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Belhhan Akpinar

Publications and source records attributed to Belhhan Akpinar.

18 recordsLinked to original sources
PubMed2006

Robotic-enhanced totally endoscopic mitral valve repair and ablative therapy.

PURPOSE: The aim of this article was to assess the feasibility of totally closed robotic mitral valve repair and ablative therapy. DESCRIPTION: Two patients with mitral valve disease and permanent atrial fibrillation underwent the combined procedure using the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA). Radiofrequency ablation was performed using the Cardioblate XL unipolar pen (Medtronic Inc, Minneapolis, MN). One patient underwent mitral commissurotomy and the other commissurotomy and Reed annuloplasty. EVALUATION: There were no procedure-related complications. Sinus rhythm was established in both patients after the operation, and transesophageal echocardiography revealed competent mitral valves without residual gradients. CONCLUSIONS: Robotic-enhanced mitral valve repair and ablation proved feasible in both patients with good clinical outcome. The described combined method may find broader application in a selected group of patients with the continuing evolution in technology.

Atrial Fibrillation↗
PubMed2006

Combined off-pump coronary artery bypass grafting surgery and ablative therapy for atrial fibrillation: early and mid-term results.

BACKGROUND: The aim of this study was to evaluate the feasibility of off-pump coronary artery bypass grafting combined with radiofrequency ablation and to compare outcomes between patients with permanent and paroxysmal atrial fibrillation (AF) in terms of restoring sinus rhythm. METHODS: Thirty-three patients underwent the combined procedure. Mean age was 62.34 +/- 8.20 years; there were 12 female and 21 male patients. Twenty-one patients were diagnosed as permanent AF (group A) and 12 had paroxysmal AF (group B). After the off-pump revascularization patients underwent pulmonary vein ablation. Rhythm was evaluated at discharge and at 6 and 12 months' follow-up. Patients in stable sinus rhythm underwent transthoracic echocardiographic examination to evaluate atrial contractility at 6 and 12 months. RESULTS: There was no operative mortality or major complications. The mean ablation time was 11 +/- 3.4 minutes, including multiple applications. At the end of the procedure 84.5% of patients were free of AF. Sinus rhythm was established in 56% (group A, 52%; group B, 58.3%), 70.5% (group A, 58%; group B, 83.3%), and 71% (group A, 59%; group B, 83.3%) of patients at discharge and at 6 and 12 months, respectively (p = 0.249). Biatrial contractility was detected in 71% of group A and 76% of group B patients at 6 months' follow-up. More patients in group A returned to AF during follow-up when compared with group B (p = 0.016). Female sex (odds ratio, 2.1), chronic lung disease (odds ratio, 1.40), left ventricular disfunction (p = 0.016), and hypertension (odds ratio, 2.57) emerged as risk factors for AF recurrence after ablation. CONCLUSIONS: Concomitant off-pump coronary artery bypass grafting and bipolar radiofrequency ablation was safe and effective. These patients should be considered for adjunctive treatment at the time of off-pump revascularization.

Aged↗
PubMed2006

Chylothorax after aortic valve replacement.

A 71-year-old-man was diagnosed with chylothorax after aortic valve replacement. He was treated with a low-fat diet and pleural drainage with thoracentesis. The pleural effusion completely resolved by the 14th postoperative day.

Aged↗
PubMed2005

Clinical experience with the Novare Enclose II manual proximal anastomotic device during off-pump coronary artery surgery.

OBJECTIVE: The aim of this study was to assess the feasibility and safety of a new proximal anastomotic device during off-pump coronary surgery. METHODS: The Novare Enclose II is a manual proximal anastomotic device that enables the surgeon to perform proximal anastomoses without side-biting clamps in a fully pressurized aorta. The device was used in 30 off-pump coronary artery bypass graft (CABG) patients (Group A) for performing 25 vein, 10 free right internal thoracic artery and 14 radial artery anastomoses to the aorta. The number of proximal anastomoses varied between 1 and 3 per patient. Intraoperative transcranial Doppler measurements were performed to detect cerebral microemboli during the use of the device and were compared with transcranial Doppler measurements of 30 off-pump patients where a partial side clamp was used for proximal anastomoses (Group B). The aorta was evaluated using transesophageal echocardiography (TEE) and epiaortic echocardiography (EAE) in both groups before the procedure and patients with a calcified aorta were excluded. RESULTS: In Group A, 49 proximal anostomoses were performed as planned with the device using conventional hand-sewn methods. Twenty-four of these were arterial conduits. In Group B, 32 proximal anastomoses were performed using 25 veins and 7 arterial grafts. There were no procedure related to adverse events or complications in both groups. The median number of microemboli was 15 (range 5-48) in Group A and 68 (range 35-290) in Group B (P<0.05). CONCLUSION: The Enclose II device can be a valuable tool to perform venous or arterial proximal anastomoses during off-pump CABG. Transcranial Doppler results suggest that the device seems to be less traumatizing than side clamping and may reduce clamp-associated complications during off-pump coronary artery surgery.

Anastomosis, Surgical↗
PubMed2004

Does off-pump CABG reduce gastrointestinal complications?

BACKGROUND: The aim of this study was to compare gastrointestinal complications and associated risk factors among patients undergoing cardiac surgery using off- and on-pump revascularization techniques. METHODS: A total of 1146 adult patients who underwent coronary artery surgery during a 6-year period were evaluated retrospectively. Group 1 consisted of 546 patients operated using off-pump techniques and group 2 consisted of 600 cases operated with cardiopulmonary bypass. Patients were compared and evaluated for gastrointestinal complications and possible associated risk factors using univariate and multivariate logistic regression analysis. RESULTS: Overall mortality was 1.6% in group 1 and 2.2% in group 2 (p = 0.523). Mortality due to gastrointestinal complications was 38.5% and 35.7% respectively in group 1 and group 2. The mean EuroSCORE value was 5.1 +/- 2.8 in group 1 and 3.8 +/- 2.4 in group 2 (p < 0.001). The most common gastrointestinal complication in the off-pump group was gastrointestinal bleeding. The leading complication in group 2 was intestinal ischemia. CONCLUSIONS: The incidence rates of gastrointestinal complications were similar in the on- and off-pump coronary artery bypass groups, the type of gastrointestinal complications, however, was different. Mortality rate due to these complications was also similar and remained high, regardless of the type of surgery. Cardiopulmonary bypass did not emerge as a risk factor for gastrointestinal complications, but prolonged cardiopulmonary bypass (longer than 98 minutes) resulted in a high incidence of such complications. Old age and advanced arteriosclerosis emerged as risk factors in both groups resulting in gastrointestinal complications suggesting the ischemic nature of the injury.

Aged↗
PubMed2004

Combined radiofrequency ablation and myxoma resection through a port access approach.

Myxomas are common cardiac tumors that are traditionally managed by complete excision through a median sternotomy approach with the use of cardiopulmonary bypass. We discuss a patient with left atrial myxoma and chronic atrial fibrillation who underwent surgical excision and combined irrigated radiofrequency ablation for atrial fibrillation through a Port Access approach. Minimally invasive operations constitute an expanding field for the treatment of many cardiac diseases and may be an alternative for the treatment of this pathology because of less surgical trauma and cosmetic superiority. In this case, both excision of the myxoma and radiofrequency ablation were feasible through this minimally invasive approach. The combination of direct and endoscopic views enabled both procedures to be performed safely and efficiently.

Atrial Fibrillation↗
PubMed2004

The use of autologous pericardium for complicated mitral valve annulus.

The study aims to discuss annular repair using the autologous pericardial patch in cases with severe mitral ring calcification and endocarditis during mitral valve replacement. In the study, annular reconstruction was applied, during mitral valve replacement, to 8 patients who had extensive annular calcification or annular destruction due to endocarditis. After annular resection, a two-centimeter wide autologous pericardial patch was sutured continuously to the left ventricular wall close to the posterior annulus. After the valve sutures with pledgets were placed at the back of the pericardial patch, the other edge of the patch was sutured continuously to the left atrial posterior wall. Suturing was complete after the whole annulus was encircled. Thereafter, an appropriately sized mechanical prosthesis valve was used. One patient died postoperatively due to low cardiac output (early mortality 12.5%). Echocardiographical paravalvular leakage was not detected in any of the cases during follow-up. Annular dehiscence and other annular pathologies were also not detected. This reconstructive approach may positively influence mortality and morbidity in cases with complicated mitral pathologies.

Adult↗
PubMed2004

Lipoprotein lipase gene polymorphism and lipid profile in coronary artery disease.

CONTEXT: Lipoprotein lipase (LPL) plays a central role in lipid metabolism, hydrolyzing triglyceride in chylomicrons and very-low-density lipoproteins. The PvuII polymorphic variant of LPL gene is common and might affect risk of coronary artery disease (CAD). OBJECTIVE: Our aim was to determine whether LPL- PvuII polymorphism can be considered to be an independent risk factor or a predictor for CAD in Turkish subjects. DESIGN: We used polymerase chain reaction and restriction enzyme digestion to determine the distribution of the previously described C-->T transition that causes a PvuII polymorphism in intron 6 among healthy blood donors of Turkish origin and among angiographically confirmed CAD patients with comparable ethnic backgrounds. RESULTS: For the PvuII genotypes, within the CAD group (n = 80), the +/- genotype was found in 39 individuals (48.8%), whereas 25 (31.3%) carried the +/+ genotype, and 14 (17.5%) carried the -/- genotype. Within the control group (n = 49), the -/- genotype was found in 19 individuals (38.8%), 16 (32.7%) carried the +/- genotype, and 14 (28.6%) carried the +/+ genotype. The genotype frequency distribution was significantly different (P =.049) in the CAD and control study groups. The most frequent genotype among CAD patients was +/-; this genotype was more frequent in patients than in control subjects. However, the -/- genotype was more prevalent in the control group. Lipoprotein lipase-PvuII polymorphism was found to be associated with fasting total cholesterol and low-density lipoprotein cholesterol levels. The +/+ genotype was found to have higher levels of total cholesterol and low-density lipoprotein cholesterol in both the CAD and control groups. CONCLUSION: There was a difference in the distribution of LPL-PvuII genotypes between the healthy subjects and the patients with CAD. Lipoprotein lipase-PvuII polymorphisms were not detected as independent risk factors for CAD in this study group, but had associations with lipid levels.

Amino Acid Substitution↗
PubMed2003

Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results.

OBJECTIVE: The aim of this study was to assess the feasibility and effectiveness of irrigated radiofrequency (RF) modified Maze procedure through a port access approach during mitral valve surgery and evaluate early and mid-term results. MATERIAL AND METHOD: During a 16 months time period, 67 patients with chronic atrial fibrillation (AF) eligible for port access mitral valve surgery were randomly assigned to either Group A, in which they underwent a combined procedure (N = 33) or Group B, in which a valve procedure alone was performed (N = 34). Both groups were similar in terms of age, sex, valve pathology, duration of AF left atrial diameter and left ventricle function (P > 0.05). Four had undergone previous operations. RESULTS: Median follow-up was 10 months for both groups, 95% CI (9.18-10.8). One patient in each group died early postoperatively (3 and 2.9%). Two patients required reoperation for bleeding, one in each group (3 and 2.9%). There were two conversions to right thoracotomy. In Group A, freedom from AF was 100% at the end of the operation (76% sinus, 24% pacemaker) Six and twelve months freedom from AF was 87.2 and 93.6%, respectively. In Group B, freedom from AF at the end of operation was 41%. At the end of 6 and 12 months, freedom from AF was 9.4% (P = 0.0001). One patient in Group A required a permanent pacemaker (3%). During follow-up, one patient in Group A died of non-cardiac causes (3%). In Group B, there were two late deaths: one cardiac (2.9%) and one neurologic (2.9%). There were no thromboembolic events detected in Group A during follow-up, whereas two patients in Group B suffered this complication (6%, P = 0.081). At 12 months, functional capacity had improved for patients in both groups (P < 0.0001). CONCLUSION: The combination of mitral valve surgery and irrigated RF Maze procedure was safe and efficient through a port access approach. There were no procedure related complications like esophageal or coronary artery injury. Early and mid-term results were favourable with 93.6% of patients free of AF at 1 year in comparison to the 9.4% of the control group. The data is not sufficient to reach any conclusions in terms of thromboembolic rates, despite favourable results for the RF Maze group. Nevertheless, in terms of feasibilty, sinus rhythm restoration and overall outcome, early results are encouraging and we advocate the use of the combined procedure through a port access approach.

Adult↗
PubMed2003

Left versus bi-atrial intraoperative saline-irrigated radiofrequency modified maze procedure for atrial fibrillation.

BACKGROUND: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified maze operation for the treatment of chronic atrial fibrillation (AF) and compare the results of the left and bi-atrial procedures. MATERIAL AND METHOD: During a period of two years, 105 patients with chronic AF having concomitant cardiac surgery underwent the procedure. Patients underwent either a bi-atrial ( n = 48) or left atrial ( n = 57) maze procedure. The first twenty patients underwent a bi-atrial maze procedure regardless of the pathology. In the following patients we adopted the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. Mean age was 52 +/- 11 years in bi-atrial group and 54 +/- 9 years in left atrial group. RESULTS: Three patients died early postoperatively (2.9%). There were 4 revisions for bleeding (3.8%). Two patients in bi-atrial group received a permanent pacemaker (4.1%). Patients in both groups were free of AF at the end of the procedure. (Bi-atrial group: sinus: 79.2%, pacemaker: 20.8%), (Left atrial group: sinus: 82.5%, pacemaker: 17.5%) ( p > 0.05). During the last follow-up, sinus rhythm was maintained in 79.6% of cases in bi-atrial group, while this rate was 75.6% in left atrial group ( p > 0.05). CONCLUSION: Saline irrigated radiofrequency modified maze procedure was performed safely and efficiently. Both the left and bi-atrial procedures were successful in terms of restoring sinus rhythm. Our current policy is to adopt the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side.

Adult↗
PubMed2003

Comparison of intraoperative transit-time flow measurement with early postoperative magnetic resonance flow mapping in off-pump coronary artery surgery.

The purpose of this prospective study was to evaluate graft patency of off-pump coronary artery surgery intraoperatively by transit-time flow measurement and to compare this technique with postoperative magnetic resonance flow mapping. Twenty patients (13 men and 7 women; mean age, 679 +/- 76 yr) underwent off-pump coronary artery surgery. Intraoperative transit-time flow measurement of grafts was performed measuring maximum, minimum, and mean flows. For each graft, the pulsatile index was calculated by dividing the difference between the maximum and the minimum flow by the mean flow In the early postoperative period (1st week), magnetic resonance flow mapping was performed using phase contrast flow quantification. Mean intraoperative flow values and mean magnetic resonance flow mapping values were compared. At the same postoperative session, contrast-enhanced magnetic resonance angiography was performed to evaluate graft patency. In 20 patients, a total of 49 coronary graft flows were assessed with intraoperative transit-time flow measurement and postoperative magnetic resonance flow mapping. Upon comparison, there was a strong correlation between techniques, with stable and statistically significant differences between the intraoperative and postoperative flow mapping values. One saphenous vein graft was revised intraoperatively, due to graft failure. Our data suggest that the combined use of intraoperative transit-time flow measurement and postoperative magnetic resonance flow analysis has a potential role in the assessment of graft patency in off-pump coronary artery surgery although more study is required.

Aged↗
PubMed2003

A radiofrequency modified maze and valve procedure through a port-access approach.

BACKGROUND: The aim of the study was to assess the feasibility and effectiveness of the irrigated radiofrequency modified maze procedure through a port-access approach during mitral valve surgery. METHODS: Forty-three patients with atrial fibrillation (AF) and mitral valve disease underwent a combined procedure through a port-access approach. The indication was a history of continuous AF for more than 6 months in patients eligible for minimally invasive mitral valve surgery. RESULTS: The incidence of early mortality was 1 patient (2.3%), and that of freedom from AF was 100% at the end of the operation (70% of patients with normal sinus rhythm, 30% with a pacemaker). One patient (2.3%) required permanent pacemaker implantation after surgery. One patient (2.3%) required reoperation for bleeding. There were no reoperations for failed valve repairs. The incidences of freedom from AF were 87% and 92% at 6 and 12 months, respectively. At 12 months, functional capacity had improved significantly (P < .05). There were no procedure-related complications. No thromboembolic events were detected during follow-up. CONCLUSION: The port-access approach provided a good access for both valve surgery and the radiofrequency maze procedure. The combination of direct and videoscopic vision allowed an adequate view and led to a safe and efficient combined procedure. Short- and intermediate-term follow-up results were favorable.

Atrial Fibrillation↗
PubMed2003

Hemodilution during off-pump coronary artery bypass grafting: can we improve flow and reduce hypercoagulability?

BACKGROUND: The aim of this study was to compare intraoperative coronary graft flows performed on pump and off pump and to evaluate the effects of hemodilution on coronary graft flows in off-pump coronary artery bypass grafting (CABG) patients by using transit time flow measurements (TTFM). METHODS: Three hundred patients undergoing only CABG procedures were enrolled in a prospective randomized manner into 3 groups. Group 1 consisted of 100 patients undergoing operations with standard cardiopulmonary bypass techniques. Group 2 consisted of 100 patients scheduled for revascularizations using off-pump techniques. Group 3 consisted of 100 patients who underwent operations with offpump techniques under controlled hemodilution (hematocrit levels kept between 25% and 28%). TTFM were performed with the coronary Flometer system. Mean flows, pulsatility indices, and flow patterns were evaluated. Twenty-five patients in each group were randomly assigned for control angiography 6 days postoperatively. Thromboelastographic (TEG) measurements were performed for each patient before and after surgery to evaluate the patient's coagulation status. RESULTS: The mean number of anastomoses was higher in group 1 than in groups 2 and 3 (P < .05). Mean arterial pressures and heart rates were similar between groups during measurements. Hematocrit values were higher in group 2 than in groups 1 and 3 (P < .05). Mean flows for left anterior descending coronary artery and right coronary artery territories were significantly lower in group 2 patients (P < .05). For the circumflex artery territory, mean flows did not reach statistically significant levels despite lower flows again in group 2. The pulsatility indices were similar in all 3 groups for all 3 coronary territories. Postoperative coronary angiographic results revealed similar graft patencies among the 3 groups (not significantly different). Postoperative TEG patterns failed to show a hypercoagulable state in off-pump patients. CONCLUSION: Off-pump CABG patients with hemodilution had significantly higher graft flows than off-pump CABG patients without hemodilution. Although we failed to show the existence of a hypercoagulable state for patients in the offpump group, an examination of the TTFM findings suggests that hemodilution may help to improve graft patency in offpump CABG patients during the early postoperative period.

Blood Coagulation Disorders↗
PubMed2002

Intraoperative saline-irrigated radiofrequency modified Maze procedure for atrial fibrillation.

BACKGROUND: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified Maze operation for treatment of chronic atrial fibrillation, and to compare the results of the left and biatrial procedures. METHODS: During a period of 11 months, 62 patients with chronic atrial fibrillation who were having concomitant cardiac surgery underwent the procedure. The mean age of the patients was 52 +/- 14 years. Patients underwent either a biatrial (group A; n = 39) or left atrial (group B; n = 23) procedure. RESULTS: Two patients (3.2%) died early in the postoperative period. Three patients (4.8%) required reoperation for bleeding. One patient in group A (1.6%) received a permanent pacemaker. Patients in both groups were free of atrial fibrillation at the end of the procedure (group A: sinus 86.9%, pacemaker 13%; group B: sinus 90.5%, pacemaker 9.5%) (p > 0.05). At 1-month and longer-term follow-up, sinus rhythm was maintained in 92% and 95% of cases in group A, respectively, whereas this rate was 71% and 81% in group B (p > 0.05). Holter monitor surveillance revealed a higher rate of atrial fibrillation, atrial arrhythmias, and atrial flutter in group B (p < 0.05). Transthoracic echocardiography revealed improvement over time in left atrial transport function in both groups (p < 0.05). CONCLUSIONS: The saline-irrigated radiofrequency modified Maze procedure was performed safely and efficiently. Both the left and biatrial procedures were successful in terms of restoring sinus rhythm during short-term follow-up. Long-term follow-up with more cases is needed to show the superiority of one method over the other.

Atrial Fibrillation↗
PubMed2002

Effects of intravenous triiodothyronine during coronary artery bypass surgery.

A prospective randomized and double-blind study was performed to evaluate whether perioperative triiodothyronine administration has any effect on cardiovascular performance after coronary artery bypass surgery. Sixty patients were assigned to 2 groups of 30 each. When crossclamping ended, group A received an intravenous bolus of triiodothyronine, followed by infusion for 6 hours. Group B received a placebo. Serum triiodothyronine levels and hemo-dynamic parameters were serially measured. Mean postoperative cardiac index was slightly, but not significantly, higher in group A, whereas systemic vascular resistance was significantly lower in group A. Compared with preoperative values, serum triiodothyronine levels dropped significantly in group B at the end of cardiopulmonary bypass and remained low 12 hours postoperatively, while levels rose significantly in group A. No significant differences were detected between the groups in the incidence of arrhythmia, the need for inotropic support, intensive care unit stay, mortality, and morbidity. Perioperative administration of triiodothyronine increased cardiac output slightly and decreased systemic vascular resistance, but it had no effect on operative outcome. Routine use after coronary surgery is thus not recommended.

Aged↗
PubMed2002

The use of stentless valves for root replacement during repair of ascending aortic aneurysms with aortic valve regurgitation.

BACKGROUND: Early and mid-term results of stentless valves for the treatment of ascending aortic aneurysm (AAA) were evaluated in a retrospective manner. MATERIAL AND METHODS: During a four-year period, 26 patients with ascending aortic aneurysms and aortic valve insufficiency underwent a total root replacement procedure using a stentless "Freestyle" valve (Medtronic Inc., Minneapolis MN). Mean age was 71 +/- 4 years (range 66 to 79 years). Eight patients were in NYHA Class 2, 13 in Class 3, and 5 in Class 4. Cardiopulmonary bypass (CPB) was begun with femoral artery-right atrium (two-stage) cannulation in all cases but four, in which the right axillary artery was used. Myocardial protection was established by retrograde, cold-blood cardioplegia and direct antegrade blood cardioplegia from the right coronary ostium. The left ventricle outflow tract was constructed by using 2-0 ticron sutures and incorporating a pericardial strip in between. Coronary buttons were sewn to the xenograft with 6-0 polypropylene sutures. Meanwhile, the patient was cooled down to 18 degrees nasopharyngeal temperature and the distal anastomosis with the proximal arch was performed with a Dacron graft under total circulatory arrest (TCA), using 4-0 polypropylene sutures. During rewarming, the connection between the Freestyle valve and the Dacron graft was performed. RESULTS: Ischemic time was 91 +/- 11 minutes and TCA time was 9 +/- 4 minutes. Operative mortality was zero, and there was one 30-day mortality (3.8%). At discharge, all 25 patients had a functional valve with low transvalvular gradients. Patients were followed for a mean period of 15 months, with one patient being lost to follow-up and one patient dying of non-cardiac causes. Follow-up was 97% complete, and echocardiographic control during the follow-up period revealed competent valves with gradients comparable to those at discharge. Two patients were screened with electron beam tomography (EBT) three years after the operation and there was no sign of wall or leaflet calcification. At the end of the 15 months (mean) follow-up, the functional capacity of the patients had improved significantly (p <0.05). CONCLUSIONS: Our early results suggest that use of the Freestyle valve in conjunction with a Dacron tube graft can be a good alternative for patients over 65 years of age who present with ascending aortic aneurysm with aortic valve insufficiency.

Aged↗
PubMedDate not supplied

Genetic variations of the apolipoprotein B gene in Turkish patients with coronary artery disease.

BACKGROUND: The results of studies that clarify the association of genetic markers at the apolipoprotein B (apo B) gene (EcoRI and XbaI polymorphisms) with coronary artery disease (CAD) are not consistent and suggest that the effect is context dependent (dependent on ethnicity and sex). The present study represents the first investigation of the apo B gene polymorphisms in Turkish patients with CAD and their influence on lipid levels. AIM: The study investigated the association of apo B gene EcoRI and XbaI polymorphisms with CAD and with variation in lipid levels (total cholesterol (T-Chol), high-density lipoprotein cholesterol (HDL-Chol), low-density lipoprotein cholesterol (LDL-Chol), and triacylglycerol (TAG)). SUBJECTS AND METHODS: The study group was composed of 150 individuals with angiographically documented CAD and 100 angiographically proven to be healthy controls. PCR-RFLP was used to determine the DNA polymorphisms of the apo B gene. RESULTS: The frequencies of apo B genotypes detected with EcoRI (AA, AG, GG) and XbaI (CC, CT, TT) did not differ significantly between case and control subjects. A significant association between EcoRI genotypes and T-Chol (p < or = 0.05), and LDL-Chol (p < or = 0.001) was observed only in CAD patients. Patients with the AA genotype had higher levels of serum T-Chol and LDL-Chol compared with AG. With logistic regression analysis the XbaI TT genotype was found to be associated with CAD prevention. However, no significant differences in lipid variables were determined for the XbaI polymorphisms in the patients with CAD. CONCLUSIONS: Apo B EcoRI genotypes were not found as risk factors for CAD, whereas XbaI TT genotype was detected to prevent against CAD in our study group.

Apolipoproteins B↗