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BackgroundThe traditional classification of left ventricular hypertrophy (LVH), which relies on left ventricular geometry, fails to correlate with outcomes among patients with increased LV mass (LVM).ObjectivesTo identify unique clinical phenotypes of increased LVM patients using unsupervised cluster analysis, and to explore their association with clinical outcomes.MethodsAmong the UK Biobank participants, increased LVM was defined as LVM index ≥72 g/m2 for men, and LVM index ≥55 g/m2 for women. Baseline demographic, clinical, and laboratory data were collected from the database. Using Ward's minimum variance method, patients were clustered based on 27 variables. The primary outcome was a composite of all-cause mortality with heart failure (HF) admissions, ventricular arrhythmia, and atrial fibrillation (AF). Cox proportional hazard model and Kaplan-Meier survival analysis were applied.ResultsIncreased LVM was found in 4,255 individuals, with an average age of 64 ± 7 years. Of these patients, 2,447 (58%) were women. Through cluster analysis, four distinct subgroups were identified. Over a median follow-up period of 5 years (IQR: 4-6), 100 patients (2%) died, 118 (2.8%) were admissioned due to HF, 29 (0.7%) were admissioned due to VA, and 208 (5%) were admissioned due to AF. Univariate Cox analysis demonstrated significantly elevated risks of major events for patients in the 2nd (HR = 1.6; 95% CI 1.2–2.16; p

IntroductionDespite ongoing efforts to minimize sex bias in diagnosis and treatment of acute coronary syndrome (ACS), data still shows outcomes differences between sexes including higher risk of all-cause mortality rate among females. Hence, the aim of the current study was to examine sex differences in ACS in-hospital mortality, and to implement artificial intelligence (AI) models for prediction of in-hospital mortality among females with ACS.MethodsAll ACS patients admitted to a tertiary care center intensive cardiac care unit (ICCU) between July 2019 and July 2023 were prospectively enrolled. The primary outcome was in-hospital mortality. Three prediction algorithms, including gradient boosting classifier (GBC) random forest classifier (RFC), and logistic regression (LR) were used to develop and validate prediction models for in-hospital mortality among females with ACS, using only available features at presentation.ResultsA total of 2,346 ACS patients with a median age of 64 (IQR: 56–74) were included. Of them, 453 (19.3%) were female. Female patients had higher prevalence of NSTEMI (49.2% vs. 39.8%, p

Introduction Immature platelets or reticulated platelets are newly released thrombocytes. They can be identified by their large size and high RNA cytoplasm concentration. Immature platelet fraction (IPF) represents the percentage of immature circulative platelets relative to the total number of platelets. The role of IPF in patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. The aim of the current trial was to assess the levels of IPF in patients undergoing TAVI and correlation with clinical outcomes. Material and Methods Immature platelet fraction levels were measured 3 times in all patients (preprocedure, 1-2 days post-procedure and 1-month post-procedure). Immature platelet fraction measurement was carried out using an autoanalyzer (Sysmex XE-2100). Patients were followed for 12 months. Primary outcomes were defined as complications during hospitalizations, rehospitalization, and mortality. Results Fifty-one patients were included in the study. Mean age was 79.8 (±9.6), and 28 (55%) were women. Twenty-one patients (41%) had complications: Of them, 6 of 21 (29%) occurred during hospitalizations (2—vascular complications; 2—sepsis, 2—implantation of a pacemaker), 9 of 21 (43%) patients were rehospitalized after the index admission, and 6 patients died during the follow-up period. Multivariate Cox regression analysis found that IPF 7% in patients undergoing TAVI is associated with worse outcomes. Further studies are needed to better understand this phenomenon.

Background: Timely reperfusion within 120 min is strongly recommended in patients presenting with non‐ST‐segment myocardial infarction (NSTEMI) with very high‐risk features. Evidence regarding the use of high‐sensitivity cardiac troponin (hs‐cTn) concentration upon admission for the risk‐stratification of patients presenting with NSTEMI to expedite percutaneous coronary intervention (PCI) and thus potentially improve outcomes is limited. Methods: All patients admitted to a tertiary care center ICCU between July 2019 and July 2022 were included. Hs‐cTnI levels on presentaion were recorded, dividing patients into quartiles based on baseline hs‐cTnI. Association between initial hs‐cTnI and all‐cause mortality during up to 3 years of follow‐up was studied. Results: A total of 544 NSTEMI patients with a median age of 67 were included. Hs‐cTnI levels in each quartile were: (a) ≤122, (b) 123–680, (c) 681–2877, and (d) ≥2878 ng/L. There was no difference between the initial hs‐cTnI level groups regarding age and comorbidities. A higher mortality rate was observed in the highest hs‐cTnI quartile as compared with the lowest hs‐cTnI quartile (16.2% vs. 7.35%, p =.03) with hazard ratio (HR) for mortality of 2.6 (95% confidence interval [CI]: 1.23–5.4; p =.012) in the unadjusted model, and HR of 2.06 (95% CI: 1.01–4.79; p =.047) with adjustment for age, gender, serum creatinine, and significant comorbidities. Conclusions: Patients with NSTEMI and higher hs‐cTnI levels upon admission faced elevated mortality risk. This underscores the need for further prospective investigations into early reperfusion strategies' impact on NSTEMI patients' mortality, based on admission troponin elevation. [ABSTRACT FROM AUTHOR]

Various compositions of the series Li1+xM3+xZr2−x(PO4)3 where M3+=Al3+, Sc3+, Y3+ were prepared by solution‐assisted solid‐state reaction, since they could have a higher reduction stability as solid electrolytes in lithium batteries than in germanium‐ or titanium‐containing materials. The influence of substitution on crystallographic parameters, density, and ionic conductivity were investigated. The cation substitution of M3+ (M=Al, Sc, Y) for Zr4+ in LiZr2(PO4)3 stabilizes the rhombohedral NaSICON structure (space group R3‾c ${R\bar{3}c}$) at room temperature and increases the ionic conductivity significantly. Here, at 25 °C and with a consistent relative density of 94 %–96 %, an ionic conductivity of 2.7×10−5 S cm−1, 6.7×10−5 S cm−1, and 3.6×10−6 S cm−1 was achieved with the compositions Li1.2Sc0.2Zr1.8(PO4)3, Li1.2Y0.2Zr1.8(PO4)3, and Li1.2Al0.2Zr1.8(PO4)3, respectively. In comparison with Li1+xScxZr2−x(PO4)3, the Y3+ substitution in LiZr2(PO4)3 enhanced the ionic conductivity slightly and denoted the maximum Li+ ionic conductivity obtained at room temperature. However, substitution with Al3+ decreased the ionic conductivity. For the first time, this work provides a complete overview of three series of solid Li‐ion conductors in the Li2O‐M2O3‐ZrO2‐P2O5 system where M=Al, Sc, Y. Noticeable differences in the chemistry of resulting compounds were observed, which likely depend on the ionic radius of the cations being substituted. The series with Sc showed complete miscibility from x=0 to x=2 with a continuous change of the NaSICON polymorphs. The series with Y showed a solubility limit at about x=0.3 and higher substitution levels led to the increasing formation of YPO4. The series with Al exhibited continuously decreasing ionic conductivity until x=1, whereupon the investigation was terminated due to its very low conductivity of about 10−10 S cm−1. [ABSTRACT FROM AUTHOR]