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Background: To investigate the relationship between anxiety and white coat hypertension (WCH) using the hospital anxiety and depression scale-anxiety (HADS-A) score. Methods: Participants lacking a pre-existing diagnosis of hypertension but displaying increased office blood pressure were included in this study. Subsequently, they were classified as either newly diagnosed sustained hypertension (SustHT) or white coat hypertension (WCH) patients, as determined by 24-hour ambulatory blood pressure monitoring measurements. The assessment of their anxiety levels was conducted using the HADS-A questionnaire. We performed regression, comparative, and sensitivity analyses to elucidate the association between anxiety and WCH. Results: In this cohort of 303 consecutive individuals (mean age 54 years, 46% female), 81 (26.7%) patients were diagnosed with WCH. Those with WCH were younger (49 vs. 56 years, P < .001), had higher heart rate (85 vs. 76 bpm, P < .001) and exhibited a female predominance (56% vs. 43%, P = .049) compared to individuals with SustHT. The HADS-A was higher in WCH than in SustHT (9.0 ± 2.9 vs. 6.6 ± 2.6, P < .001). Furthermore, HADS-A showed positive correlation with systolic and diastolic pressures measured in the outpatient clinic (r=0.523 and r=0.387, respectively; P < .001 for both). The full model with HADS-A had better discriminatory power (Harrell's c-index 0.82 vs. 0.77, P = .0025), increased calibration, and a greater net benefit than the base model without. The ROC curve analysis, using a cut-off of >6 for HADS-A, demonstrated a sensitivity of 76.5% and specificity of 53.6% in detecting WCH (Area Under the Curve=0.72, P < .001). Conclusions: Our study revealed that individuals with WCH, in comparison to those with SustHT, exhibit a higher level of anxiety as indicated by HADS-A. [ABSTRACT FROM AUTHOR]

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Our study aims to report the findings of transesophageal echocardiography (TEE), Risk of Paradoxical Embolism (RoPE) score, the Patent Foramen Ovale-Associated Stroke Causal Likelihood (PASCAL) classification analyses, and follow-up results after percutaneous PFO closure in patients diagnosed with cryptogenic stroke. The medical records of patients with acute arterial ischemic stroke who were diagnosed with PFO by TEE and applied percutaneous PFO closure between 2020-2023 were reviewed. The echocardiography (Echo) score, the RoPE score, and the PASCAL classification were calculated for all patients as indicated in the literature. Newly developed arrhythmia, recurrent stroke, and cardiovascular death were recorded during follow-up. A total of 65 patients were included in the study. The median age was 41 years [range:33 -47]), the median RoPE score was 8, and the Echo score was 3. While 29.2% of the patients were in the possible group according to the PASCAL classification, 70.8% were in the probable group. We did not have any patients in the unlikely group. Recurrent ischemic stroke was detected in only two patients at a median follow-up of 12.1 months. No cardiac arrhythmia or cardiovascular death was observed. PFO closure in PFO-associated stroke patients was safe, with a low incidence of arrhythmia and cardiovascular and cerebrovascular events during the short -term follow-up. [ABSTRACT FROM AUTHOR]

Objective: Vascular complications (VCs) contribute to increased morbidity and mortality in patients who have undergone transcatheter aortic valve implantation (TAVI); however, studies on their incidence and predictors show conflicting results. In this study, we sought to assess the incidence, impact, and predictors of VCs in transfemoral (TF) TAVI and also investigated the predictive role of manufacturer’s size charts and a new predictor modified sheath-to-femoral artery ratio. Methods: A total of 223 patients undergoing TF-TAVI were categorized into 2 groups. The patients were divided as eligible and ineligible according to the manufacturer’s guidelines (MG), and the same patient cohort was dichotomized into eligible and ineligible on the basis of sheath-to-femoral artery ratio (SFAR) value of less than or greater than or equal to modified SFAR (md-SFAR). VCs (defined according to the Valve Academic Research Consortium II criteria) were retrospectively compared. Results: According to the manufacturer’s size charts, 65 patients were unsuitable; however, 35 patients were ineligible for TF-TAVI per the md-SFAR criteria. Although VCs occurred in 42 (18.8%) patients, 17 (27.7%) of those patients were classified as ineligible according to MG, whereas 14 (41.2%) were classified as ineligible in the md-SFAR group. In a multiple logistic regression analysis that included md-SFAR, MG, SFAR ≥1.05, peripheral artery disease, and minimum iliofemoral artery diameter, only md-SFAR was the independent predictor of VCs (odds ratio=3.71, 95% confidence interval=1.13–12.53, p=0.031). Conclusion: According to our results, md-SFAR might provide better patient selection to prevent VCs and improve outcomes in TF-TAVI procedures. [ABSTRACT FROM AUTHOR]

A quiz concerning a case study of a 57-year-old male who was diagnosed with newly developed lesions in right coronary artery during percutaneous coronary intervention (PCI).

Objective: Due to the conflict in Syria since 2011, more than 3.5 million Syrian citizens reside in Türkiye. Because Syrian patients were underrepresented in previous studies on percutaneous coronary intervention (PCI) outcomes, we aimed to analyze the severity of coronary artery disease and in-hospital outcomes of PCI in this population., Methods: We retrospectively analyzed 142 Syrian patients who underwent PCI at our center between June 2020 and October 2022 and compared the data with that of age- and sex-matched Turkish patients (n = 271) who also underwent PCI. We assessed comorbidities, coronary anatomy features, procedural complications, and in-hospital cardiovascular outcomes (Major Adverse Cardiac and Cerebrovascular Events, MACCE)., Results: The mean age of the study population was 57 ± 12 years, with 15% being female. Clinical indication and coronary anatomy features did not differ between the groups. However, the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was higher in Syrian patients compared to Turkish patients (16 [11-22] vs. 12 [8-20]; P < 0.001). Complex PCI rates, in-hospital bleeding and contrast nephropathy were similar in both groups. MACCE was comparable between Syrian and Turkish patients (13 [4.8%] vs. 13 [9.2%], P = 0.083)., Conclusion: Comparable MACCE rates were observed in both ethnic groups undergoing PCI, despite a higher SYNTAX score in Syrian patients. Future research should investigate whether similar in-hospital MACCE rates are observed in other regions of Türkiye and whether long-term cardiovascular outcomes differ between Turkish and Syrian patients.

Introduction: The non-O phenotype of the ABO genotype has been linked with an increased risk of cardiovascular disease. Atrioventricular (AV) block (AVB) is defined as retardation or cessation in the route of an electrical impulse passing from the atria to the ventricles because of an anatomical or functional disruption in the conduction system. We aimed to interpret the association between blood group status and high-grade atrioventricular block (HAVB)., Material and Methods: This study was implemented as a retrospective review of the recorded data of patients diagnosed with high-grade AV block and a control group. The study population consisted of 640 patients with HAVB and 570 control subjects., Results: Presence of non-O blood group ( p < 0.001) was significantly more prevalent in HAVB patients than in the control subjects. Blood group type was the sole independent predictor of HAVB in multiple regression analysis ( p < 0.001, OR = 1.35, 95% CI: 1.08-1.57). Also, third-degree AVB had a higher incidence in the non-O blood subgroup and also non-O blood group was a predictor of third-degree AVB ( p < 0.001, OR = 1.39, 95% CI: 1.13-1.69). The incidence of HAVB did not distinguish between the two Rh (D) groups. Rh (D) status did not have an impact on HAVB., Conclusions: This is the first study that has evaluated the potential relationship between HAVB and ABO blood groups. The main finding of this report is that patients with non-O blood group types have a higher risk for development of HAVB compared with O blood group patients., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2019 Termedia & Banach.)