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Objectives: The objective of this research was to investigate the correlation between the SYNTAX score II (SS-II), a measure of the occurrence of coronary artery disease and mortality over a 4-year period, and factors that increase the susceptibility of individuals to atherosclerosis in coronavirus disease-2019 (COVID-19) patients diagnosed with non-ST-elevation myocardial infarction (NSTEMI). Materials and Methods: We retrospectively examined 200 NSTEMI patients with COVID-19 who applied to Adıyaman Training and Research Hospital between 01.07.2021 and 01.11.2021. We recorded demographic data (age, gender), comorbid diseases, laboratory parameters (hemogram, biochemistry, serological test results), thorax computed tomography findings (COVID-19-compatible or not), angiography results, intervention needs, and mortality status. COVID-19 was confirmed by positive reverse transcription polymerase chain reaction. All patients had SS values and SS-II values calculated. Based on a median SS II value of 28.5, the patients were classified into the low and high SS-II groups. Results: The high-SS-II group exhibited elevated total cholesterol, low-density lipoprotein, carotid intima-media thickness (CIMT), and left ventricular ejection fraction values (p

YKL-40 is a glycoprotein synthesized by several cell types, including macrophages, neutrophils, and endothelial cells. It plays a role in several biological processes, such as tissue remodeling, inflammation, and cell proliferation. Research findings have shown that levels of YKL-40 tend to be higher in individuals diagnosed with cardiovascular diseases (CVDs), including atherosclerosis. Elevated concentrations of YKL-40 have been associated with detrimental CV outcomes. In general, while the precise function of YKL-40 in CVDs is still under investigation, it is evident that this glycoprotein has significant potential as a biomarker for CVDs. Furthermore, CVD treatment has the potential to specifically target the protein YKL-40.

Resumo Fundamento A Terapia Antiplaquetária Dupla (DAPT, do inglês dual antiplatelet therapy) é o tratamento de escolha para pacientes com síndromes coronarianas agudas e crônicas, uma vez que ela reduz mortalidade e previne complicações trombóticas recorrentes. A avaliação da carga isquêmica e do risco de sangramento é crucial na escolha da DAPT e de sua duração. Objetivos O objetivo de nosso estudo foi conduzir um acompanhamento clínico prospectivo de pacientes recebendo terapia combinada (AAS 75mg + clopidogrel 75 mg). Nosso estudo é um estudo multicêntrico, transversal, observacional, do tipo coorte. Métodos Foram incluídos 1500 pacientes que iniciaram DAPT combinada para o tratamento de síndrome coronariana aguda ou síndrome coronariana crônica. Os desfechos primários foram internação hospitalar por qualquer motivo, internação por causa cardiovascular, infarto agudo do miocárdio, trombose de stent, revascularização de vaso alvo e sangramento; os desfechos secundários foram morte por qualquer razão ou por causa cardiovascular e acidente vascular cerebral. O nível de significância adotado na análise estatística foi 5%. Resultados A idade mediana foi 63 anos; 78,5% dos pacientes estavam recebendo DAPT por síndrome coronariana aguda. As taxas de internação por causas cardiovasculares, de infarto agudo do miocárdio, de trombose de stent e de revascularização de vaso alvo foram 7,9%, 2,3%, 1,3% e 4,2%, respectivamente. Enquanto a taxa de sangramento segundo a escala BARC tipo 1 foi de 3,3%, a taxa de sangramento BARC tipo 5, 3, ou 2 foi 0,6%. As taxas dos desfechos secundários morte por qualquer razão, morte por causa cardiovascular e acidente vascular cerebral foram 0,5%, 0,3% e 0,3%, respectivamente. Conclusão Nosso estudo mostrou que a DAPT em regime combinado de doses fixas de AAS e clopidogrel é eficaz e seguro em pacientes com síndrome coronariana aguda ou crônica adequadamente selecionados.

Background: The recent 2019 European Society of Cardiology/European Atherosclerosis Society practice guidelines introduced a new risk categorization for patients with diabetes. We aimed to compare the implications of the 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines with regard to the lipid-lowering treatment use, low-density lipoprotein cholesterol goal attainment rates, and the estimated proportion of patients who would be at goal in an ideal setting. Methods: Patients with diabetes were classified into 4 risk categories according to 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidemia guidelines from the database of EPHESUS (cross-sectional, observational, countrywide registry of cardiology outpatient clinics) study. The use of lipid-lowering treatment and low-density lipoprotein cholesterol goal attainment rates were then compared according to previous and new guidelines. Results: This analysis included a total of 873 diabetic adults. Half of the study population (53.8%) were on lipid-lowering treatment and almost one-fifth (19.1%) were on high-intensity statins. While low-density lipoprotein cholesterol goal was achieved in 19.5% and 7.5% of patients, 87.4% and 69.6% would be on target if their lipid-lowering treatment was intensified according to 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society lipid guidelines, respectively. The new target

Objective: This study was performed to examine the association between the SYNTAX II score (SS-II) and no-reflow observed on electrocardiography and examine their use in the evaluation of risk of an in-hospital major adverse cardiovascular event (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 126 consecutive STEMI patients who underwent primary percutaneous coronary intervention (pPCI) were recruited. The SS-II was derived using angiographic and basic patient clinical features. The difference in the sum of ST-segment elevations measured between before the pPCI and the assessment determined approximately 60 minutes after the pPCI was interpreted as the sum of ST-segment resolution (ΣSTR). MACE is a composite endpoint frequently used in cardiovascular research and usually includes endpoints reflecting safety and effectiveness. ΣSTR

Objective: The ratio of monocytes to high-density lipoprotein (MHR) has recently been recommended as a new prognostic factor in cardiovascular disease. Studies have documented the value of the Selvester QRS score for prediction of prognosis of ST-elevation myocardial infarction (STEMI). However, no study has examined the association between the QRS score and MHR in patients with STEMI. The present study analyzed the relationship between MHR and QRS score in patients with STEMI. Methods: A cohort of 99 consecutive patients who experienced STEMI between June and September 2016 was retrospectively evaluated. Serial electrocardiogram, monocyte count, and lipid panel measurements (day 1, day 2, and after discharge) were performed in all patients, and MHR was calculated. The patients were classified into 2 groups based on the median values according to the estimated infarct size: QRS score

The tricuspid annular plane systolic excursion (TAPSE) (transthoracic apical two-chamber stretch) and pulmonary artery systolic pressure (PASP) ratio is a measure of cardiac function that is used to assess left ventricular systolic function. PASP is typically measured using a catheterization procedure, in which a small tube is inserted into a blood vessel and advanced to the pulmonary artery. A TAPSE/PASP ratio higher than 0.36 mm/mmHg has been shown in several studies to be a good sign of normal or generally well-maintained right ventricular function. It is important to note that the TAPSE/PASP ratio should be interpreted in the context of other clinical findings and should not be used as the sole indicator of cardiac function. A decrease in the TAPSEpulmonary arterial systolic pressure (PASP) ratio (i.e., (RV)-arterial uncoupling), which quantitatively depicts the function of the RV, was detected in patients with heart failure. In pulmonary arterial hypertension patients, TAPSE/PASP is linked to hemodynamics and functional class. In diseases impacting right cardiac function, the TAPSE/PASP may also be beneficial. The purpose of this review is to demonstrate how the TAPSE/PASP impacts how the (RV) functions. We believe that this is the first review on the topic written.

The Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (SS) has significantly improved angiographic risk stratification. By analyzing angiographic variables, this score characterizes coronary artery disease qualitatively and quantitatively. To date, combining this score with other non-angiographic clinical scores has broadened perspectives regarding risk estimation, and future research on this topic appears promising.

Resumo Fundamento A ectasia da artéria coronária (EAC) é definida como a dilatação difusa ou localizada do lúmen da artéria coronária com diâmetro de 1,5 a 2,0 vezes o diâmetro da artéria coronária normal adjacente. A relação proteína C-reativa/albumina (CAR, sigla em inglês) é um marcador inflamatório útil que tem sido documentado em doença arterial coronariana. Objetivo Analisar a associação entre a EAC e a CAR. Métodos Um protocolo caso-controle foi utilizado neste estudo. Foram incluídos 102 pacientesconsecutivos com EAC isolada sem estenose (56 homens e 46 mulheres; idade média de 60,4 ± 8,8 anos). O grupo controle era constituido pelo mesmo número de pacientes pareados por sexo e idade com artérias coronárias normais (55 homens e 47 mulheres; idade média de 61,2 ± 9,1 anos). Características clínicas, achados laboratoriais e histórico de uso de medicamentos foram registrados. Foram realizados teste t de Student, teste U de Mann-Whitney, teste do qui-quadrado, análise de regressão linear e logística. Foi considerado estatisticamente significativo p bilateral < 0,05. Resultados A CAR estava aumentada nos pacientes com EAC em comparação com os controles (32 e 16; p < 0,001). Além disso, foi verificado que a CAR era um preditor independente da EAC (razão de chances = 2,202; intervalo de confiança 95%, 1,184 – 5,365; p < 0,001). Conclusão No presente estudo, determinamos que os níveis da CAR estavam significativamente mais altos no grupo EAC que no grupo controle e a CAR estava significativamente correlacionada com a EAC. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Endothelial cell dysfunction proceeding with increased inflammation and monocyte increase is one of the main causes of vessel injury in CAD. SIRT1 (Sirtuin 1) protein plays an important role in the regulation of cellular physiological mechanisms. SIRT1 has roles in regulating angiogenesis and preventing endothelial dysfunction and reperfusion injury due to ischemia. Suppression of SIRT1 causes monocyte affinity due to endothelial dysfunction. Sirtuins activators are involved in pathologies of many diseases with promising treatments. The objective of this review is to summarize the current progress and future directions of sirtuin protein in the field of CAD.

Coronary artery disease (CAD) is one of the severe diseases that may cause significant moral and financial burden on society today. There are many studies in the literature on whether psychiatric disorders may cause CAD or an increase in prevalence after CAD. Although many studies have emphasized the importance of early diagnosis and treatment of depression in CAD patients, clinicians do not attach much attention to depression in daily practice. Several scales have been developed that are comfortable to use to describe anxiety and depression in CAD patients. High depression and anxiety scores predicted by psychological symptom scales following CAD treatment are closely related to treatment success and prognosis of the CAD. We believe that patients with CAD should be followed carefully for the diagnosis of depression and anxiety disorders; since the treatment of them may improve the prognosis of CAD.

Cardiac troponin is the preferred biomarker for the diagnosis of the acute coronary syndrome (ACS), but many other diseases can be identified with elevated troponin levels in the absence of ACS. The recent development of a high-sensitive cardiac troponin T (hs-cTnT) assay permits the detection of very low levels of cTnT. The use of hs-cTnT assay has emerged as a tool for identifying high-risk individuals for primary preventive treatment and can detect subclinical injury in asymptomatic patients. Hs-cTnT analyses are generally related to ischemia in the literature. Thus, we made an evaluation of hs-cTnT analysis in non-coronary patients, which may contribute to the literature.

The relationship between serum vaspin levels and metabolic or coronary artery disease is currently of interest for researchers. Although adipokine concentrations have been shown to be increased significantly in atherosclerotic lesions, the role adipokines in the atherosclerotic process remains to be elucidated. Vaspin is a new biological marker associated with obesity and impaired insulin sensitivity. Plasma vaspin concentration has been shown to correlate with the severity of coronary artery disease. Vascular inflammation triggered by vaspin inhibits atherogenesis by suppressing macrophage foam cell formation and vascular smooth muscle cell migration and proliferation. Vaspin also contributes to plaque stabilization by increasing collagen content and reducing the intraplaque macrophage to vascular smooth muscle cell ratio. The therapeutic goal concerning vaspin is to fight atherosclerosis and related diseases, as well as to maintain vascular health.

INTRODUCTION[|]To test the hypothesis that multicenter automatic defibrillator implantation trial (MADIT) - implantable cardioverter-defibrillator (ICD) scores predict replacement requirement and appropriate shock in a mixed population including both primary and secondary prevention and long-term adverse cardiovascular events.[¤]METHODS[|]The study has a retrospective design. Patients who were implanted with ICD in the cardiology clinic of Atatürk University Faculty of Medicine between 2000 and 2013 were included in the study. For this purpose, 1394 patients who were implanted with a device in our clinic were reviewed. Then, those who were implanted with permanent pacemaker (n=1005), cardiac resynchronization treatment (CRT) (n=45) and CRT-ICD (n=198) were excluded.[¤]RESULTS[|]A total of 146 patients (98 males, 67.1%) with a mean age of 61.1 (+-14.8) years were recruited. The median follow-up time was 21.5 months (mean 30.6+-25.9 months; minimum 4 months, and maximum 120 months). The median MADIT-ICD scores in the patients were 2. MADIT-ICD scores were categorized as low in 15.1%, intermediate in 57.5%, and high score in 27.4% of patients. Accordingly, MADIT-ICD scores (1.29 [1.00–1.68], p=0.050), hemoglobin (0.86 [0.75–0.99], p=0.047), and left ventricular ejection fraction (EF) (0.97 [0.94–0.99], p=0.023) were determined as independent predictors of major adverse cardiovascular events in the long-term follow-up of ICD-implanted population.[¤]DISCUSSION AND CONCLUSION[|]In this study, we showed that there was an independent association of long-term adverse cardiovascular events with MADIT-ICD score, hemoglobin, and EF in patients implanted with ICD.[¤]

Background: High-sensitivity cardiac troponin T (hs-cTNT) is an important non-invasive laboratory-based marker of subclinical myocardial injury. Prehypertension, which may be a precursor of hypertension, is a major public health issue. Our aim was to evaluate the importance of serum hs-cTnT as a marker predicting prehypertension. Methods: A total of 100 subjects (45 women and 55 men) consisting of 50 consecutive prehypertensive patients with blood pressures between 120/80 and 139/89 mmHg and 50 normotensive patients with blood pressures < 120/80 mmHg were enrolled prospectively. The hs-cTNT level was calculated and compared between the two groups. Echocardiographic examinations were performed in all patients. Results: The hs-cTnT level was significantly higher in the prehypertensive group (p

Background: The presence of premature ventricular contractions (PVCs) is a sign of arrhythmia and typically trigerred by over stimulation of the sympathetic nervous system. This study examined the relationships among PVCs, heart rate variability (HRV), and 24-hour ambulatory blood pressure (ABP) results. Methods: This observational clinical study evaluated a cohort of 100 consecutive patients (58 women and 42 men) with PVCs. The individuals were split into occasional (n = 50) and frequent (n = 50) PVCs groups. All Holter recordings were performed during a working day. Results: Daytime low-frequency power (LFP), daytime low frequency/high frequency (LF/HF), nighttime LFP, and nighttime LF/HF and 24-hour systolic blood pressure (SBP) were slightly higher in the frequent PVCs group (p = 0.046, p = 0.027, p = 0.038, p = 0.032, and p

Recent studies have revealed that chemerin plays an essential role in the development of cardiovascular diseases. Autopsy studies found a strong correlation between the secretion of chemerin in peripheral tissues and aortic and coronary atherosclerosis. Plasma chemerin is a marker of systemic inflammation and is associated with metabolic syndrome. Chemerin plays a vital role in vascular inflammation and atherogenesis. Plasma chemerin levels are increased in patients with dilated cardiomyopathy, and chemerin is associated with left ventricular dysfunction. In this review, we focus on chemerin expression, chemerin processing, its biological function, and its role in the diagnosis of cardiovascular diseases.

Recently, muscular function/dysfunction has gained importance in the maintenance of metabolic homeostasis in cardiovascular diseases. Skeletal muscle plays a vital role in coordinating the activity and metabolism of endocrine organs by secreting many myokines, especially irisin. Irisin is a polypeptide hormone consisting of 112 amino acids secreted into the blood from muscle and adipose tissues. Serum irisin levels are associated with cardiometabolic risk factors such as obesity and insulin resistance as defined by homeostatic model assessment. Irisin reduces endothelial damage by inhibiting inflammation and oxidative stress, thus playing a key role in maintaining endothelial cell function. Unsurprisingly, low irisin levels cause endothelial dysfunction and increase the incidence of atherosclerosis. We aimed to summarize the studies on this issue since we have not found any review in the literature on the role of serum irisin levels in the process of atherosclerosis and other cardiovascular events in cardiovascular diseases.

Resumo A doença de coronavírus 2019 (COVID-19) é uma pandemia global afetando o mundo, estando presente em mais de 1.300.000 pacientes. O COVID-19 age pelo receptor da enzima conversora de angiotensina 2 (ECA2). As comorbidades cardiovasculares são mais frequentes com COVID-19, e cerca 10% de casos desenvolvem miocardite (22% de pacientes críticas). Mais pesquisas serão necessárias para continuar ou descontinuar inibidores de ECA e bloqueadores dos receptores da angiotensina, que são essenciais para hipertensão e insuficiência cardíaca em COVID-19. Pesquisa intensiva é promissora para o tratamento e a prevenção da COVID-19.