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OP-218 Endocan: A Novel Inflammatory Indicator in Newly Diagnosed Hypertensive Patients? A pilot Study
MARCH 13e16, 2014 Material & Method: A total number of 465 patients with metabolic syndrome were surgically treated at our institute. Of those 311 underwent IISG operation, while other surgical options were applied to the remaining. IISG patients consisted of 209 males and 102 females with a mean age of 42.2 (min 24, max 79). All patients had a long standing (mean 10.3 years) diabetes with a mean preoperative HbA1c of 9.41%. Two third of the patients (65.7%) had a BMI <35 and one third (34.3%) had a BMI >35 kg/m2. A total of 192 patients also had hypertension and 168 had dyslipidemia. Results: Complete remission (HbA1c<6%) occurred in 61.1% (190 patients) and partial remission in 20.1% (65 cases). Glycemic control (HbA1c <7) was noted in 31 patients (9.9%). The remaining 25 patients (8.1%) had an HbA1c level above 7%. In total 90.1% of patients experienced a glycemic control. Remission of hypertension (blood pressure <130/80 mmHg) was noted in 299 patients (96.1%) and remission of dyslipidemia was observed in 287 patients (92.2%). Mean change in BMI according to preoperative levels were 6.27, 7.91, 10.41 and 13 kg/m2 in ascending order according to preoperative BMI <30, 30-35, 35-40 and >40, respectively. Conclusion: IISG operation provides effective control in all components of metabolic syndrome in subjects who failed to obtain metabolic control with medical treatment. More clinical investigation is warranted to define the exact mechanism of action and pathophysiology.
- OP-218 Endocan: A Novel Inflammatory Indicator in Newly Diagnosed Hypertensive Patients? A pilot Study. S. Balta1, D.P. Mikhailidis2, S. Demirkol3, C. Ozturk1, E. Kurtoglu4, M. Demir3, T. Celik3, T. Turker5, A. Iyisoy3. 1Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey; 2Department of Clinical Chemistry, University College London Medical School London, University College London (UCL), England; 3Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey; 4Department of Cardiology, Malatya State Hospital, Malatya, Turkey; 5Department of Epidemiology, Gulhane Medical Academy, Ankara, Turkey.
Diverted sleeve gastrectomy D ileal interposition technique
Endothelial dysfunction is regarded as the initial lesion in the development of atherosclerosis. Endocan, previously called endothelial cell specific molecule-1 (ESM-1), is a new candidate immunoinflammatory marker that may be associated with cardiometabolic risk factors. Therefore, we assessed serum levels of endocan in newly diagnosed patients
Improved dyslipidemia
with type 2 diabetes (body mass index [BMI] >35 kg/m2), bariatric surgery offers a treatment modality that is effective and has a low procedure related mortality (<0.5%). Ileal Interposition with sleeve gastrectomy (IISG) is a novel Metabolic Surgery procedure that has been shown to be safe and effective in the treatment of T2DM in any BMI range. We hereby declare our initial results of dyslipidemia and hypertension remission after IISG operation in patients with Metabolic Syndrome.
Figure 1. ROC curve analysis suggested that the optimum endocan level cut-off point for patients with HT was 0.992, with a sensitivity and specificity, of 61 and 91%, respectively (area under curve: 0.717, 95% confidence interval ¼ 0.535-0.899, p ¼ 0.01).
The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
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with untreated essential hypertension (HT). A total of 18 HT patients and 23 normotensive control subjects were included in the study. Serum endocan levels, carotid-intima media thickness (cIMT) and high sensitivity C-reactive protein (hsCRP) were measured. Serum endocan levels were significantly higher in the HT group (p< 0.001). In patients with HT, serum endocan levels correlated positively with cIMT and hsCRP (r ¼ 0.551, p<0.001; r ¼ 0.644, p<0.001, respectively). ROC curve analysis suggested that the optimum endocan level cut-off point for patients with HT was 0.992, with a sensitivity and specificity, of 61 and 91%, respectively (area under curve: 0.717, 95% confidence interval ¼ 0.5350.899, p ¼ 0.01) (Figure 1). Our findings suggest that circulating endocan levels represent a new marker in patients with essential HT. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders.
- OP-219 Rate of Blood Pressure Control and Antihypertensive Treatment Approaches in Diabetic Patients with Hypertension. N. Kahya Eren1, E. Harman2, D. Dolek2, A.P. Tütüncüoglu2, S.V. Emren1, F. Levent1, G. Korkmaz3, S. Yakar Tülüce1, C. Nazlı1. 1 Izmir Katip Çelebi University Atatürk Research and Education Hospital, Cardiology Clinic, Turkey; 2Izmir Katip Çelebi University Atatürk Research and Education Hospital, Endocrinology Clinic, Turkey; 3Izmir Katip Çelebi University Atatürk Research and Education Hospital, Internal Medicine Clinic, Turkey. Objective: Hypertension is a common co-morbidity in patients with type 2 diabetes. Management of hypertension has paramount importance in reducing macro- and microvascular complications of diabetes. The aim of this study is to determine the rate of blood pressure control (< 140/85 mm Hg) in diabetic patients with hypertension and to evaluate the prescribing pattern of antihypertensive medications. Methods: This was a prospective, cross-sectional, observational study conducted in a tertiary center in Turkey. Diabetic hypertensive patients were evaluated to determine the control of hypertension and antihypertensive treatment attitudes. Logistic regression analysis was used to evaluate the likelihood of prescription of each class of antihypertensive medications for the presence of macro- and microvacular complications. Results: Out of 707 type 2 diabetic patients, 500 (71%) had coexisting HT. The mean age of the diabetic hypertensive patients was Antihypertensive prescribing patterns in the study population
61.09.9 years, and 39% were male. There were 114 (23%) patients with nepropathy, 27% had retinopathy and 40.4% had cardiovascular disease. Four hundred and seventy four patients (95%) were on antihypertensive therapy while only 41% achieved target blood pressure values (<140/85 mm Hg). Most of the patients were on 1 antihypertensive drug or combination of 2 drugs (39.5%; 44.7%, respectively). Renin angiotension system (RAS) blockers were the most frequently (82.4%) prescribed antihypertensive agents. Prescribing patterns of antihypertensive drugs are shown in table 2. Patients on monotherapy were most frequently receiving RAS blockers (67.3%) followed by beta blockers (BB) and calcium channel blockers (CCB) (14.9% and 12.8%, respectively). Combination of RAS blockers with diuretics was the most common combination therapy. Diuretics were commonly prescribed in patients receiving combination therapy and were included in 60.8% of 2 drug regimens and 82.6% of the 3 or more drug combinations. The presence of micro- or macrovascular complications did not have an effect on the likelihood of prescription of specific antihypertensive agents except for beta blockers which were more likely to be prescribed in patients with coronary artery disease (Odds ratio¼3.6, 95% confidence interval¼2.3-5.6; p < 0.001). Conclusions: This cross sectional study demonstrated that although most of the diabetic hypertensive patients were on antihypertensive therapy, more than half had uncontrolled blood pressure. The possible reasons for the nonadherence to current guideline recommendations should be investigated and every effort to improve blood pressure control in diabetic patients should be implemented.
- OP-220 Asymmetric Dimethylarginine and Augmentation Index in Newly Diagnosed Patients With Hypertension. M. Cakar1, F. Bulucu1, M. Karaman1, S.A. Ay1, O. Kurt1, S. Balta2, S. Demirkol3, H. Sarlak1, M. Akhan1, B. Altun1, E. Arslan1, K. Saglam1. 1Department of Internal Medicine, Gulhane Medical Faculty, Ankara, Turkey; 2Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey; 3 Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey. Pulse wave velocity (PWV), augmentation index (Aix), and central aortic pressure (CAP) are arterial stiffness markers of endothelial dysfunction (ED). We investigated the relationship between arterial stiffness parameters and asymmetric dimethylarginine (ADMA; a marker of ED), in newly diagnosed patients with hypertension (n ¼ 101; 61 females). These patients were investigated in accordance with the recommendations of hypertension guidelines. Arterial stiffness was measured, and serum ADMA and C-reactive protein (CRP; a marker of inflammation) levels were determined. In both women and men, there was no difference in terms of age, body mass index, systolic and diastolic blood pressures, PWV, CAP and the levels of ADMA, while Aix and CRP levels were significantly higher in women (P ¼.004, P ¼.046, respectively). In the whole group, ADMA levels correlated with Aix (Pearson r ¼.237, P ¼.024). Our findings provide further evidence of a link between arterial stiffness and ED in newly diagnosed patients with hypertension.
- OP-221 Relationship Between Mean Platelet Volume Elevatıon And Left Ventrıcular Mass Index in Hypertensive Patients. M. Yavuzkır1, E. Kurtoglu2, M. Yılmaz2, H. Korkmaz1, T. Çakmak1, A. Uysal3, M. Özguler3, A. Güler4, M. Akbulut1. 1Firat University, School of Medicine, Department of Cardiology; 2Elazig Training and Research Hospital, Department of Cardiology; 3Firat University, School of Medicine, Department of Cardiovascular Surgery; 4Firat University, School of Medicine, Department of Nephrology.
S42 The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
- OP-218 Endocan: A Novel Inflammatory Indicator in Newly Diagnosed Hypertensive Patients? A pilot Study. S. Balta1, D.P. Mikhailidis2, S. Demirkol3, C. Ozturk1, E. Kurtoglu4, M. Demir3, T. Celik3, T. Turker5, A. Iyisoy3. 1Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey; 2Department of Clinical Chemistry, University College London Medical School London, University College London (UCL), England; 3Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey; 4Department of Cardiology, Malatya State Hospital, Malatya, Turkey; 5Department of Epidemiology, Gulhane Medical Academy, Ankara, Turkey.
Diverted sleeve gastrectomy D ileal interposition technique
Endothelial dysfunction is regarded as the initial lesion in the development of atherosclerosis. Endocan, previously called endothelial cell specific molecule-1 (ESM-1), is a new candidate immunoinflammatory marker that may be associated with cardiometabolic risk factors. Therefore, we assessed serum levels of endocan in newly diagnosed patients
Improved dyslipidemia
with type 2 diabetes (body mass index [BMI] >35 kg/m2), bariatric surgery offers a treatment modality that is effective and has a low procedure related mortality (<0.5%). Ileal Interposition with sleeve gastrectomy (IISG) is a novel Metabolic Surgery procedure that has been shown to be safe and effective in the treatment of T2DM in any BMI range. We hereby declare our initial results of dyslipidemia and hypertension remission after IISG operation in patients with Metabolic Syndrome.
Figure 1. ROC curve analysis suggested that the optimum endocan level cut-off point for patients with HT was 0.992, with a sensitivity and specificity, of 61 and 91%, respectively (area under curve: 0.717, 95% confidence interval ¼ 0.535-0.899, p ¼ 0.01).
The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S41
O R A L A B S T R A C T S
MARCH 13e16, 2014
O R A L A B S T R A C T S
with untreated essential hypertension (HT). A total of 18 HT patients and 23 normotensive control subjects were included in the study. Serum endocan levels, carotid-intima media thickness (cIMT) and high sensitivity C-reactive protein (hsCRP) were measured. Serum endocan levels were significantly higher in the HT group (p< 0.001). In patients with HT, serum endocan levels correlated positively with cIMT and hsCRP (r ¼ 0.551, p<0.001; r ¼ 0.644, p<0.001, respectively). ROC curve analysis suggested that the optimum endocan level cut-off point for patients with HT was 0.992, with a sensitivity and specificity, of 61 and 91%, respectively (area under curve: 0.717, 95% confidence interval ¼ 0.5350.899, p ¼ 0.01) (Figure 1). Our findings suggest that circulating endocan levels represent a new marker in patients with essential HT. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders.
- OP-219 Rate of Blood Pressure Control and Antihypertensive Treatment Approaches in Diabetic Patients with Hypertension. N. Kahya Eren1, E. Harman2, D. Dolek2, A.P. Tütüncüoglu2, S.V. Emren1, F. Levent1, G. Korkmaz3, S. Yakar Tülüce1, C. Nazlı1. 1 Izmir Katip Çelebi University Atatürk Research and Education Hospital, Cardiology Clinic, Turkey; 2Izmir Katip Çelebi University Atatürk Research and Education Hospital, Endocrinology Clinic, Turkey; 3Izmir Katip Çelebi University Atatürk Research and Education Hospital, Internal Medicine Clinic, Turkey. Objective: Hypertension is a common co-morbidity in patients with type 2 diabetes. Management of hypertension has paramount importance in reducing macro- and microvascular complications of diabetes. The aim of this study is to determine the rate of blood pressure control (< 140/85 mm Hg) in diabetic patients with hypertension and to evaluate the prescribing pattern of antihypertensive medications. Methods: This was a prospective, cross-sectional, observational study conducted in a tertiary center in Turkey. Diabetic hypertensive patients were evaluated to determine the control of hypertension and antihypertensive treatment attitudes. Logistic regression analysis was used to evaluate the likelihood of prescription of each class of antihypertensive medications for the presence of macro- and microvacular complications. Results: Out of 707 type 2 diabetic patients, 500 (71%) had coexisting HT. The mean age of the diabetic hypertensive patients was Antihypertensive prescribing patterns in the study population
61.09.9 years, and 39% were male. There were 114 (23%) patients with nepropathy, 27% had retinopathy and 40.4% had cardiovascular disease. Four hundred and seventy four patients (95%) were on antihypertensive therapy while only 41% achieved target blood pressure values (<140/85 mm Hg). Most of the patients were on 1 antihypertensive drug or combination of 2 drugs (39.5%; 44.7%, respectively). Renin angiotension system (RAS) blockers were the most frequently (82.4%) prescribed antihypertensive agents. Prescribing patterns of antihypertensive drugs are shown in table 2. Patients on monotherapy were most frequently receiving RAS blockers (67.3%) followed by beta blockers (BB) and calcium channel blockers (CCB) (14.9% and 12.8%, respectively). Combination of RAS blockers with diuretics was the most common combination therapy. Diuretics were commonly prescribed in patients receiving combination therapy and were included in 60.8% of 2 drug regimens and 82.6% of the 3 or more drug combinations. The presence of micro- or macrovascular complications did not have an effect on the likelihood of prescription of specific antihypertensive agents except for beta blockers which were more likely to be prescribed in patients with coronary artery disease (Odds ratio¼3.6, 95% confidence interval¼2.3-5.6; p < 0.001). Conclusions: This cross sectional study demonstrated that although most of the diabetic hypertensive patients were on antihypertensive therapy, more than half had uncontrolled blood pressure. The possible reasons for the nonadherence to current guideline recommendations should be investigated and every effort to improve blood pressure control in diabetic patients should be implemented.
- OP-220 Asymmetric Dimethylarginine and Augmentation Index in Newly Diagnosed Patients With Hypertension. M. Cakar1, F. Bulucu1, M. Karaman1, S.A. Ay1, O. Kurt1, S. Balta2, S. Demirkol3, H. Sarlak1, M. Akhan1, B. Altun1, E. Arslan1, K. Saglam1. 1Department of Internal Medicine, Gulhane Medical Faculty, Ankara, Turkey; 2Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey; 3 Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey. Pulse wave velocity (PWV), augmentation index (Aix), and central aortic pressure (CAP) are arterial stiffness markers of endothelial dysfunction (ED). We investigated the relationship between arterial stiffness parameters and asymmetric dimethylarginine (ADMA; a marker of ED), in newly diagnosed patients with hypertension (n ¼ 101; 61 females). These patients were investigated in accordance with the recommendations of hypertension guidelines. Arterial stiffness was measured, and serum ADMA and C-reactive protein (CRP; a marker of inflammation) levels were determined. In both women and men, there was no difference in terms of age, body mass index, systolic and diastolic blood pressures, PWV, CAP and the levels of ADMA, while Aix and CRP levels were significantly higher in women (P ¼.004, P ¼.046, respectively). In the whole group, ADMA levels correlated with Aix (Pearson r ¼.237, P ¼.024). Our findings provide further evidence of a link between arterial stiffness and ED in newly diagnosed patients with hypertension.
- OP-221 Relationship Between Mean Platelet Volume Elevatıon And Left Ventrıcular Mass Index in Hypertensive Patients. M. Yavuzkır1, E. Kurtoglu2, M. Yılmaz2, H. Korkmaz1, T. Çakmak1, A. Uysal3, M. Özguler3, A. Güler4, M. Akbulut1. 1Firat University, School of Medicine, Department of Cardiology; 2Elazig Training and Research Hospital, Department of Cardiology; 3Firat University, School of Medicine, Department of Cardiovascular Surgery; 4Firat University, School of Medicine, Department of Nephrology.
S42 The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral