or insulin secretagogues. In this study we aimed to evaluate the type 2 diabetes treatment perception of doctors practicing in internal medicine. Method: A survey about type 2 diabetes treatment and relevant complications were conducted on 29 doctors practicing internal medicine. A questionnaire about their choices in treatment of type 2 diabetes and how much they have faith in those drugs was filled by participants. Results: Metformin was the most preferred agent as first line therapy. Sixty-five percent of the participants found it unnecessary to use insulin for treating a disease characterized with hyperinsulinemia however 73% claimed preferring insulin treatment frequently.
The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S87
O R A L A B S T R A C T S
MARCH 26e29, 2015
O R A L A B S T R A C T S
Sulfonylureas were not used at all by 45 %. Concerns about safety of GLP-1 analogues and DPP-4 inhibitors were expressed by 65% and 50% respectively. Fifty-nine percent of the doctors found available type 2 diabetic treatments partially beneficial. Conclusions: Results of the study show a significant change in doctors’ view of type 2 diabetes treatment. Sulfonylureas, the most common prescribed drug class of our country for many years seemed to be abandoned in recent years. In a sulphonylurea based study (ADVANCE) which was concluded as positive study, there was no macrovascular or microvascular protection with sulfonylurea treatment except for a reduction in proteinuria which had no beneficial effect on renal outcomes. Various meta-analysis results proved significant increase in cardiovascular risk with sulfonylurea treatment. Action to Control Cardiovascular Risk in Diabetes (ACCORD) study showed worsened outcomes as diabetic drugs were used more intensively. Among new agents DPP4 inhibitors are found to be “non-inferior to placebo(!)” on cardiovascular outcomes. Truth to be said medical world has failed in treatment of type 2 diabetes unlike the miraculous discovery of insulin to cure type 1 diabetes. We would like to ask if it is the time to open our eyes and say “the king is naked”.
- OP-194 Frequencies of Cardiovascular Diseases Detected in a Pretest Screening Examination of Apparently Healthy Young Subjects. Mustafa Aparci1, Cengiz Ozturk2, Sevket Balta3, Sercan Okutucu4, Mehmet Karaduman5, Ugur Kucuk6. 1Dept.of Cardiology Kasimpasa Military Hospital, Istanbul, Turkey; 2Dept. of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 3Eskis¸ehir Military Hospital, Dept. of Cardiology and Aviation Medicine; 4Dept. of Cardiology, Memorial Hospital, Ankara, Turkey; 5Dept. of Internal Medicine, Etimesgut Military Hospital, Ankara, Turkey; 6Dept. of Cardiology, Haydarpasa Training Hospital, Istanbul. Aim: Although the clinical significance of screening tests is still controversial for the professional sportsmen and elite athletes or special occupational status e.g. military, aviation, altitude climbers we claim that it may give more vital data than expected. Detection of various type of aortic or valvular disease could prevent the progression of current status while detection of congenital heart disease could prevent the actual disease to consequence with heart failure or sudden cardiac/ arrhythmic deaths. We aimed to present the spectrum of cardiovascular disease which could further be related significant cardiovascular events unless they were not detected in a large population (n¼2969) of young healthy adolescents. Material-Method: We retrospectively analyzed the medical recording of healthy young subjects (ranging between 19-24 years old) and echocardiographic diagnosis of subjects. Echocardiographic examination was performed by standard parasternal long axis and short axis view and from the apical four/five chamber view and when necessary from the suprasternal view. Results: Total prevalence of the disease was 2.2%.Trivial valvular regurgitations (n¼12) were the most frequent pathologies which were not potentially related with any hemodynamic abnormality while rheumatic mitral diseases (n¼9) and mitral valve prolapse with significant mitral regurgitation (n¼7) were the other frequent disorders. Atrial septal defects (n¼3) or patent foramen ovales (n¼3) were less frequent but with potential to progress to right sided heart failure or
Figure. Frequencies of the cardiovascular diseases detected during the pretest screening echocardiographic examination of apparently healthy young subjects.
thromboembolic disease unless they were detected until adult age. Aortic aneurysm/dilatation either alone (n¼7) or coexisting with Bicuspid aortic valve (n¼6) were detected at a frequency which could not be ignored in this study population. Conclusion: In our country echocardiography is a cardiac imaging modality which could not be priced. So screening tests for young subjects including echocardiography examination could be inexpensive but a wealthy way of imaging cardiac status. Especially avoidance of young patients with those abovementioned cardiovascular diseases from the isometric type of exercises e.g. straining, weight lifting, scuba diving, special occupations e.g. military, security, and high altitude could prevent too many cardiac disorders which could be irreversibly progressed or requiring surgical correction. Single echoardiographic examination during adolescent age (15-18) or young age (19-24 years old) could provide the data of subjects that should be followed up for 3-5 years period. Medically archiving of those data will reduce too many unnecessary echocardiographic examinations in future life period of subjects.
- OP-195 The Relationship of Coronary Artery Disease with Alleles of Chromosome 9p21 in Turkish Population. Çagrı Yayla1, Kaan Okyay2, Akın Yılmaz3, Asife Sahinarslan1, Atiye Seda3, Azmi Eyiol1, Ata Bolayır1, Burak Sezenöz1, Sevda Menevs¸e3, Atiye Çengel1. 1 Department of Cardiology, Gazi University, Ankara, Turkey; 2 Department of Cardiology, Baskent University, Ankara, Turkey; 3Department of Biology and Genetics, Gazi University, Ankara, Turkey. Background: Genetic predisposition is an important risk factor for coronary artery disease. Genetic studies showed that single nucleotide polymorphisms on chromosome 9p21 are related to coronary atherosclerosis and myocardial infraction in different populations. In this study we aimed to evaluate the impact of polymorphisms on chromosome 9p21 on presence and severity of CAD in Turkish population.
S88 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral