Person: FAK, ALİ SERDAR
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FAK
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ALİ SERDAR
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Publication Metadata only Expert panel on cost analysis of atrial fibrillation(TURKISH SOC CARDIOLOGY, 2013) FAK, ALİ SERDAR; Fak, Ali Serdar; Kucukoglu, M. Serdar; Fak, Nazire Afsar; Demir, Mesut; Agir, Aysen A.; Demirtas, Mustafa; Kose, Sedat; Ozdemir, MuratObjective: To estimate total cost of atrial fibrillation (AF) management concerning acute coronary syndrome, heart failure, stroke and drug related adverse events with respect to clinical practice and available guidelines. Methods: This cost analysis study was based on identification of total costs related to management of acute coronary syndrome, heart failure, stroke and the drug related adverse events in patients with AF based on standardized questionnaire forms filled by experts according to their daily clinical practice and also to ACCF/AHA/ESC guidelines. Total cost included cost items related to treatment, healthcare resources utilization, and diagnostic test and consultations. Results: The yearly cost of acute coronary syndrome per patient was 5.478.43 TL according to expert's view reflecting real clinical practice whereas it was 11.319.44 TL when calculation was based on recommendations in the guidelines. The average total cost of heart failure was 4.523.74 TL according to expert's view whereas it was 2.925.86 TL based on guidelines. The average total cost of stroke was 5.719.25 TL according to expert's view but 7.931.18 TL based on guidelines. Among drug related adverse events, only those related to cardiac adverse events were estimated to be higher according to expert view as compared to guideline recommendations (288.65 vs. 150.99 TL). Conclusions: Reflecting the treatment algorithms in the management of AF and related adverse events, our findings seem to emphasize the extra burden on health economics posed by patients suffering from the uncontrolled disease. (Anadolu Kardiyol Derg 2013; 13: 26-38)Publication Metadata only The effect of postmenopausal hormone therapy with or without folic acid supplementation on serum homocysteine level(TAYLOR & FRANCIS LTD, 2005) FAK, ALİ SERDAR; Toprak, A; Erenus, M; Ilhan, AH; Haklar, G; Fak, AS; Oktay, AObjective To evaluate the effects of postmenopausal hormone therapy (HT) with or without the addition of folic acid (FA) on serum homocysteine levels in a randomized, placebo-controlled design. Additionally, a non-randomized control group with no treatment was included. Methods Forty non-hysterectomized healthy postmenopausal women were randomly allocated to receive either oral continuous combined HT (0.625 mg conjugated equine estrogen with 2.5 mg medroxyprogesterone acetate daily) and oral folic acid (5 mg/day, n = 20) or HT and placebo (n = 20) for 3 months. A control group (n = 15) did not receive any study medication and was followed in the same manner. The fasting total serum homocysteine level was measured by fluorescence polarization immunoassay with a sensitivity of < 0.5 mu mol/l. Serum levels of folate, estrogen and lipid profile were also followed. Results The mean age of the postmenopausal women was 52 +/- 6 years. Baseline homocysteine level was the highest in the HT + FA group (9.96 +/- 2.82 mu mol/l), compared to HT + placebo (9.64 +/- 1.89 mu mol/l) and control groups (9.01 +/- 1.83 mu mol/l) (ANCOVA, p=0.022). Low baseline folate and vitamin B12 levels contributed significantly to the high level of baseline homocysteine in the HT + FA group. The addition of FA to HT led to a significant decrease in the serum homocysteine level from the baseline level of 9.96 +/- 2.82 mu mol/l to the final level of 8.92 +/- 2.53 mu mol/l (p = 0.023). On the other hand, HT alone (HT + placebo group) significantly increased the serum homocysteine level from 9.64 +/- 1.89 mu mol/l to 10.22 +/- 1.77 mu mol/l without a decline in serum folate level (p = 0.045). The serum homocysteine level in the control group did not change significantly (from 9.01 +/- 1.83 mu mol/l to 9.58 +/- 2.05 mu mol/l, p = 0.29). Conclusions Three months of oral continuous combined FIT increased the fasting total serum homocysteine level without affecting the serum folate level. Lowering the homocysteine level in postmenopausal woman on HT is achievable by folic acid supplementation.Publication Metadata only Interaction between C-Reactive Protein and Endothelin-1 in Coronary Artery Disease(KARGER, 2007) FAK, ALİ SERDAR; Gemici, Goekmen; Erdim, Refik; Tokay, Sena; Tezcan, Hakan; Fak, A. Serdar; Oktay, AhmetBackground: Increased concentrations of serum C-reactive protein (CRP) have been reported to predict major cardiovascular events in patients with coronary artery disease (CAD). Increased concentrations of endothelin-1 (ET-1) are also associated with poor prognosis after myocardial infarction. Hypothesis: We tested the hypothesis that ET-1 might contribute to CRP in prediction of adverse outcome in CAD. Methods: Serum high sensitive CRP and plasma ET-1 levels of 40 patients who have stable CAD and 25 control subjects were measured, and correlation analysis between these molecules was performed. Results: Mean high sensitive CRP was 8.64 +/- 12.73 mg/l, and mean ET-1 was 8.24 +/- 7.06 pg/ml in the CAD group. We found that there was no statistically significant correlation between high sensitive CRP and ET-1 in either CAD group (p = 0.82), or the control group (p = 0.85). In a subgroup of 13 patients who were not under statin treatment, we found a strong correlation between the levels of these molecules (p = 0.01). Conclusion: Our study does not clearly support or exclude a link between CRP and ET-1 in patients who have stable CAD. Copyright (C) 2007 S. Karger AG, BaselPublication Metadata only Inferior vena caval tumor thrombus extending into the right atrium in a patient with pancreatic cancer(SPRINGER, 2007) FAK, ALİ SERDAR; Ozben, Beste; Papila, Nurdan; Tanrikulu, M. Azra; Bayalan, Fatih; Fak, Ali Serdar; Oktay, AhmetVenous thromboembolism is a common complication in patients with cancer and an important cause of morbidity and mortality. Idiopathic thrombosis, migratory or recurrent thrombophlebitis may be the first manifestation of an occult malignancy. While deep venous thrombosis and pulmonary embolism are the most common thrombotic conditions in patients with malignant disease, tumor thrombus may be seen in inferior vena cava, mainly in patients with renal cell carcinoma, hepatocellular carcinoma, testicular tumors or adrenal carcinoma. Although pancreatic cancer is one of the cancers that are most strongly associated with thrombotic complications along with cancers of ovary and brain, there has been no report about presence of thrombus in the inferior vena cava in pancreatic cancer. We report a female patient with pancreatic cancer associated with tumor thrombus extending from the inferior vena cava to the right atrium.Publication Metadata only Effects of a single dose of oral estrogen on left ventricular diastolic function in hypertensive postmenopausal women with diastolic dysfunction(2000) FAK, ALİ SERDAR; Fak, A. S.; Erenus, M.; Tezcan, H.; Caymaz, O.; Oktay, S.; Oktay, A.OBJECTIVE: To evaluate the acute effects of a single dose of oral estrogen on left ventricular diastolic function in hypertensive postmenopausal women with diastolic dysfunction. DESIGN: Prospective, double-blind, placebo-controlled, clinical study. SETTING: Cardiology and postmenopausal outpatient clinics of a university hospital. PATIENT(S): Thirty postmenopausal women with hypertension (diastolic blood pressure of >90 mm Hg) and left ventricular diastolic dysfunction (mitral E/A ratio [the ratio of peak velocity of early mitral diastolic filling to late diastolic filling] of <1 and isovolumic relaxation time of >100 ms) were included in the study. Thirty normotensive postmenopausal women with normal left ventricular diastolic function served as the control group. INTERVENTION(S): Conjugated equine estrogen (0.625 mg) was given orally. Left ventricular diastolic function was assessed by Doppler echocardiography at baseline and 3 hours after the administration of estrogen. MAIN OUTCOME MEASURE(S): Left ventricular diastolic filling as assessed by Doppler echocardiography. RESULT(S): Estrogen had no effect on heart rate or blood pressure in either study group. The baseline E/A ratios were 0.72 +/- 0.26 and 1.22 +/- 0.30, and the isovolumic relaxation times were 122 +/- 18 ms and 89 +/-14 ms in the hypertensive and normotensive groups, respectively. Estrogen had no significant effect on any of the Doppler parameters in the normotensive group. In the hypertensive group, there was a trend toward normalization of the E/A ratio (from 0.73 +/- 0.11 to 0.84 +/- 20) and a significant improvement in the isovolumic relaxation time (from 124 +/- 20 ms to 105 +/- 13 ms) in response to the administration of estrogen compared with placebo. CONCLUSION(S): A single dose of oral estrogen caused a significant improvement in left ventricular diastolic filling in hypertensive postmenopausal women with diastolic dysfunction.Publication Metadata only Peripartum cardiomyopathy presenting with repetitive monomorphic ventricular tachycardia(WILEY, 2004) FAK, ALİ SERDAR; Gemici, G; Tezcan, H; Fak, AS; Oktay, AGEMICI, G., ET AL.: Peripartum Cardiomyopathy with Repetitive Ventricular Tachycardia. A 30-year-old asymptomatic pregnant woman at 38 weeks' gestation was noticed to have repetitive monomorphic ventricular tachycardia. A dilated left ventricle with moderately reduced systolic function was found on echocardiographic examination. To the best of our knowledge, a case of peripartum cardiomyopathy presenting with repetitive monomorphic ventricular tachycardia has not been previously reported.Publication Open Access Perindopril decreases P wave dispersion in patients with stage 1 hypertension(SAGE PUBLICATIONS LTD, 2009-06) FAK, ALİ SERDAR; Ozben, Beste; Sumerkan, Mutlu; Tanrikulu, Azra Meryem; Papila-Topal, Nurdan; Fak, Ali Serdar; Toprak, AhmetIntroduction. Angiotensin-converting enzyme inhibitors prevent atrial fibrillation episodes by effective control of blood pressure and improving electrical and structural remodelling in the atria. Increased P wave dispersion (PWD) is a non-invasive electrocardiographic marker for paroxysmal atrial fibrillation. The aim of the study was to evaluate the effect of perindopril treatment on PWD in hypertensive patients. Methods. Forty-eight hypertensive patients (mean age 57.4 +/- 11.8 years, 18 men) were included. Blood pressure values were determined and 12-lead electrocardiograms were recorded at the beginning and at the first week, first month, third month and sixth month of the perindopril treatment. The difference between maximum and minimum P wave durations was calculated as PWD. Results. PWDs were significantly shortened at the first, third and sixth months (41.7 +/- 8.8 ms, 39-1 +/- 6.9 ms and 38.3 +/- 7.1 ms, respectively) compared with baseline and first-week measurements (54.3 +/- 9.2 ms and 49.0 +/- 9.1 ms, respectively, p<0.001). Baseline PWD was correlated with body mass index (r=0.32, p=0.026), while PWD at the sixth month of treatment was significantly correlated with left atrial volume index (r=0.30, p=0.042). Multiple linear regression analysis revealed that PWD at the sixth month was related to baseline PWD (p=0.001). Conclusion. Perindopril treatment significantly reduced PWD in hypertensive patients.Publication Open Access Polymorphisms of the angiotensin-converting enzyme and angiotensinogen gene in patients with atrial fibrillation(SAGE PUBLICATIONS LTD, 2011-12) FAK, ALİ SERDAR; Topal, Nurdan Papila; Ozben, Beste; Hancer, Veysel Sabri; Tanrikulu, Azra Meryem; Diz-Kucukkaya, Reyhan; Fak, Ali Serdar; Basaran, Yelda; Yesildag, OsmanActivation of the renin-angiotensin system (RAS) is associated with atrial fibrillation (AF). The aim of this study was to investigate the relation between AF and polymorphisms in RAS. One hundred and fifty patients with AF, 100 patients with no documented episode of AF and 100 healthy subjects were consecutively recruited into the study. The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism, and the M235T, A-20C, and G-6A polymorphisms of the angiotensinogen gene were genotyped. Patients with AF had significantly lower frequency of II genotype of ACE I/D and higher frequency of angiotensinogen M235T polymorphism T allele and TT genotype and G-6A polymorphism G allele and GG genotype compared with the controls. AF patients had significantly larger left atrium, higher left ventricular mass index (LVMI) and higher frequency of significant valvular pathology. ACE I/D polymorphism II genotype, angiotensinogen M235T polymorphism TT genotype and G allele and GG genotype of angiotensinogen G-6A polymorphism were still independently associated with AF when adjusted for left atrium, LVMI and presence of significant valvular pathology. Genetic predisposition might be underlying the prevalence of acquired AF. Patients with a specific genetic variation in the RAS genes may be more liable to develop AF.Publication Open Access Yeni Bir Yaklaşımla Genç Bireylerde Kalp Sağlığı Takibi için Web ve Mobil Uygulama Geliştirilmesi(2019-11-01) FAK, ALİ SERDAR; ZEHRA AYSUN ALTIKARDEŞ;Mensur BAJGORA;Ufuk SARIKAYA;BUKET DOĞAN;ALİ SERDAR FAKKardiyovasküler hastalık riskini tetikleyen hipertansiyon, obezite, diyabet gibi önlenebilir hastalıkların ve risk faktörülerinin sıklığı ülkemizdekigenç bireylerde hızla artmaktadır. Bu hastalıkların kontrollü bir şekilde takip edilebilmesi ve önlenebilmesi için Marmara Üniversitesiöğrencilerinin demografik ve sağlık verilerinin kayıt altına alınmasını ve izlenmesini sağlayan web ve mobil uygulamanın geliştirilmesisağlanmıştır. Böylece, Framingham risk skoruna göre öğrencilerin 10 yıllık kardiyovasküler risklerinin hesaplanarak görüntülendiğive kişiye özel hale getirilmiş tıbbi önerilerin e-posta yoluyla bildirildiği bir web platformu PHP ve MySQL kullanılarak oluşturulmuştur.Öğrencilerin ilerleyen zamandaki kardiyovasküler hastalık risklerinin takip edilebildiği bu platform, yüksek risk grubunda olan bireylerinrisk seviyelerinin normale indirilebilmesi için farkındalıklarını arttıran bir işlevselliğe sahiptir. Hazırlanan web platformunun desteklenmesiiçin, Marmara Üniversitesi öğrencilerinin kendi sağlık durumlarını takip edebilecekleri, kalp sağlığı konusunda bilinçlendirici bildirimlerledestekleneceği ve yaşam kalitelerini arttırabilmeleri için bir standart oluşturulmasına yardımcı olacak “Sağlıklı Kalpler” adındaAndroid ve iOS platformlarında kullanılmak üzere bir mobil uygulama geliştirilmiştir. Bu uygulama içerisinde adım sayar, egzersiz ekleme,listeleme, sağlıklı beslenme ve güncel sağlık durumunu izleme gibi fonksiyonlar bulunmaktadır.Publication Metadata only Investigation of the Association Between Dopamine D1 Receptor Gene Polymorphisms and Essential Hypertension in a Group of Turkish Subjects(INFORMA HEALTHCARE, 2011) FAK, ALİ SERDAR; Orun, Oya; Nacar, Cevdet; Cabadak, Hulya; Tiber, Pinar Mega; Dogan, Yuksel; Guneysel, Ozlem; Fak, Ali Serdar; Kan, BekiDopamine has been shown to influence blood pressure by regulating renal sodium excretion through direct interaction with the dopamine receptors, especially with the Dopamine D1 receptor (DRD1). To better understand the role of polymorphisms in those effects, we investigated the association between two polymorphic sites in the DRD1 promoter region (A-48G, G-94A) and essential hypertension in the Turkish population. The DRD1 variants were genotyped by restriction fragment length polymorphism (RFLP) analysis. A total of 205 unrelated individuals were enrolled in the study. We found that genotype distributions and allele frequencies of the control and hypertensive subjects were very similar and did not show any significant difference with respect to blood pressure (BP) and hypertension. Contribution of the gene variances in BP or hypertension by sex differences and dependence on body mass index (BMI) were also evaluated. Distribution of genotypes and allele frequencies were found to be in line with previous reports. However, increments detected in hypertensive subjects were far from being statistically significant.
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