Aim:We aimed to report our postoperative results in elderly patients that had off-pump coronary bypass grafting. Method:Data of 173 patients with isolated coronary bypass 70 years of age or older were retrospectively evaluated. One month follow-up data were evaluated in all patients. After getting verbal informed consent a total of 91 patients were included in the quality of life assessment via EuroQoL form. The data of patients with age of 70-74 and 75 or older were compared.Results:The mean ages of patients at age of 70-74 and ≥75 were 71.69±0.16 and 76.81±0.23 years; respectively. Eleven cases had in-hospital mortality (%6 of 173 patients). The mean follow-up period for the group that were reached for EuroQoL assessment was 46,3 ± 20,8 months. The percent of cases among the whole study group that had participated in the quality of life questionnaire were in good condition in terms of mobility, self-care, usual activities, pain/discomfort, anxiety/depression were %75, %87, %81, %92 and %89; respectively.Discussion:Off-pump coronary bypass operation may be safely used in elderly patients with high quality of life and low morbidity and mortality.

Background:The aim of this study is to determine the frequency of sarcopenia at the time of diagnosis in RA patients, evaluate the effects of sarcopenia on RA disease activity, prognosis and examine the factors that may be associated with sarcopenia.Objectives:To determine the frequency of sarcopenia at the time of diagnosis in rheumatoid arthritis (RA) patients, assessing disease activity and factors that may be associated with sarcopenia and observe effects of treatment on sarcopenia.Methods:A prospective study was conducted on RA patients with newly diagnosed. Patients were evaluated twice, at the time of diagnosis and three months after the initiation of treatment. Demographic data, anthropometric measurements, disease activity scores and sarcopenia status were recorded. Sarcopenia was evaluated with grip strength and bioelectric impedance. The results were also compared with healthy volunteers.Results:Hand grip strength (p<0.001), skeletal muscle mass (p=0.009) and skeletal muscle mass index (p=0.032) were found to be reduced in RA patients compared to the control group. The frequency of sarcopenia in RA at onset of diagnosis was found to be 31.5%. There was a significant decrease in the rate of sarcopenia after three months of treatment (31.5% versus 8.7%; p=0.046).Conclusion:Sarcopenia was found in approximately one third of the patients with newly diagnosed RA in our study. With treatment, sarcopenia improved significantly. RA patients should be evaluated in terms of sarcopenia besides evaluating joint and extra-articular findings at the time of diagnosis. Early detection and treatment planning may improve the quality of life.Figure 1.Distribution of skeletal muscle mass index (SMMI) and prevalence of sarcopenia in RA and control groupsTable 1.Demographics, clinical features, anthropometric measurements and disease activity scores of sarcopenic and non-sarcopenic RA patientsRA without sarcopenian=37RA with sarcopenian=17pAge, mean (SD), years47,3 (12,8)58,0 (16)0,011*Gender, female, n (%)27 (73)9 (52,9)0,215Marital status, married, n (%)34 (91,9)13 (76,5)0,258Tobacco consumption, n (%) Active smoker10 (27)5 (29,4)0,086 Ex-smoker8 (21,6)8 (47,1) Never smoker19 (51,4)4 (23,5)Alcohol consumption, n (%) Active drinker2 (5,4)2 (11,8)0,244 Ex-drinker0 (0,0)1 (5,9) Never drinker35 (94,6)14 (82,4)Occupation, n (%) Worker15 (40,5)12 (70,6)0,060Height, mean (SD), meter1,6 (0,1)1,6 (0,1)0,664Weight, mean (SD), kg80,6 (17,7)65,3 (8,6)<0,001*BMI, mean (SD), kg/m231,4 (7,3)24,9 (3,2)<0,001*Obese, n (%)20 (54,1)2 (11,8)0,006*Waist circumference, mean (SD), cm97,1 (14,2)89,3 (12,8)0,058Hip circumference, mean (SD), cm108,1 (12,7)96,6 (5,1)0,001*Calf circumference, mean (SD), cm35,4 (5,1)29,6 (4,0)<0,001*Triceps skin thickness, median (min-max), mm22 (8-36)15 (6-31)0,022*Loss of muscle strength, n (%) Right10 (27,0)9 (52,9)0,076 Left12 (32,4)10 (58,8)0,081Dominant hand, right, n (%)33 (89,2)13 (76,5)0,418SMM, mean (SD)25,1 (5,8)21,9 (4,7)0,049*SMMI, mean (SD)9,6 (1,5)8,2 (1,2)<0,001*DAS 28 - CRP, median (min-max)4,4 (1,7-6,5)4,4 (2,4-6,3)0,860SDAI, median (min-max)36,1 (8,8-113)31,1 (17,1-113)0,668CDAI, median (min-max)23 (0-48)23 (6-39)0,993PrGA, median (min-max)6 (0-9)5 (2-10)0,627PtGA, median (min-max)8 (0-10)7 (4-10)0,666Presence of morning stiffness, n (%)32 (86,5)14 (82,4)0,999Swollen joint count, median (min-max)2 (0-10)4 (0-9)0,423Tender joint count, median (min-max)6 (0-20)7 (0-18)0,911Disclosure of Interests:None declared

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BackgroundExternal validation of the 2022 ACR/EULAR GPA, EGPA and MPA Classification Criteria is recommended by the DCVAS study group [1-3].ObjectivesTurkish Vasculitis Study (TRVaS) prospective cohort is an electronic database including 15 centres from all over Turkey. We aimed to test performance of the recent criteria sets in TRVaS cohort.MethodsPatients diagnosed according to physicians’ decisions have been recruited prospectively in TRVaS (in total 3730 patients by January 2023). 2022 ACR/EULAR and 1990 ACR Classification Criteria sets were applied to all of the patients with AAV [GPA (n=533), EGPA (n=112), MPA (n=105), and unclassified AAV (n=70)], poliarteritis nodosa (PAN, n=47) and IgA Vasculitis (n=76). Performances were analysed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.ResultsFor the patients with GPA, 2022 criteria had higher sensitivity and specifity compared to 1990’s (83.6% vs. 71.0% and 95.6% vs. 88.6%, respectively in Table). A significant increase was observed in sensitivity for 2022 criteria for patients with EGPA (86.4% vs.59.1%) with no change in specificity. Sensitivity and specificity of 2022 MPA criteria was calculated as 83.8% and 89.8%, respectively. Using the 2022 criteria to the patients with unclassified AAV, led to classify seven (10.0%) patients as GPA and 29 (41.0%) patients as MPA. Of 47 patients with PAN, one patient fulfilled 1990 ACR and another fulfilled 2022 GPA criteria. Others were not classified as EGPA or MPA. None of the patients with IgA vasculitis fulfilled 2022 AAV criteria. Of 533 patients with GPA, 1.5% fulfilled both 2022 GPA and MPA criteria and 7.7% fulfilled only MPA criteria (Figure). In each clinically diagnosed AAVs, around 10% of patients were not classified by any 2022 criteria.ConclusionUsing 2022 ACR/EULAR Classification Criteria, improved sensitivity and specifity for GPA and sensitivity for EGPA were observed. Additionally, half of the unclassified AAV patients could be classified as either GPA or MPA. These criteria functioned well for the discrimination of patients with AAV from other small/medium vessel vasculitides such as PAN and IgA vasculitis. In total, over 80% of the patients with AAV were accordingly classified in paralel to the clinical diagnosis in each GPA/EGPA/MPA.References[1]Robson, J.C.et al s.Ann Rheum Dis2022,81, 315-320.[2]Grayson, P.C. et al.Ann Rheum Dis2022,81, 309-314.[3]Suppiah, R.Ann Rheum Dis2022,81, 321-326.Figure.Classification of clinically diagnosed GPA/EGPA/MPA patients using 2022 ACR/EULAR criteria setsTable.Performance of 1990 ACR and 2022 ACR/EULAR criteriaGPANon-GPA AAVEGPANon-EGPA AAVMPANon-MPA AAVPAN + IgAV1990 ACR Wegener criteriaSn/Sp71/88.671/84----71/99.2PPV/NPV89.3/69.689.6/60----99.7/44Accuracy78.675.4----76.32022 ACR/EULAR GPASn/Sp83.6/95.683.6/94.1----83.6/99.2PPV/NPV96.3/81.296.5/74.5----99.8/58.2Accuracy88.787.1----86.51990 Churg-Strauss criteriaSn/Sp--59.1/10059.1/100--59.1/100PPV/NPV--100/94.6100/93.7--100/73.1Accuracy--9594.2--80.62022 ACR/EULAR EGPASn/Sp--86.4/99.886.4/99.8--86.4/100PPV/NPV--98.9/98.198.9/97.81--100/89.1Accuracy--98.297.9--93.52022 ACR/EULAR MPASn/Sp----83.8/89.883.8/87.983.8/100PPV/NPV----52.1/97.752.1/97.2100/87.8Accuracy----89.187.492.5Acknowledgements:NIL.Disclosure of InterestsNone Declared.