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Objectives: Insulin resistance (IR) is associated with an increased risk of adverse cardiovascular outcomes. The triglyceride-glucose index (TyG index) is a reliable marker of IR. No study has examined the impact of the TyG index on major adverse cardiac and cerebrovascular events (MACCEs) in RTRs. Therefore, this study aimed to investigate the predictive value of the TyG index for MACCEs in RTRs., Materials and Methods: Non-diabetic patients undergoing renal transplantation were retrospectively enrolled. The patients were divided into two groups according to MACCE development. The cut-off value of the TyG index for MACCE was conducted., Results: The mean age of 522 patients was 41 (31-51) years, and 349 (66.9%) were male. During the 5.4-year follow-up, 84 (16%) MACCE were recorded. TyG index was significantly higher in the group that developed MACCE ( p  < 0,001). Cox regression analysis revealed that TyG index [HR: 3.297 (1.228-8.855), p  = 0.018], left ventricle ejection fraction [HR: 0.934 (0.900-0.968), p  < 0.001], cadaveric transplantation [HR: 8.886 (4.764-16.576), p  < 0.001], graft survey [HR: 0.608 (0.542-0.682), p  < 0.001)], and smoking [HR: 1.965 (1.117-3.456), p  = 0.019] were independent predictors of MACCEs in nondiabetic RTRs., Conclusion: TyG index is an independent predictor of MACCEs in non-diabetic RTRs. The widespread use of the TyG index may positively affect long-term treatment costs and survival.

Objective: The purpose of this study was to explore the efficacy of the triglyceride glucose (TyG) index on in-hospital mortality in nondiabetic coronavirus disease 2019 (COVID-19) patients with myocardial injury., Methods: This was a retrospective study, which included 218 nondiabetic COVID-19 patients who had myocardial injury. The TyG index was derived using the following equation: log [serum triglycerides (mg/dL) ×fasting blood glucose (mg/dL)/2]., Results: Overall, 49 (22.4%) patients died during hospitalization. Patients who did not survive had a higher TyG index than survivors. In multivariate Cox regression analysis, it was found that the TyG index was independently associated with in-hospital death. A TyG index cutoff value greater than 4.97 was predicted in-hospital death in nondiabetic COVID-19 patients with myocardial damage, with 82% sensitivity and 66% specificity. A pairwise evaluation of receiver operating characteristic (ROC) curves demonstrated that the TyG index (AUC: 0.786) had higher discriminatory performance than both triglyceride (AUC: 0.738) and fasting blood glucose (AUC: 0.660) in predicting in-hospital mortality among these patients., Conclusions: The TyG index might be used to identify high-risk nondiabetic COVID-19 patients with myocardial damage.

Introduction: The current investigation intended to evaluate the correlation between eosinophil-to-lymphocyte ratio (ELR) and the coronary slow-flow phenomenon (CSFP) in patients undergoing elective coronary angiography., Material and Methods: A case-control investigation was conducted on 200 individual CSFP patients and another 200 individuals with normal coronary arteries and who were matched for age, gender, and body mass index. ELR was computed by dividing the number of eosinophils by the number of lymphocytes. Thrombolysis in myocardial infarction frame count was used to determine the CSFP., Results: The ELR in the CSFP group was substantially greater than in the control group [0.38 (0.28-0.50)] and [0.22 (0.17-0.35)], p < 0.001, respectively). With the help of multivariable logistic regression analysis, ELR independently predicted the CSFP presence (odds ratio = 1.040, 95% CI: 1.026-1.053), p < 0.001). The effective cutoff point of ELR in predicting CSFP presence was > 0.29 with sensitivity of 77% and specificity of 70%. ELR had better diagnostic accuracy to predict CSFP than either lymphocyte or eosinophil count alone [AUC = 0.746 vs. AUC = 0.687 vs. AUC = 0.687, respectively]., Conclusions: To our knowledge, this was the first investigation to determine the connection between ELR and CSFP. We discovered that individuals with CSFP had higher ELR than those with normal coronary arteries in the control group., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Termedia & Banach.)

Introduction: The focus of this research was to explore the link between CRP (C-reactive protein) /albumin ratio (CAR), a novel inflammatory response marker, and no-reflow (NR) phenomena in non-ST elevation myocardial infarction (non-STEMI) patients during percutaneous coronary intervention (PCI). Methods: The current study recruited 209 non-STEMI participants who underwent PCI. The patients were divided into two groups based on their post-intervention Thrombolysis in Myocardial Infarction (TIMI) flow grade; those with and without NR. Results: In all, 30 non-STEMI patients (6.9%) had NR after PCI. CAR values were substantially greater in the NR group. The CAR was identified to be a determinant of the NR (OR: 1.250, 95% CI: 1.033-1.513, P =0.02), although CRP and albumin were not independently related with NR in the multivariate analysis. In our investigation, low density lipoprotein-cholesterol levels and high thrombus burden were also predictors of the occurrence of NR. According to receiver operating characteristic curve evaluation, the optimal value of CAR was>1.4 with 60% sensitivity and 47% specificity in detecting NR in non-STEMI patients following PCI. Conclusion: To the best of knowledge, this is the first investigation to demonstrate that the CAR, a new and useful inflammatory marker, can be utilized as a predictor of NR in patients with non-STEMI prior to PCI., (© 2022 The Author(s).)

Objective: In this study, we aimed to investigate the prognostic accuracy of the presence of fragmented QRS (fQRS) on baseline electrocardiogram on the adverse outcome in critical patients with coronavirus disease 2019 (COVID-19) with cardiovascular disease (CVD)., Methods: The current study was retrospective designed and included 169 patients who were critically ill with COVID-19 and CVD (mean age of 62±15 years). The patients were grouped into those who died (non-survivor group) and those who survived (survivor group)., Results: The non-survivors were older and more often had CVD (p=0.009), hypertension (p=0.046), diabetes (p=0.048), cancer (p=0.023), and chronic renal failure (p=0.001). Although the presence of fQRS on the basal electrocardiogram was more common in patients who died, this was not statistically significant (p=0.059). Furthermore, non-survivors had more frequent the coexistence of CVD and fQRS (p=0.029). In Model 1 multivariate regression analysis, CVD alone was not a predictor of mortality (p=0.078), whereas coexistence of CVD and fQRS was found to be an independent predictor of mortality in Model 2 analysis [hazard ratio (HR): 2.243; p=0.003]. Furthermore, older age (HR: 1.022; p=0.006 and HR: 1.023; p=0.005), cancer (HR: 1.912; p=0.021 and HR: 1.858; p=0.031), high SOFA score (HR: 1.177; p=0.003 and HR: 1.215; p<0.001), and increased CRP level (HR: 1.003; p=0.039 and HR: 1.003; p=0.027) independently predicted the mortality in both multivariate analysis models, respectively., Conclusion: fQRS may be a useful and handy risk-stratification tool for clinical outcomes by identifying high-risk individuals, especially among those with CVD.

The prognostic value of malnutrition in elderly patients with non-ST-elevated myocardial infarction (NSTEMI) is not fully understood. Nutritional characteristics were evaluated by novel Controlling Nutritional status (CONUT), the prognostic nutritional index (PNI) and the geriatric nutritional risk index (GNRI) scores. The impact of these scores on major outcomes in 253 NSTEMI patients over 60 years and older were assessed. Compared to those with good nutritional status; malnourished patients had more major adverse cardiac and cerebrovascular events (MACCEs) at 1-year follow up. Multivariable cox regression analysis revealed that CONUT (hazard ratio = 1.372; p < 0.01) was independent predictor of MACCEs, whereas PNI ( p = 0.44) and GNRI ( p = 0.52) were not. The discriminating power of the CONUT (AUC: 0.79) was adequate and significantly superior to both the PNI (AUC: 0.68) and the GNRI (AUC: 0.60), with a p -value for both < 0.01. Patients with elevated CONUT exhibited the highest event rate for all-cause mortality and MACCEs in survival analysis ( p < 0.01). We conclude that malnutrition is strongly associated with adverse outcomes in older patients with NSTEMI. In fact, the CONUT score adequately predicts one-year MACCEs among elderly NSTEMI patients who achieve complete revascularization after coronary intervention.

Introduction: P-wave dispersion (PWD) obtained from the standard 12-lead electrocardiography (ECG) is considered to reflect the homogeneity of the atrial electrical activity. The aim of this investigation was to evaluate the effect of percutaneous chronic total occlusion (CTO) revascularization on the parameters of P wave duration and PWD on ECG in cases before and after procedure at 12 th months. Methods: We analyzed 90 consecutive CTO cases who were on sinus rhythm and underwent percutaneous coronary intervention (PCI). P-wave maximum (P -max ) and P-wave minimum (P -min ), P-wave time, and PWD were determined before and twelve months after the CTO intervention. The study population was categorized into two groups as successful and unsuccessful CTO PCI groups. Results: The CTO PCI was successful in 71% of cases (n=64) and it was unsuccessful in 29% of cases (n=26). Both groups, except for age and hypertension, were similar in terms of demographic and clinical aspects. CRP levels were significantly elevated in the unsuccessful CTO PCI group. Pre-PCI ECG parameters showed no significant difference. Irrespective of the target vessel revascularization, we observed that PWD and P -max values were significantly lower in the 12 th months follow-up. In all Rentrop classes, PWD values were significantly decreased at 12 th months follow-up in comparison to the pre-CTO PCI values. Conclusion: This study has determined that PWD and P -max , which are both risk factors for atrial arrhythmias, are significantly reduced within 12 th months after successful CTO PCI regardless of the target vessel., (© 2021 The Author(s).)

Objectives: The inter-arm systolic blood pressure difference (IASBPD) is closely related to cardiovascular mortality and morbidity. The SYNTAX score indicates the extent and complexity of coronary artery disease, which are determined by coronary angiography. The aim of our study is to examine the relationship between the IASBPD (which is easily calculated in routine practice) and the SYNTAX score., Methods: 104 patients were included in this cross-sectional study. The IASBPD was calculated by blood pressure measurements obtained simultaneously from both arms. The SYNTAX score was calculated by coronary angiography., Results: Patients were divided into two groups: those with a high SYNTAX score (≥20) and those with a low SYNTAX score (<20). The mean IASBPD values were significantly higher in the group with a high SYNTAX score (≥20) (p<0.001). The patients with IASBPD≥10 were more likely to have a high SYNTAX score compared to the patients with IASBPD<10 (p<0.001). Multiple logistic regression analysis revealed that only the IASBPD values were found to be independently associated with high SYNTAX score (OR: 1.717 (CI: 1.307-2.257), p<0.001)., Conclusion: The IASBPD values obtained by only blood pressure measurements are closely related to the extent of coronary artery disease.

Objective: Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment for urinary tract calculi. While serious side effects are rare, transient cardiac arrhythmias may occur. New electrocardiographic (ECG) parameters, such as P wave dispersion (PWD), QT dispersion (QTd), T peak to T end (Tp-e) interval, Tp-e interval/QT ratio, and Tp-e interval/corrected QT ratio have been defined to help predict atrial and ventricular arrhythmias. However, effect of ESWL on these ECG parameters has not been previously investigated. The present study was an examination of the effect of ESWL on ECG parameters., Methods: Total of 40 consecutive patients who underwent ESWL were prospectively enrolled in the study. Pre-procedure ECG parameters were compared with post-procedure ECG parameters., Results: PWD values were significantly longer on post-procedure ECG compared with pre-procedure ECG (p=0.017). Corrected QT duration and QTd were significantly longer on postprocedure ECG compared with pre-procedure ECG (p=0.046 and p=0.008, respectively). In addition, Tp-e interval, Tp-e interval/QT ratio, and Tp-e interval/QTc ratio were significantly longer post procedure (p=0.035, p=0.045, and p=0.022, respectively). In univariate correlation analysis, duration of procedure was significantly correlated with post-procedure PWD, QTc, and QTD values., Conclusion: Clinical use of ECG parameters may be helpful in monitoring of patients receiving ungated ESWL in order to detect cardiac dysrhythmia.

A 61-year-old man underwent successful percutaneous revascularization of both lower limbs with multiple stent implantations. Paralysis of right lower limb was noticed after completion of procedure when transferring the patient from angiography table. Since hematoma compressing lumbosacral neural plexus could be a fatal complication, computed tomography (CT) image was taken. CT showed bulge of distended bladder compressing stent struts. Following placement of Foley catheter, condition improved and he was subsequently discharged uneventfully.

A 52-year-old man complaining of persistent recurring chest pain at night underwent coronary angiogram at another institution. Normal coronaries were observed and he was discharged with muscle spasmolytic prescription. Since symptoms had continued, 24-hour Holter monitoring was ordered at our facility and results revealed huge ST elevation and polymorphic ventricular tachycardia. Cold pressor test performed in catheterization laboratory also resulted in ventricular tachycardia. Nifedipine was prescribed and follow-up Holter monitoring revealed no further vasospastic episodes. Utility of 24-hour Holter rhythm monitoring and cold pressor test in patients with recurrent chest pain at night is demonstrated in this report.

Background: SYNTAX score (SxS) has been demonstrated to predict long-term outcomes in stable patients with coronary artery disease. But its prognostic value for patients with acute coronary syndrome remains unknown., Aim: To evaluate whether SxS could predict in-hospital outcomes for patients admitted with ST elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (pPCI)., Methods: The study included 538 patients with STEMI who underwent pPCI between January 2010 and December 2012. The patients were divided into two groups: low SxS (< 22) and high SxS (> 22). The SxS of all patients was calculated from aninitial angiogram and TIMI flow grade of infarct related artery was calculated after pPCI. Left ventricular systolic functions of the patients were evaluated with an echocardiogram in the following week. The rates of reinfarction and mortality during hospitalisation were obtained from the medical records of our hospital., Results: The high SxS group had more no-reflow (41% and 25.1%, p < 0.001, respectively), lower ejection fraction (38.2 ± 7.5% and 44.6 ± 8.8%, p < 0.001, respectively), and greater rates of re-infarction (9.5% and 7.3%, p = 0.037, respectively) and mortality (0.9% and 0.2%, p = 0.021, respectively) during hospitalisation compared to the low SxS group. On multivariate logistic regression analysis including clinical variables, SxS was an independent predictor of no-reflow (OR 1.081, 95% CI 1.032-1.133, p = 0.001)., Conclusions: SxS is a useful tool that can predict in-hospital outcomes of patients with STEMI undergoing pPCI.