BACKGROUND:Advancements in artificial intelligence are being seen in multiple fields, including medicine, and this trend is likely to continue going forward. To analyze the accuracy and reproducibility of ChatGPT answers about acute coronary syndromes (ACS).METHODS:The questions asked to ChatGPT were prepared in two categories. A list of frequently asked questions (FAQs) created from inquiries asked by the public and while preparing the scientific question list, 2023 European Society of Cardiology (ESC) Guidelines for the management of ACS and ESC Clinical Practice Guidelines were used. Accuracy and reproducibility of ChatGPT responses about ACS were evaluated by two cardiologists with ten years of experience using Global Quality Score (GQS).RESULTS:Eventually, 72 FAQs related to ACS met the study inclusion criteria. In total, 65 (90.3%) ChatGPT answers scored GQS 5, which indicated highest accuracy and proficiency. None of the ChatGPT responses to FAQs about ACS scored GQS 1. In addition, highest accuracy and reliability of ChatGPT answers was obtained for the prevention and lifestyle section with GQS 5 for 19 (95%) answers, and GQS 4 for 1 (5%) answer. In contrast, accuracy and proficiency of ChatGPT answers were lowest for the treatment and management section. Moreover, 68 (88.3%) ChatGPT responses for guideline based questions scored GQS 5. Reproducibility of ChatGPT answers was 94.4% for FAQs and 90.9% for ESC guidelines questions.CONCLUSIONS:This study shows for the first time that ChatGPT can give accurate and sufficient responses to more than 90% of FAQs about ACS. In addition, proficiency and correctness of ChatGPT answers about questions depending on ESC guidelines was also substantial.

Objective: This study aimed to investigate the learning curve (LC) of Perclose ProGlide (Chicago, IL: Abbott Laboratories) utilization for percutaneous coronary intervention (PCI) for the first time. Methods: The study was conducted in a prospective manner and the final sample of the study was determined as 80 patients. Patients’ characteristics, diameter of common femoral artery (CFA), distance from skin to CFA, degree of calcification (<50% or ≥50%), procedure-related parameters, complications, and success of procedures were recorded. Patients were equally divided into four groups and groups were compared according to patient demographic properties, procedure-related parameters, complications, and success. Results: The mean age and mean BMI of the study population were 55.5 years and 27.5 kg/m2, respectively. The mean procedure time was 144.8 minutes (min) in group 1, 138.9 min in group 2, 122.2 min in group 3, and 101.1 min in group 4, and the difference was statistically shorter in favor of group 3 and group 4 (p=0.023). Moreover, mean fluoroscopy time significantly decreased after 20 cases (p=0.030). Hospitalization period was significantly shortened following 40 procedures (p=0.031). Complications were detected in five patients in group 1, four patients in group 2, and one patient in group 4 (p=0.044). Success was significantly higher in group 3 and group 4 in comparison to group 1 and group 2 (p=0.040). Conclusion: This study showed that procedure time and hospitalization time significantly decreased after 40 cases and fluoroscopy time significantly decreased after 20 cases. Moreover, after 40 procedures, the success of Perclose ProGlide utilization during PCI significantly increased and complications of the procedure significantly decreased.

Introduction: To clarify the correlation between coronary artery calcium score (CACS) and triglycerideglucose (TyG) index in post-menopausal women. Methods: Post-menopausal women who underwent computed tomography angiography with the suspicion of acute coronary syndrome were included in the study. Patients were categorized into three groups (CACS < 100 as group 1, CACS = 100-300 as group 2, and CACS > 300 as group 3). Groups were compared with regard to demographic characteristics, laboratory test outcomes, electrocardiogram findings, and the TyG index. Results: The study was conducted by examining the data of 228 patients. Median TyG index was 9.0 and median CACS was 79.5. The median age was significantly lower in group 1 (p = 0.001). Diabetes mellitus rate and smoking rate were higher in group 3 compared to the other groups (p = 0.037 and p = 0.032). The glucose level was significantly higher for group 3 (p = 0.001). Additionally, the TyG index was 9.3 in group 3 and was statistically significantly higher than the values in group 1 and group 2 (8.9 and 9.1, respectively) (p = 0.005). There was a moderate correlation between CACS and age (correlation coefficient (CC): 0.241, p = 0.001). Also, there was a significant correlation between glucose level and CACS (CC: 0.307, p = 0.001). A high correlation was found between the TyG index and CACS (CC: 0.424, p = 0.001). Conclusion: Our study demonstrated for the first time that there was a strong correlation between the TyG index and CACS in post-menopausal patients. In addition, patients with increased age, patients with higher glucose levels, and diabetic patients had significantly higher CACS.

Abstract Background Although cardiac implantable electronic device (CIED) implantation is considered to be minor surgery, almost 60% of the patients suffer from shoulder‐related problems a short time after the procedure. The purpose of this study was to determine the possible effects of the preference of the dominant side for CIED implantation on the ipsilateral superior extremity functions. Methods The study included a total of 107 patients who had been living with a CIED for >6 months. Patients were separated into two groups according to the dominant hand and side of the CIED. The ipsilateral dominant‐hand group comprised those with a CIED on the same side as the dominant hand and the contralateral dominant‐hand group included patients with the CIED placed on the contralateral side to the dominant hand. Visual analogue scale (VAS) pain score, quick disability of the arm shoulder and hand questionnaire (QuickDASH) and maximum isometric grip strength tests were used to evaluate the upper extremity disabilities. Results No significant difference was determined between the groups in respect of VAS pain scores (P = 0.10), QuickDASH scores (P = 0.21), and limitations of the shoulder joint range of motion (P = 0.192). The maximum isometric grip strength was significantly different in the right hands between two groups (34 [16‐95]‐40 [24‐85]) (P = 0.02). Conclusion The present study shows that the joint range of motion limitation, pain, and disability of the upper extremity were no different in the affected arm compared to the healthy contralateral side with respect to the placement of the CIED on the dominant or non‐dominant side.

Introduction: We compared transcatheter and surgical closure of secundum atrial septal defects (ASDs) in terms of cost in this study. Materials and Methods: Between 2006 and 2015, 291 consecutive patients having secundum ASD, in whom percutaneous or surgical closure was performed, were included in this study. We compared the in-hospital cost of transcatheter versus surgical ASD closure in these patients. Results: We collected totaly 291 patients, 214 transcatheter and 77 surgical closure procedures, retrospectively. Patients with a surgical closure had a longer length of stay (11.8 ± 3.8 days vs. 2.8 ± 1.6 days, P < 0.001). There was no in-hospital mortality in two groups. Costs denominated in Turkish lira (TL) and United States Dollar (USD) of transcatheter closure were higher than that of surgical closure (TL 10955.6 ± 183.4 vs. TL 6016.7 ± 371.9 P < 0.001; USD 6531.2 ± 149.62 vs. USD 3896.2 ± 234.7 P < 0.001). The cost of percutaneous ASD closure increase does not correlate with the dollar rate on the annual basis. This with the supplier firms has excessive profits in the first year of the study. Conclusion: Compared with other countries with regard to cost, transcatheter ASD closure is a more expensive treatment than surgical closure in our country.

Introduction: There are some studies regarding the prognostic value of coagulation abnormalities both in heart failure and acute pulmonary embolism patients. However, it is unclear whether prothrombin time (PT) at presentation will be associated with long-term mortality in acute coronary syndrome (ACS) patients not on anticoagulant therapy. Thus, we investigated the prognostic role of initial PT in such patients. Patients and Methods: A total of 1100 consecutive patients with ACS undergoing percutaneous coronary intervention (PCI) who were not receiving anticoagulant therapy were included in the study, retrospectively. PT was measured on admission in these patients before anticoagulation therapy. The study population was divided into three groups based on the PT values: A high-PT group (PT ≥ 14 sec, n= 50), intermediate-PT group (12.5 < PT < 14 sec, n= 169), and low-PT group (PT ≤ 12.5 sec, n= 881). The primary end point was all-cause death during the median follow-up of 30.5 months. Results: The rate of the primary end point was 15% in the low-PT group, 27% in the intermediate-PT group, and 52% in the high-PT group (p< 0.001). For long-term mortality, a significantly higher mortality risk was observed in high-PT group (HR: 2.648, 95% CI: 1.590-4.410, p< 0.001) compared with the others group in multivariate analysis. The addition of PT to a multivariable model that included the left ventricular ejection fraction, histories of diabetes mellitus and stroke, age, hemoglobin, creatinine, white blood cell count, total bilirubin levels and Killip class led to a significant net reclassification improvement (NRI) of 26.7% (p< 0.001) and an integrated discrimination improvement of 0.022 (p= 0.001). Conclusion: Our findings suggest that prolonged initial PT in the absence of anticoagulant therapy can be associated with all-cause mortality in ACS patients who were undergoing PCI. In addition, PT may be used to identify the high-risk patients with ACS.

The prognostic significance of changes in mean platelet volume (MPV) during hospitalization in ST segment elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (pPCI) has not been previously evaluated. The aim of this study was to determine the association of in-hospital changes in MPV and mortality in these patients.

We investigated whether the lymphocyte-to-monocyte ratio (LMR) 48 hours after admission is related to 30-day and long-term mortality in patients with ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI). We evaluated 318 consecutive patients with STEMI who were undergoing primary PCI. The relationship between the LMR48h and all-cause mortality (30-day and long-term) was analyzed by categorizing the patients into tertiles (T) according to LMR48h-T1 (>2.46), T2 (1.67-2.46), and T3 (<1.67). The T3 group exhibited the highest risk of 30-day all-cause mortality (hazard ratio [HR]: 8.093 [1.006-65.074]; P = .049). For long-term mortality, a significantly higher mortality risk was observed in both T2 (HR: 2.005 [1.021-3.939]; P = .043) and T3 groups (HR: 2.374 [1.160-4.857]; P < .001) compared to the T1 group (reference group). In multivariate analysis, these associations remained unaltered even after adjusting for confounders. A low LMR at 48 hours after admission may be independently associated with both 30-day and long-term mortality in patients with STEMI who were treated with primary PCI. This marker may be used for identifying patients with STEMI at high risk.

OBJECTIVE:Atrioventricular nodal reentrant tachycardia (AVNRT) attacks is one of the common arrhythmias adversely affecting quality of life. The Umea 22 (U22) is a questionnaire developed for the assessment of symptoms associated with supraventricular tachycardia (SVT), and it is found to be effective in evaluation of quality of life after radiofrequency ablation. Using this questionnaire, the study aimed to assess quality of life among Turkish patients with ANRT before and after the successful RFA.METHODS:The study was conducted between January 2011 and September 2013, and included 57 patients who had undergone RFA due to AVNRT. The U22 questionnaire was administered pre-procedure and at 6 months post-procedure. The participants were asked to report on their general well-being, arrhythmia effects on their wellbeing, and intensity of discomfort associated with episodes. They were asked to provide a score from 1 to 10 in order to determine to severity of discomfort, and the quantity of symptoms was then assessed according to the visual analogue scale (VAS).RESULTS:Patients' general wellbeing (7.5±2.3 vs. 8.7±1.8, p<0.001), the effects of arrhythmia episodes on general well-being (8.1±1.7 vs. 1.0±2.1, p<0.001), frequency of symptoms (2.8±0.8 vs. 0.4±0.9, p<0.001) and duration of symptoms were reduced significantly after RFA. The rate of drug use among patients also decreased after RFA (70% vs. 23%, p=0.017).CONCLUSION:Treatment success was high in patients undergoing RFA due to AVNRT according to the U22 quality of life questionnaire. General and arrhythmia-associated quality of life had improved significantly by the 6th month post-procedure.

Pulmonary embolism (PE) is a potentially life-threatening emergency that is sometimes difficult to diagnose due to nonspecific symptoms and findings. A 69-year-old male was admitted to our hospital with new-onset chest pain and sweating. The electrocardiogram (ECG) revealed sinus rhythm with ST elevations in the inferior leads. His angiogram showed noncritical coronary artery disease with a few plaques. Right heart catheterization was made, which revealed an elevated pulmonary artery pressure of 45/23 mmHg. A pulmonary angiogram was then performed, at first from the pulmonary trunk and then the right pulmonary artery, which showed occlusion of the pulmonary artery to the right lower lobe. This report emphasizes that acute PE should be suspected in every patient with ST elevation myocardial infarction and normal coronary arteries. ST changes may be in the inferior as well as the anterior leads.