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Introduction: Although the incidence of acute ST-segment elevation myocardial infarction (STEMI) in the elderly population has decreased in recent years, this is not the case for young people. At the same time, no reduction in hospitalization rate after STEMI was shown in young people. Clinical characteristics, risk factors, angiographic findings, in-hospital and one-year outcomes of patients under the age of 40 and their gender differences were investigated. Methods: This study has been performed retrospectively in two centers. Between January 2015 and April 2019, 212 patients aged 18-40 years with STEMI and who underwent reperfusion therapy were included. The gender differences were compared. Results: The median age of (male 176; 83.0% and female 36; 17.0%) patients included in the study was 36 (33-38) for men and 36 (34-38) for women. Chest pain was the most common complaint for both genders (96.0% vs. 94.4%; P = 0.651). While men presented more often with Killip class 1,women presented more often with Killip class 2. The anterior myocardial infarction (MI) was the most common MI type and it was higher in women than in man (P = 0.027). At one year of follow-up, the prevalence of all-cause hospitalization was 24%, MI 3.8%, coronary angiography 15.1%, cardiovascular death 1.4%, and all-cause death 0.47%, there was no gender difference. Conclusion: Anterior MI was the most common type of MI and it was more common in women than in men. Left anterior descending artery was the most common involved coronary artery. The most common risk factor is smoking. In terms of in-hospital outcome, left ventricular ejection fraction was significantly lower in women. There was no significant difference in one-year outcomes between both genders.

Background Heart rate decrease after exercise, that is associated with reactivation of parasympathetic system, is important, as it is also associated with mortality. Previous studies have shown that this is an independent mortality predictor in patients having no coronary artery disease and having normal left ventricular function. In our study, we aimed to study heart rate recovery (HRR) after exercise in patients having impaired left ventricular function. Methods One hundred and two consecutive patients (68 males, 34 females) requested to perform an exercise stress test were included in our study. Patients were divided into two groups as those having a normal heart rate reserve (Group1, n = 72) and those having an abnormal heart rate reserve (Group2, n = 30). Results In Group1 and Group2, resting heart rate averages were found to be 83.61 ± 18.01/min and 85.10 ± 13.40/min, respectively (P > 0.05), and maximum heart rates during exercise were 141.42 ± 19.70/min and 121.17 ± 19.01/min while those in Group1 had statistically significantly higher heart rates (P < 0.001). A statistically significant positive association was found in the correlation test carried out between the maximum heart rate during the treadmill exercise test and ejection fraction (EF) value (r = 0.201; P < 0.05). Metabolic equivalents of task values obtained during the treadmill exercise test in Group1 and Group2 were 9.48 ± 2.28 and 8.36 ± 2.50, respectively, and the difference between the said values was statistically significant (P < 0.05). Conclusions We believe that the association between low EF and abnormal HRR is worth studying and randomized large-scale studies are needed to determine mortality risk.

Heart rate decrease after exercise, that is associated with reactivation of parasympathetic system, is important, as it is also associated with mortality. Previous studies have shown that this is an independent mortality predictor in patients having no coronary artery disease and having normal left ventricular function. In our study, we aimed to study heart rate recovery (HRR) after exercise in patients having impaired left ventricular function.One hundred and two consecutive patients (68 males, 34 females) requested to perform an exercise stress test were included in our study. Patients were divided into two groups as those having a normal heart rate reserve (Group1, n = 72) and those having an abnormal heart rate reserve (Group2, n = 30).In Group1 and Group2, resting heart rate averages were found to be 83.61 ± 18.01/min and 85.10 ± 13.40/min, respectively (P0.05), and maximum heart rates during exercise were 141.42 ± 19.70/min and 121.17 ± 19.01/min while those in Group1 had statistically significantly higher heart rates (P0.001). A statistically significant positive association was found in the correlation test carried out between the maximum heart rate during the treadmill exercise test and ejection fraction (EF) value (r = 0.201; P0.05). Metabolic equivalents of task values obtained during the treadmill exercise test in Group1 and Group2 were 9.48 ± 2.28 and 8.36 ± 2.50, respectively, and the difference between the said values was statistically significant (P0.05).We believe that the association between low EF and abnormal HRR is worth studying and randomized large-scale studies are needed to determine mortality risk.

WOS: 000280010500023, PubMed ID: 19108911, Coronary angiography, despite current shortcomings, has been regarded as golden standard for the assessment of coronary arteries. Geodesic pattern of coronary arteries characterized by curvature, torsion and tortuosity parameters can also be determined through angiography. Apart from atherosclerosis; age, hypertension, left ventricular hypertrophy and coronary flow are some of the determinants for the geodesic pattern of coronary arteries. Besides, a unique feature of coronary vasculature that differs from all other arterial sites is the repetitive flexion during each cardiac contraction. Thus, the geodesic pattern of coronary arteries may conceivably possess an adjunctive merit in estimating cardiovascular risk and have promising implications for discerning those who require meticulous follow-up. A more thorough understanding of the precise determinants for the coronary geodesic pattern would help establish its potential causal interaction with cardiovascular risk. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

WOS: 000282679000004, PubMed ID: 19150141, Free-floating intracardiac thrombi represent a severe yet uncommon condition and mostly coexist with thromboembolism. Notably, mobile right heart thrombus can occur in patients with massive pulmonary embolism. Early diagnosis and management can be life-saving. Spontaneous atrial thrombosis due to restrictive cardiomyopathy has also been rarely reported. We describe here an unusual case of free-floating biatrial thrombi with concomitant saddle pulmonary embolism in a patient with idiopathic restrictive cardiomyopathy and sinus rhythm who had lower extremity deep vein thrombosis following the left knee arthroplasty. In the absence of treatment, mortality from pulmonary embolism remains high. Nevertheless, in our patient, blood stasis with dilated atria, resulting from restrictive hemodynamics, and deep venous thrombosis were the most likely causes for the formation of biatrial thrombi and concomitant pulmonary embolism. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

An anomalous right coronary artery (RCA) with a high anterior takeoff is an uncommon and technically challenging vessel to cannulate and to intervene upon. We describe here an unusual case of chronic total occlusion in a patient with an anomalous dominant RCA accompanied by a high anterior takeoff, in whom there was insufficient catheter seating despite the exchange of several different guiding catheters during percutaneous intervention. This illustrative case demonstrates that if routine guiding catheters fail, early consideration can be made to use a right coronary bypass guiding catheter positioned with clockwise torque to obtain a stable platform for intervening on complex lesions in an anomalous RCA with a high anterior takeoff. This technique resulted in a successful procedure when many other guiding catheters had failed; it provided satisfactory backup support for the passage of stent and balloon catheters and reduced the procedural time and radiation exposure, as well as the amount of radiocontrast agent used.