The hydroethanolic Rosa rubiginosa extract is evaluated in vitro for antioxidant, anti-inflammatory, antiplatelet, photoprotective, and antimicrobial activities. Rich in phenolics and carotenoids, it shows strong antioxidant activity (notably in DPPH) and high SPF-related UV protection. Major compounds include rosmarinic acid, hydroxybenzoic acid, quercetin, and luteolin. Synergistic interactions among bioactives enhance antioxidant capacity beyond that of individual compounds. The extract demonstrates pronounced anti-inflammatory effects against platelet-activating factor (PAF), exceeding those of isolated standards, while showing lower activity against ADP-induced platelet aggregation, indicating specificity toward PAF-mediated pathways. Molecular docking supports interactions with the PAF receptor. Given PAF's role in UV-induced inflammation and melanoma, the extract's UV absorption, antioxidant capacity, and anti-PAF activity suggest protective effects against photoaging. Antimicrobial activity is stronger against Gram-negative bacteria, with slower effects on Gram-positive strains. Overall, R. rubiginosa extract exhibits broad bioactivity, supporting its potential as a multifunctional ingredient in functional foods, nutraceuticals, supplements, and cosmetic formulations.

Background: Gestational diabetes mellitus (GDM) is a frequent pregnancy pathology with poor maternal and fetal outcomes and risk of type 2 diabetes in later life. Despite known risk factors, such as obesity, age, and familial history, new data suggest that environmental exposure to agents, such as pesticides, can play a role in the etiogenesis of GDM. Objective: The epidemiologic, experimental, and mechanistic evidence between pesticide exposure and GDM risk is summarized here, and we concentrate on recent research (2000–2025). Methods: We conducted a literature search in PubMed, Embase, and the Cochrane Library for studies published from January 2000 to December 2025 using combinations of the terms “fertilizers”, “herbicides”, and “pesticides” with “diabetes mellitus” and “gestational diabetes”. After deduplication, 12 unique studies met inclusion criteria for qualitative synthesis (GDM endpoint or pregnancy glycemia with pesticide exposure). Results: Occupational and agricultural exposure to pesticides during first pregnancy was determined to be associated with a significantly increased risk of GDM through various epidemiologic studies. New studies have implicated new classes of pesticides, including pyrethroids and neonicotinoids, with higher GDM risk with first-trimester exposure. Experimental studies suggest that pesticides provide potential endocrine-disrupting chemicals that can induce insulin resistance through disruption of hormonal signaling, oxidative stress, inflammation, β-cell toxicity, and epigenetic modifications. However, significant limitations exist. Most of the evidence is observational, measurement of exposure is often indirect, and confounding factors are difficult to exclude. Notably, low dietary and residential exposure is not well studied, and dose–response relationships are undefined. Conclusions: New data indicate that pesticide exposure during early pregnancy and occupational exposure may increase the risk of GDM. Prospective cohort studies using biomonitoring, chemical mixture exposure, and geographic variation in pesticide exposure should be the focus of future research. Due to potential public health implications, preventive strategies to ensure the quality of nutrition and to reduce maternal exposure to pesticides during pregnancy are rational.

Background: Reduced tissue sensitivity to insulin, as well as the associated increased risk of gestational diabetes mellitus is genetically controlled and often varies racially and geographically. Roma populations constitute a genetically autonomous society with particularities in their type of sociability, and they are reported to have an increased prevalence of type 2 diabetes mellitus, which is pathophysiologically related to insulin resistance. Objectives: The aim of this study was to investigate the level of insulin sensitivity in pregnancies of Roma mothers compared to controls. Methods: A total of 65 pregnancies were studied during the third trimester, divided between 33 Roma mothers (RP) and 32 mothers of European descent to serve as control volunteers (CP). The presence of gestational diabetes was confirmed according to the WHO diagnostic criteria by a 75 mg oral glucose tolerance test and insulin resistance status by the means of HOMA-IR index. Results: The mean fasting insulin levels as well as the mean HOMA-IR index were statistically significantly higher in the Roma population (p = 0.0013) and (p < 0.001), respectively, regardless of the age and BMI of the participants. Gestational Diabetes Mellitus developed in seven women (10.7%), five of whom were Roma (15.1%) and in two controls (6.2%) (p = 0.247). Conclusions: Increased insulin resistance is observed in Roma pregnancies, so it would be beneficial to provide these women with appropriate counseling focused on healthy diet and lifestyle.

The medicinal potential of plant extracts, especially their antimicrobial, antioxidant, antiviral and cytotoxic properties, has gained significant attention in recent years. This study examined the in vitro bioactivities of several selected Greek medicinal plants, like Eucalyptus globulus L., Thymus vulgaris L., Salvia rosmarinus L. and Ocimum basilicum L., are well-known for their traditional therapeutic use. Minimum inhibitory concentration (MIC) assays were used to evaluate the antimicrobial activity of the extracts against pathogenic bacteria. The antioxidant activity was carried out using the DPPH method, while the cytotoxicity of the plants was determined using the Alamar Blue method. In addition, the antiviral efficacy of the samples was tested against DENV in different cell lines. The majority of medicinal herbs demonstrated significant antimicrobial action (MIC = 30–3000 μg∙mL−1). The extracts showed great antioxidant activity, while the Salvia rosmarinus L. extract turned out to be the most effective (IC50 = 12.89 ± 0.11 μg∙mL−1). In contrast, the extract of Eucalyptus globulus L. had the lowest antioxidant action (IC50 = 71.02 ± 0.42 μg∙mL−1). The results of the Alamar Blue method were presented with CC50 values, and it was shown that Eucalyptus globulus L. extract exhibited the highest cytotoxicity (CC50 = 5.94% v/v ± 0.04). Similarly, the results of the antiviral potential of extracts were expressed as EC50 values, and Eucalyptus globulus L. was characterized as the most effective sample against dengue virus infection, with EC50 values estimated at 2.37% v/v ± 0.6 (HuhD-2 cells infected with DENV-2) and 0.36% v/v ± 0.004 (Huh7.5 cells infected with DVR2A). These findings provide a foundation for further studies in order to combat infectious diseases and promote human health.

Background/Objectives: SIRT1 is a NAD+-dependent protein deacetylase regulating metabolic and stress response pathways. Genetic variations in the SIRT1 gene may contribute to the pathogenesis of type 2 diabetes mellitus (T2DM). This case–control study investigates the associations of two SIRT1 promoter polymorphisms, rs12778366 and rs3758391, in patients with type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM), preeclampsia, and healthy controls. Methods: This case–control study compared the genotypes between T2DM and pregnant and non-pregnant controls. We also compared genotypes between pregnant women with T2DM, GDM, preeclampsia, and healthy pregnant controls. Genomic DNA was extracted and analyzed using PCR-RFLP for the detection of rs12778366 and rs3758391 polymorphisms. Genotype frequencies were compared using chi-square tests, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: The study included 66 patients with T2DM, 36 with GDM, 12 with preeclampsia, and 81 pregnant and non-pregnant controls (33 pregnant controls). Although rs3758391 was more frequent in T2DM, the difference was not statistically significant between SIRT1 polymorphisms and T2DM. The CT genotype was more prevalent in T2DM (54.5%) compared to controls (33.4%); however, this difference was not significant. We finally found no significant association of the investigated SIRT1 polymorphisms with any of the conditions studied. In addition, the small sample size, especially for preeclampsia cases, limits the statistical power to detect significant associations. Conclusions: Although no significant association was observed between SIRT1 polymorphisms and diabetes, the findings of our study underscore the need for further studies examining SIRT1 polymorphisms in various ethnic groups, with a focus on leveraging these genetic variations in diabetes pathophysiology. Larger studies in the Greek population could also provide additional meaningful findings.

The COVID-19 pandemic has raised significant concerns regarding its potential impact on maternal and neonatal health. This study aimed to investigate the immunologic and hemostatic profiles of neonates exposed to SARS-CoV-2 during the peripartum period (0–14 days prior to delivery). This retrospective study included 28 neonates born to COVID-19-positive mothers during the peripartum period and a control group of 54 neonates born to mothers who never tested positive for SARS-CoV-2 during pregnancy. Arterial blood samples were collected from all neonates on the second day of life for the simultaneous assessment of full blood count, C-reactive protein (CRP), serum interleukin-6 (IL-6), and Interferon gamma-induced protein 10 (IP-10) levels, as well as Rotational Thromboelastometry (ROTEM) tests (EXTEM, INTEM, and NATEM). Neonates born to COVID-19-positive mothers and those born to COVID-19-negative mothers exhibited similar coagulation profiles based on ROTEM analysis. Multiple linear regression analysis revealed that peripartum COVID-19 infection was associated with higher IP-10 levels in neonates (coefficient: +16.8, 95% CI: +9.0 to +24.6, p < 0.0001). Our study findings suggest that the presence of immunologic disturbance in neonates is related to recent peripartum exposure to maternal SARS-CoV-2 infection, as evidenced by increased IP-10 levels in blood samples obtained from neonates born to SARS-CoV-2-positive mothers. However, peripartum exposure to maternal SARS-CoV-2 did not appear to disrupt the hemostatic profile of the exposed newborns based on ROTEM test results.

Background/Objectives: The vaginal microbiota constitutes a highly dynamic microbial ecosystem shaped by the distinct mucosal, hormonal, and immunological environment of the female genital tract. Accumulating evidence suggests that shifts in cervical microbial composition and function may influence host-microbe interactions and contribute to gynecological disease risk. Within this framework, the present study aimed to perform an in-depth genomic characterization of the cervical microbiota in a well-defined cohort of Greek women. The primary objective was to explore the functional microbial landscape by identifying dominant bacterial taxa, taxon-specific signatures, and potential microbial pathways implicated in cervical epithelial homeostasis, immune modulation, and disease susceptibility. Methods: Microbial genomic DNA was isolated from 60 cervical samples using the Magcore Bacterial Automated Kit and analyzed through full-length 16S rRNA gene sequencing using the Nanopore MinION™ platform, allowing high-resolution taxonomic assignment and enhanced functional inference. In parallel, cervical samples were screened for 14 HPV genotypes using a real-time PCR-based assay. Results: The cervical microbial communities were dominated by Lactobacillus iners, Lactobacillus crispatus, and Aerococcus christensenii, collectively representing over 75% of total microbial abundance and suggesting a functionally protective microbiota profile. A diverse set of low-abundance taxa-including Stenotrophomonas maltophilia, Stenotrophomonas pavanii, Acinetobacter septicus, Rhizobium spp. (Rhizobium rhizogenes, Rhizobium tropici, Rhizobium jaguaris), Prevotella amnii, Prevotella disiens, Brevibacterium casei, Fannyhessea vaginae, and Gemelliphila asaccharolytica-was also detected, potentially reflecting niche-specific metabolic functions or environmental microbial inputs. No HPV genotypes were detected in any of the cervical samples. Conclusions: This genomic profiling study underscores the functional dominance of Lactobacillus spp. within the cervical microbiota and highlights the contribution of low-abundance taxa that may participate in metabolic cross-feeding, immune signaling, or epithelial barrier modulation. Future large-scale, multi-omics studies integrating metagenomics and host transcriptomic data are warranted to validate microbial functional signatures as biomarkers or therapeutic targets for cervical health optimization.

Gestational diabetes mellitus (GDM) is associated with metabolic alterations that may influence maternal and neonatal microbiota. While the impact of GDM on the infant gut microbiome has been increasingly studied, its effect on the breast milk microbiota remains poorly understood. In this pilot study, we compared the breast milk microbiota received from 25 women with GDM compared to that of 25 non-diabetic breastfeeding mothers to serve as controls using full-length 16S rRNA gene sequencing on the Oxford Nanopore platform. Significant differences in microbial composition were observed between the two groups. Breast milk from GDM mothers showed increased abundance of Pseudomonadota (formerly Proteobacteria), including species such as Acinetobacter johnsonii and Bradyrhizobium mercantei, while beneficial Bacillota (e.g., Lacticaseibacillus paracasei) were significantly reduced compared to non-GDM samples. These findings suggest that GDM may alter breast milk microbial composition in ways that could influence neonatal early-life microbial colonization and immune programming. Given the known links between dysbiosis and metabolic and immune-mediated diseases, our results underscore the need for longitudinal, multi-omic studies to elucidate the long-term health implications of GDM-associated shifts in the breast milk microbiome.

Background/Objectives: Low levels of vitamins and minerals are linked to increased frailty, but the effectiveness of micronutrient supplementation remains debated. Methods: A systematic search of PubMed and Embase (end of search 10 June 2025) identified 21 randomized controlled trials from 33 articles assessing supplementation in frail individuals. Results: Regarding vitamin D supplementation, seven studies (2600 participants) reported all-cause mortality (pooled RR: 1.04, 95% CI: 0.83 to 1.31, I2 = 35%) with moderate certainty of evidence, whereas only one study reported on the change in frailty levels. For multicomponent supplementation, four studies (180 participants) were identified on all-cause mortality, and two studies on change in frailty levels (pooled MD = −0.28, 95% CI: −0.71 to 0.16, I2 = 0%) with very low certainty of evidence for both outcomes. Only one study investigated nicotinamide supplementation. Conclusions: Further research is needed to justify the prescription of micronutrient supplementation in this population. Future research in frailty should focus on longitudinal change in frailty levels, cognitive function, and functional measures.

Abstract Introduction Sodium-glucose cotransporter-2 (SGLT2) inhibitors have found success in treating patients with chronic heart failure (HF) across the entire spectrum of left ventricular ejection fraction (EF). Their benefits may also extend to patients with acute HF decompensation, as they may aid effective decongestion. Purpose This study aims to present the various patterns in changes of N-terminal pro b-type natriuretic peptide (NT-proBNP) according to SGLT2 inhibitor use in patients hospitalized for acute HF decompensation. Methods In this prospective cohort study, we enrolled consecutive patients hospitalized for HF decompensation during a 4-month period in a cardiology department. Prior medical history and cardiovascular risk factors were recorded. The patterns in SGLT2 inhibitor use were noted and patients were classified into three groups; Group 1 (No SGLT2 inhibitor use/Discontinuation), Group 2 (Prior SGLT2 inhibitor use and continuation), and Group 2 (SGLT2i-naïve and initiation). Categorization according to left ventricular (EF) to HF with reduced EF (HFrEF), HF with mildly reduced EF (HFmrEF), and HF with preserved EF (HFpEF) was also performed. Moreover, estimated glomerular filtration rate (eGFR) was used as an estimate of renal function. Results In this analysis, 159 patients were included (median age: 79 years old, male sex: 64.8%, median duration of hospitalization: 6 days). In this population, 67.9% of the patients were not receiving a SGLT2 inhibitor on admission. Concerning demographic and clinical variables (Figure 1), there were no major differences in age, sex distribution, history of diabetes mellitus, dyslipidemia, and atrial fibrillation, as well as in renal function. Group 2 patients had a lower prevalence of arterial hypertension compared to Group 3 (36.6% vs. 52.6%, p<0.05). Moving to the changes in NTproBNP (Figure 2), we observed that patients who did not use SGLT2 inhibitors and did not initiate them during hospitalization had negligible changes in NTproBNP, either as an absolute change (Group 1: 506 (8792) pg/ml vs. Group 2: -5610 (9461) pg/ml vs. Group 3: -3602 (4409) pg/ml, p=0.001) or as percentage change (Group 1: -2.1 (63.4) % vs. Group 2: -30.3 (39.0) % vs. Group 3: -38.3 (41.5) %, p=0.001), compared to the rest of the study population who were already taking SGLT2 inhibitors or initiated them during hospitalization. Conclusion In this study we found NTproBNP, a widely used biomarker of congestion and prognosis in HF, was significantly reduced in decompensated HF patients receiving SGLT2 inhibitors, with the greatest change being observed in those being treatment-naïve prior to admission. These findings further highlight the role of this drug class even in the acute phase of the disease.Figure 1Figure 2

Introduction: Irritable bowel syndrome (IBS) symptoms can be effectively managed with the low FODMAP diet. However, its efficacy in reducing inflammation is not yet proven. On the contrary, the Mediterranean diet has anti-inflammatory properties with proven efficacy in treating chronic low-grade inflammation-related diseases. Aim: To publicly share our protocol evaluating the efficacy of the Mediterranean low-FODMAP (MED-LFD) versus NICE recommendations (British National Institute for Health and Care Excellence) diet in managing IBS symptoms and quality of life. Materials and Methods: Participants meeting the Rome IV criteria will be randomly assigned to MED-LFD or NICE recommendations and they will be followed for six months. Efficacy, symptom relief, quality of life and mental health will be assessed using validated questionnaires. In addition, fecal samples will be analyzed to assess gut microbiota, and to measure branched and short-chain fatty acids, and volatile organic compounds (metabolic byproducts from bacteria). Expected results and discussion: By publicly sharing this clinical study protocol, we aim to improve research quality in the field of IBS management by allowing for peer review feedback, preventing data manipulation, reducing redundant research efforts, mitigating publication bias, and empowering patient decision-making. We expect that this protocol will show that MED-LFD can effectively alleviate IBS symptoms and it will provide pathophysiology insights on its efficacy. The new dietary pattern that combines the LFD and the MED approaches allows for the observation of the synergistic action of both diets, with the MED’s anti-inflammatory and prebiotic properties enhancing the effects of the LFD while minimizing its limitations. Identifier in Clinical Trials: NCT03997708

Several individual-based social deprivation and vulnerability indices have been developed to measure the negative impact of low socioeconomic status on health outcomes. However, their variables and measurable characteristics have not been unequivocally assessed. A comprehensive database literature scoping review was performed to identify all individual-based social deprivation and vulnerability indices. Area-based indices and those developed for pediatric populations were excluded. Data were extracted from all eligible studies and their methodology was assessed with quality criteria. A total of 14 indices were identified, of which 64% (9/14) measured social deprivation and 36% (5/14) measured socioeconomic vulnerability. Sum of weights was the most common scoring system, present in 43% (6/14) of all indices, with no exclusive domains to either vulnerability or deprivation indices. A total of 83 different variables were identified; a very frequent variable (29%; 5/14) related to an individual’s social relationships was “seen any family or friends or neighbors.” Only five deprivation indices reported a specific internal consistency measure, while no indices reported data on reproducibility. This is the first scoping review of individual-based deprivation and vulnerability indices, which may be used interchangeably when measuring the impact of SES on health outcomes.

The increased prevalence of obesity worldwide has been implicated in the alarming rise of the incidence of gestational diabetes and preeclampsia, which are both considered threatening conditions for both mother and fetus. We studied gene polymorphisms of the proinflammatory cytokine Interleukin 6 (IL-6) and the gene expression levels of VEGF (vascular endothelial growth factor) and VEGF-R (endothelial growth factor receptor), all known to be involved in pregnancy complications, aiming to identify possible predisposing risk factors in pregnancies with obesity. The G allele of IL-6 was found to correspond with an increased risk for gestational diabetes and preeclampsia occurrence. Furthermore, in obese pregnant mothers with either gestational diabetes or pre-existing type 2 diabetes and those who developed preeclampsia, it was confirmed that gene expression levels of VEGF were reduced while they were increased for VEGF receptors. We conclude that the genetic profile of an obese pregnant woman shares a common background with that of a patient with pre-existing type 2 diabetes mellitus, and therefore predisposes them to complications in pregnancy.

Traditional methods of detecting foodborne pathogens take several days to produce the required results. Furthermore, various molecular techniques (e.g., PCR) that also produce reliable results in the detection of pathogenic bacteria have been introduced, but the cost–time ratio required does not allow them to be considered a substantial solution to this specific problem. Three-dimensional (3D) printing technology provides the ability to design and manufacture microfluidic analytical devices using conventional 3D printers, which, in combination with colorimetric loop-mediated isothermal amplification (LAMP), may further simplify the process. The overall reduction in time and cost may provide the opportunity to upscale this diagnostic modality. Moreover, unlike most microfluidic analytical devices, this technique is simpler and more user-friendly, as it does not require any expertise or additional equipment apart from a conventional oven. A 3D-printed microfluidic analytical device in combination with LAMP was developed and tested for the simultaneous detection of foodborne pathogens in food samples. A total of 150 commercial food specimens (50 milk, 50 chicken, 50 lettuce samples) were analyzed for possible contamination with Salmonella typhimurium, Listeria monocytogenes and Escherichia coli. The 3D-printed microfluidic device was 100% precise for both negative (80 samples) and positive samples (7 samples were positive for S. typhimurium, 28 for L. monocytogenes, and 35 for E. coli) for all pathogens. Overall, the amount of data analyzed led to a high level of confidence in the precision of this device. As such, this new 3D device in combination with LAMP provides a precise detection method for food pathogens with a low detection limit.

Intravenous thrombolysis (IVT) and/or endovascular therapy (EVT) are currently considered best practices in acute stroke patients. Data regarding the efficacy and safety of reperfusion therapies in patients with atrial fibrillation (AF) are conflicting as regards haemorrhagic transformation, mortality, and functional outcome. This study sought to investigate for any differences, in terms of safety and effectiveness, between AF patients with acute ischaemic stroke (AIS) treated and untreated with reperfusion therapies. Data from two multicenter cohort studies (RAF and RAF-NOACs) on consecutive patients with AF and AIS were analyzed to compare patients treated and not treated with reperfusion therapies (IVT and/or EVT). Multivariable logistic regression analysis was performed to identify independent predictors for outcome events: 90-day good functional outcome and mortality. A propensity score matching (PSM) analysis compared treated and untreated patients. Overall, 441 (25.4

Background: Diabetes mellitus (DM) is a prevalent disease in the general population and also a well-established risk factor for the development of ischemic stroke. Patients who have been diagnosed with diabetes have a 20% higher risk for developing ischemic stroke in comparison to non-diabetic individuals. The aim of the current systematic review is to provide the latest evidence regarding the association between antidiabetic treatment and the prevention of ischemic stroke. Methods: A comprehensive search in scientific literature databases PUBMED, COCHRANE, and SCOPUS was conducted. The studies that were deemed as eligible for this review were those that examined the clinical benefits of therapeutic strategies in terms of preventing ischemic strokes. Results: A total of 32 studies met the established selection criteria. The included studies showed that pioglitazone treatment significantly reduced the risk for recurrent stroke in patients with DM. Furthermore, in the context of primary prevention, the improvement in glycemic control after treatment with the glucagon-like peptide-1 receptor agonists (GLP-1RA) semaglutide and dulaglutide was associated with a reduction in the risk of ischemic stroke in diabetic subjects. Metformin monotherapy may reduce stroke risk, while dipeptidyl peptidase 4 inhibitors, sodium-glucose co-transporter 2 inhibitors, and insulin do not seem to affect the incidence of stroke. Conclusions: The findings of the present systematic review suggest that pioglitazone and GLP-1RA may decrease the risk of stroke. Further studies are needed to provide additional data regarding the preventive effect of novel antidiabetic drugs, such as dual glucose-dependent insulinotropic polypeptide/GLP-1RA agents, on stroke.

Nowadays adulteration of meat products, especially of ground meat products which form an easy case scenario for implementing adulteration practices due to their structure and texture, emerges a critical issue of raised concern threatening fair trade, food quality and consumers’ health and protection. Food authentication testing is the tool to address this kind of fraud. There is several analytical methodologies applied for meat authentication targeting at different biomarkers and using a variety of analytical techniques. However, the applied methodologies should exhibit suitable performance characteristics such as reliability, sensitivity, reproducibility and availability in order to be fit for purpose. During the last 20 years, amplification tests have emerged as an important diagnostic tool, not only for clinical applications, but also for food quality and safety. It was urgent to develop molecular techniques fast and sensitive. The introduction of new DNA technologies has facilitated the ease and accuracy of of methods for fraud detection. The closed-tube methods of Loop-mediated isothermal amplification (LAMP) and Gold Nanoparticles linked with oligonucleotides used as molecular probes are well known for their robust and highly sensitive and specific amplification of target DNA. Moreover, these techniques are rapid, low-cost diagnostics and available on site. This review provides a comprehensive overview of the molecular methods developed that can be applied for investigating ground meat adul-teration and focuses on the advantages of the rapid closed tube methods that can yield color results interpreted with the naked eye. The application of such time- and cost-effective molecular tools in the food market is proposed to provide a first-level filter for meat adulterated products, serving as a complementary tool to the more in-depth -omics approach.

Application of microfluidic paper-based analytical devices (μPADs) for food microbial detection, published in Journal of the Science of Food and Agriculture, https://doi.org/10.1002/jsfa.11822. The above article, published online on 18 February 2022 in Wiley Online Library (wileyonlinelibrary.com), has been withdrawn by agreement between the journal Editor in Chief, Andrew Waterhouse, and John Wiley & Sons, Ltd. The withdrawal has been agreed following no response from the author to requests to sign the Journal's publishing license. © 2022 Society of Chemical Industry.

Introduction: The best therapeutic strategy for patients with mechanical heart valves (MHVs) having acute ischemic stroke during treatment with vitamin K antagonists (VKAs) remain unclear. Being so, we compared the outcomes for: (i) full dose heparin along with VKA (bridging therapy group) and (ii) restarting VKA without heparin (nonbridging group). Patients and methods: For this multicenter observational cohort study, data on consecutive acute ischemic stroke patients with MHV was retrospectively collected from prospective registries. Propensity score matching (PSM) was adopted to adjust for any treatment allocation confounders. The primary outcome was the composite of stroke, systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding at 90 days. Results: Overall, 255 out of 603 patients (41.3%) received bridging therapy: 36 (14.1%) had combined outcome, compared with 28 (8.0%) in the nonbridging group (adjusted OR 1.83; 95% CI 1.05-3.18; p = 0.03). Within the bridging group, 13 patients (5.1%) compared to 12 (3.4%) in the nonbridging group had an ischemic outcome (adjusted OR 1.71; 95% CI 0.84-3.47; p = 0.2); major bleedings were recorded in 23 (9.0%) in the bridging group and 16 (4.6%) in the nonbridging group (adjusted OR 1.88; 95% CI 0.95-3.73; p = 0.07). After PSM, 36 (14.2%) of the 254 bridging patients had combined outcome, compared with 23 (9.1%) of 254 patients in the nonbridging group (OR 1.66; 95% CI 0.95-2.85; p = 0.07). Conclusion: Acute ischemic stroke patients with MHV undergoing bridging therapy had a marginally higher risk of ischemic or hemorrhagic events, compared to nonbridging patients.