Background and Objectives: Inflammatory and nutritional impairment may contribute to adverse outcomes after permanent pacemaker implantation, but their prognostic value in degenerative complete atrioventricular block remains unclear. We evaluated the association between routinely available inflammatory and nutritional indices and long-term all-cause mortality in this population. Materials and Methods: This retrospective single-center study included 272 patients who underwent permanent pacemaker implantation for isolated complete atrioventricular block attributed to degenerative conduction system disease between August 2020 and July 2024. Baseline laboratory values were used to calculate the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and pan-immune-inflammation value. The primary endpoint was all-cause mortality during follow-up. Discriminatory performance was assessed by ROC analysis, and independent predictors were evaluated using multivariable Cox regression. Results: During a mean follow-up of 27.8 ± 16.6 months, 69 patients (25.4%) died. Non-survivors were older and had lower hemoglobin, lymphocyte count, albumin, estimated glomerular filtration rate, GNRI, LMR, and PNI, whereas C-reactive protein, NLR, and SIRI were higher. PNI showed the highest discriminative ability for mortality prediction (AUC 0.720, 95% CI 0.648-0.793; p< 0.001), exceeding albumin, lymphocyte count, GNRI, and other inflammatory indices. In multivariable Cox regression, PNI remained independently associated with mortality (HR 0.945, 95% CI 0.909-0.983; p=0.004). Single-chamber pacemaker implantation was also associated with all-cause mortality (HR 2.137, 95% CI 1.202-3.802; p=0.010), although this should be interpreted in the context of baseline vulnerability and device-selection patterns. Conclusions: PNI may provide useful prognostic information for mortality risk stratification in patients undergoing permanent pacemaker implantation for degenerative complete atrioventricular block.

Background and Objectives: Systemic inflammation and nutritional impairment may influence outcomes after permanent pacemaker implantation, but the prognostic value of composite indices in degenerative complete atrioventricular block remains unclear. We evaluated the associations of routinely available inflammatory and nutritional indices with long-term all-cause mortality in this population. Materials and Methods: This retrospective, single-center study included 272 patients who underwent permanent pacemaker implantation for isolated complete atrioventricular block attributed to degenerative conduction system disease between August 2020 and July 2024. Baseline laboratory values were used to calculate the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and pan-immune-inflammation value. The primary endpoint was all-cause mortality during follow-up. Discriminatory performance was assessed using receiver operating characteristic (ROC) analysis, and independent associations were evaluated using multivariable Cox regression. Results: During a mean follow-up of 27.8 ± 16.6 months, 69 patients (25.4%) died. Compared with survivors, non-survivors were older and had lower hemoglobin, lymphocyte count, albumin, estimated glomerular filtration rate, GNRI, LMR, and PNI values, whereas C-reactive protein, NLR, and SIRI values were higher. PNI had the numerically highest AUC for mortality prediction (AUC: 0.720, 95% CI: 0.648–0.793; p < 0.001), corresponding to moderate discriminatory performance, whereas GNRI showed fair discrimination (AUC: 0.677, 95% CI: 0.589–0.766; p < 0.001). In multivariable Cox regression, PNI remained independently associated with mortality (HR: 0.945, 95% CI: 0.909–0.982; p = 0.004). Conclusions: Among the evaluated inflammatory and nutritional indices, PNI demonstrated the numerically highest discriminatory performance and remained independently associated with long-term all-cause mortality. PNI may therefore serve as a readily available adjunct to clinical risk stratification in patients undergoing permanent pacemaker implantation for degenerative complete atrioventricular block; however, external validation is required.

Background: Arrhythmia recurrence after cryoballoon ablation remains a clinically relevant problem in atrial fibrillation (AF). However, factors associated with documented recurrence in low-risk patients without major comorbidities are not well defined. This study aimed to evaluate factors associated with documented arrhythmia recurrence after cryoballoon ablation in a highly selected low-risk AF population. Methods: This retrospective, single-center study included 153 eligible patients selected from an institutional cryoablation database after application of predefined exclusion criteria. Only patients with a CHA2DS2-VA (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack/thromboembolism, vascular disease, and age 65-74 years) score ≤ 1 and without major comorbidities, including diabetes mellitus, hypertension, coronary artery disease, chronic kidney disease, cerebrovascular disease, and heart failure, were included. Recurrence was defined as electrocardiographically documented AF or atrial tachyarrhythmia after the 3-month blanking period over 1 year of follow-up; Holter-detected episodes were required to last ≥30 s. The primary multivariable model included sex, age, AF type, and absolute left atrial diameter; a sensitivity model replaced absolute left atrial diameter with left atrial diameter indexed to body surface area (BSA). Results: The study population included 70 women (45.8%) and 83 men (54.2%). Paroxysmal AF was present in 125 patients (81.7%), whereas 28 patients (18.3%) had persistent AF. Documented arrhythmia recurrence occurred in 40 patients (26.1%). Female sex was more frequent in the recurrence group than in the no-recurrence group (62.5% vs. 39.8%, p = 0.013). The complete-case primary multivariable model included 126 patients with 36 recurrence events. Female sex was associated with documented arrhythmia recurrence (odds ratio [OR] 2.69, 95% confidence interval [CI] 1.14-6.37; p = 0.024). The estimate for left atrial diameter was directionally positive but statistically uncertain (OR 1.086 per mm, 95% CI 0.989-1.192; p = 0.085). In the BSA-indexed sensitivity model (n = 123), the female-sex estimate was attenuated and statistically uncertain (OR 2.16, 95% CI 0.90-5.18; p = 0.084), while left atrial diameter/BSA was also statistically uncertain (OR 1.145 per mm/m2, 95% CI 0.977-1.343; p = 0.095). Conclusions: In this selected low-risk cohort undergoing second-generation cryoballoon ablation, female sex was associated with clinically detected, electrocardiographically documented arrhythmia recurrence in the primary model under an intermittent rhythm-surveillance strategy based on scheduled 12-lead electrocardiograms (ECGs) and symptom-driven evaluations. However, the estimate was attenuated and statistically uncertain after indexing left atrial diameter to BSA. Given the retrospective, single-center design, non-systematic rhythm monitoring, and sensitivity of the sex estimate to body-size adjustment, these findings should be interpreted as hypothesis-generating.

Background/Objectives: Arrhythmia recurrence after cryoballoon ablation is commonly linked to persistent atrial fibrillation (AF), atrial enlargement, aging, obesity, inflammation, renal dysfunction, and accumulated cardiovascular comorbidity. Whether these predictors retain their value when the usual systemic risk drivers are largely absent remains insufficiently defined. This study evaluated recurrence predictors after cryoballoon ablation in a strictly selected low-risk AF population defined by a CHA₂DS₂-VA score ≤1 and the absence of major comorbidities. Methods: This retrospective study included 170 consecutive patients who underwent cryoballoon ablation for AF between August 2020 and July 2024. Patients with diabetes mellitus, hypertension, coronary artery disease, chronic kidney disease, cerebrovascular disease, heart failure, significant valvular disease, inflammatory disease, obstructive sleep apnea syndrome, thyroid dysfunction, prior ablation, dialysis treatment, pulmonary venous anatomical variants, or failure to achieve pulmonary vein isolation were excluded. Recurrence was defined as any documented AF or atrial tachyarrhythmia lasting ≥30 seconds after the 3-month blanking period during 1-year follow-up. Results: The cohort included 81 women (47.6%) and 89 men (52.4%); 141 patients (82.9%) had paroxysmal AF and 29 (17.1%) had persistent AF. Arrhythmia recurrence occurred in 43 patients (25.3%). Female sex was more frequent among patients with recurrence than among those without recurrence (62.8% vs. 42.5%, p = 0.021). In multivariable logistic regression analysis, female sex was the only independent predictor of recurrence (OR: 2.817, 95% CI: 1.193-6.649; p = 0.018). Age, AF type, left atrial diameter, body mass index, creatinine level, CHA₂DS₂-VA score, and routine inflammatory markers were not independently associated with recurrence. Conclusions: In a comorbidity-free, low-risk AF cohort, female sex remained the dominant residual clinical signal for arrhythmia recurrence after cryoballoon ablation. This finding supports the hypothesis that sex-related mechanisms, potentially including differences in atrial substrate, non-pulmonary vein triggers, autonomic regulation, hormonal milieu, and lesion durability, may influence rhythm outcomes even when conventional risk burden is minimized.

To evaluate the association of anatomical localization with early recurrence during 24-hour telemetry among patients achieving acute electrophysiology laboratory (EP-lab) success, and secondarily with acute EP-lab outcome and target PVC detection in the overall cohort. This retrospective single-center study included 357 patients undergoing radiofrequency PVC ablation. Acute EP-lab success was assessed after provocation and 30-minute observation. Target PVC detection during 24-hour telemetry was evaluated in the overall cohort. Early recurrence was defined as target-morphology PVC reappearance during telemetry only after acute EP-lab success. Multivariable logistic regression assessed factors associated with acute success and absence of target PVCs during telemetry; localization-specific early recurrence was compared in the acute-success subgroup. Acute EP-lab success was achieved in 252 patients (70.6

Abstract Funding Acknowledgements Type of funding sources: None. Background The effect of intravenous ferric carboxymaltose (FCM) on reverse electrical remodeling (RER) in patients with heart failure with reduced ejection fraction (HFrEF) following cardiac resynchronization therapy (CRT) implantation is unknown. Purpose The current study aims to examine the effect of iron replacement with intravenous FCM on RER in CRT-implanted patients with HFrEF and iron deficiency. Methods The present study retrospectively analyzed 65 patients with successful CRT-D device implantation between March 2017 and January 2020 with iron deficiency (defined as ferritin <100 μg/L) at implantation. Follow-up data were obtained from the 6-month routine follow-up visits of patients following CRT implantation. Demographic characteristics, laboratory results, medical history, medication details, functional status, information on whether intravenous FCM therapy was administered during CRT device implantation, echocardiographic left ventricular (LV) measurements, baseline electrocardiogram (ECG) recorded before CRT device implantation, and follow-up ECG were collected for analysis for each study patient. From baseline to 6-month follow-up, the change in intrinsic QRS duration (without biventricular pacing) was calculated as a primary endpoint, and the change in LV ejection fraction (LVEF) was assessed as a secondary endpoint of the study. Results Thirty-five of 65 patients were in the FCM group, while the remaining 30 study participants were in the non-FCM. The two study groups were similar regarding baseline characteristics, except for ferritin levels, which were minimally significantly lower in the FCM group (10.7±5.0μg/L vs 13.5 ±3.9μg/L, p= 0.012). At the 6-month follow-up, both mean ferritin levels increased significantly in the FCM group compared to baseline (from 10.7±5.0 to 86.5±7.6μg/L, p < 0.0001), while these levels were not significantly increased in the non-FCM group (from 13.5±3.9 to 14.1±4.2μg/L, p = 0.962). There was a significant reduction in intrinsic QRS durations compared to baseline at 6-month follow-up after CRT implantation in both FCM and non-FCM group (from 148.4±5.3 to 138.0±5.1ms, p < 0.0001; from 149.8±5.0 to 146.8±4.6ms, p < 0.0001, respectively). The change in intrinsic QRS duration from baseline to 6-month follow-up was significantly greater in the FCM group than in the non-FCM group (-10.4±2.2ms vs -3±2.9ms, p < 0.0001). At the 6-month follow-up, the change in LVEF from baseline was significantly higher in the FCM group than in the non-FCM group (+3.6±1.6% vs -0.1±1.7%, p < 0.0001). The change in ferritin level was negatively correlated with the change in intrinsic QRS duration (r = -0.725, p < 0.0001), whereas there was a positive correlation between the change in ferritin level and the change in LVEF (r = 0.712, p < 0.0001). Conclusions Treatment with FCM was induced RER and improvement in LVEF in HFrEF patients with iron deficiency following CRT implantation.

OBJECTIVE:We aimed to assess the real-world label adherence of non-vitamin K antagonist oral anticoagulant (NOAC) dosing patterns, including apixaban, edoxaban, and rivaroxaban, in Turkish patients with atrial fibrillation. METHODS:This was an observational, prospective, cross-sectional, multicenter study. Patients with atrial fibrillation (AF) who were prescribed NOACs within the last 4 months were recruited from 34 cardiology clinics in Türkiye. Baseline data were initially collected, and patient awareness was evaluated at 3-4 weeks. RESULTS:A total of 903 patients were enrolled in the study. The mean age was 72.84 ± 10.17 years. We found that 140 (15.5%), 721 (79.8%), and 42 patients (4.7%) were prescribed off-label low, on-label, and off-label high dosing, respectively. The age of the patients in the on-label group was significantly lower than that of those in the off-label low and off-label high groups (both P < 0.001). Female patients were more frequently observed in the off-label high group (P = 0.019). The body mass index values of the patients in the off-label high-dose group were significantly lower than those in the other groups (P < 0.001). The perception of income levels also revealed significant differences between the groups (P = 0.010). Furthermore, the HAS-BLED scores (the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly, Drugs/Alcohol Concomitantly) were significantly lower in the on-label group than in the other groups (P < 0.001). Similarly, the CHA2DS2-VASc [the Congestive Heart Failure, Hypertension, Age ≥75 (Doubled), Diabetes, Stroke (Doubled), Vascular Disease, Age 65-74, and Sex Category (Female)] scores were significantly lower in the on-label group than in the off-label group (P < 0.001). CONCLUSION:The clinical impact off-label NOAC prescriptions may vary. Therefore, raising clinician awareness about proper NOAC dosing could aid in improve the outcomes.

BACKGROUND: Atrial fibrillation (AF) is a common cardiac rhythm disorder associated with hemodynamic disruptions and thromboembolic events. While antiarrhythmic drugs are often recommended as the initial treatment, catheter ablation has emerged as a viable alternative. However, the recurrence of AF following ablation remains a challenge, and there is growing interest in exploring inflammatory markers as predictors of recurrence. METHODS: This retrospective, cross-sectional analysis included 249 patients who underwent cryoablation for paroxysmal AF. The relationship between the ‘C-reactive protein (CRP) to albumin ratio (CAR)’ and AF recurrence was examined. RESULTS: Two hundred and forty-nine patients with paroxysmal non-valvular atrial fibrillation were included. They were divided into two groups: those without recurrence (Group 1) and those with recurrence (Group 2). Significant differences were observed in age (57.2 ± 9.9 vs. 62.5 ± 8.4, p = 0.001) and left atrial size (4.0 ± 0.5 vs. 4.2 ± 0.7, p = 0.001) between the two groups. In blood parameters, significant differences were found in CRP (5.2 ± 1.3 vs. 9.4 ± 2.8, p < 0.001) and neutrophil counts (5.1 ± 2.2 vs. 6.7 ± 3.6, p = 0.001). In univariate regression analysis, age (OR: 1.058, CI: 1.024–1.093, p = 0.001), WBC count (OR: 1.201, CI: 1.092–1.322, p < 0.001), neutrophil count (OR: 1.239, CI: 1.114–1.378, p = 0.001), CAR (OR: 1.409, CI: 1.183–1.678, p < 0.001), and left atrial diameter (OR: 0.968, CI: 0.948–0.989, p = 0.002) showed significant associations with AF recurrence. CONCLUSIONS: Inflammation plays a crucial role in the initiation and progression of AF. This study demonstrated that along with age, the CAR can serve as an independent predictor of AF recurrence following cryoablation.

Aim: This study aimed to estimate the association of coronary artery disease complexity with non-HDL-C levels in premature CAD. Background: Primary prevention has utmost importance in terms of minimizing the number of patients who had premature coronary artery disease (CAD). Non-high density lipoprotein cholesterol (non-HDL-C) contains potentially atherogenic lipoprotein fractions. Material and methods: Coronary angiographic recordings of two hundred acute coronary syndrome patients were evaluated by two cardiologists. Clinical, demographic and lipid parameters of the patients were compared with SYNTAX score. Results: Median age of the study group was 41 (18-45) years. One hundred eighty five (90.5%) of them were male, nineteen (9.5%) of them were female. Median SYNTAX score and ejection fraction of the patients were 17 (4.5-39) and 50 (33-68), respectively. SYNTAX score of the male patients was significantly higher compared to females [17 (4.5-39) vs 12 (8-26), p=0.048), similarly, diabetic patients had higher values of syntax score compared to non-diabetic patients [19 (10-39) vs 16 (4.5-37), p=0.005), There were no differences of SYNTAX score with respect to presence of hypertension, smoking status and family history of CAD. There were very strong positive correlation between SYNTAX score and non-HDL-C, TC and LDL-C levels (r=0.958, r=0.946 and r=0.921, respectively, p<0.001 for all). HgA1c levels showed positive correlation, whereas HDL-C showed negative correlation with SYNTAX score (r=0.793 and r=-0.620, respectively, p<0.001 for both). Conclusion: non-HDL-C was a valuable tool in assessing the complexity of atherosclerotic cardiovascular disease in young patients.

Introduction: Cardiac resynchronization therapy (CRT), is a therapeutic option for patients with refractory heart failure. We aimed to examine the usefulness of N-terminal pro-brain-type natriuretic peptide (NT-proBNP), mid-regional pro-atrial natriuretic peptide (MR-proANP), and adiponectin in monitoring CRT-induced left ventricular (LV) reverse remodeling, reverse electrical remodeling, and clinical response.

Resumo Fundamento A nova doença por coronavírus (COVID-19) pode levar a uma enfermidade grave e causar a morte. Sabe-se que a COVID-19 afeta o sistema cardiovascular. A detecção precoce da progressão para um estágio grave da doença que afeta o sistema cardiovascular pode desempenhar um papel crítico no tratamento da COVID-19. Objetivos Explorar a possível relação entre a pneumonia por COVID-19 e os achados de strain do ventrículo direito no eletrocardiograma (ECG). Métodos Foi realizado um estudo retrospectivo de 141 pacientes hospitalizados com COVID-19. A correlação de Spearman e as análises de regressão logística foram aplicadas para avaliar as relações entre as manifestações de strain ventricular direito na ECG e os níveis de biomarcadores e outros achados laboratoriais e de imagem do tórax. O nível de significância foi considerado estabelecido como p < 0,05. Resultados Os sinais de ECG de estresse ventricular direito foram significativamente mais frequentes e os níveis de fibrinogênio, PCR e ferritina foram significativamente mais elevados em pacientes com COVID-19 com níveis elevados de hs-cTnI, procalcitonina e dímero-D. A análise univariada mostrou que existem relações significativas entre a presença de pneumonia bilateral, a maioria dos sinais eletrocardiográficos de strain ventricular direito e lesão cardíaca e biomarcadores inflamatórios e trombóticos. A análise multivariada revelou que o supradesnivelamento do segmento ST em V1 e padrão S1Q3T3 são preditores independentes de lesão cardíaca ( odds ratio =0,23; IC95%, 0,06 a 0,90; p=0,035) e níveis elevados de procalcitonina ( odds ratio =0,19; IC 95%, 0,06 a 0,62; p=0,006), respectivamente. Conclusão Os achados do presente estudo sugerem que a dano cardíaco direito é prevalente na COVID-19. Além disso, nosso estudo demonstra o valor clínico do ECG na avaliação e monitoramento de pacientes com pneumonia por COVID-19.

Cardiac resynchronization therapy (CRT) is a treatment modality for selected patients with refractory heart failure. We intended to examine the usefulness of coronary venous system imagining with conventional coronary angiogram before the CRT implantation procedure. A total of 180 patients were scheduled for CRT and were prospectively randomized 1:2 into 2 groups. Group 1 (n = 60) received standard CRT procedure without the guidance of selective left coronary angiography. In group 2 (n = 120), CRT implantation was accomplished with the guidance of the preprocedural coronary angiography. We compared the 2 groups in terms of the total implantation time, total fluoroscopy time, the amount of contrast medium used, and cumulative radiation exposure. The total implantation and fluoroscopy times, the amount of contrast medium used, and cumulative radiation exposure were significantly less in group 2 compared with group 1 (53 ± 7 vs 66 ± 9 minutes, 11 ± 3 vs 20 ± 5 minutes, 24 ± 8 vs 42 ± 14 mL, 26 192 ± 6658 vs 37 388± 9064 mGy cm 2 , and 253 ± 49 vs 392 ± 79 mGy, P < .0001, respectively). We concluded that coronary angiography prior to CRT implantation is useful in simplifying the procedure, saving time, reducing radiation exposure, and reducing contrast use.

BULGULAR: Hastane içi mortalite, EKG skoru ≥10 olan COVID-19 hastalarında anlamlı olarak daha yüksekti (% 15 vs % 0, p = 0.001). Tek değişkenli regresyon analizi, nötrofil ve lenfosit sayılarını, kreatininkinaz, D-dimer, fibrinojen, Creaktif protein (CRP), kardiyak biyobelirteçler, ferritin ve prokalsitonin düzeylerini EKG skoru ≥10' nun önemli prediktörleri olarak ortaya koymaktadır. EKG skoru, COVID19 hastalarında mortalitenin anlamlı bir prediktörü olarak bulundu (olasılık oranı 0.33,% 95 güven aralığı 0.14-0.77, p = 0.01). Çok değişkenli regresyon analizine göre, CRP (olasılık oranı 1.03,% 95 güven aralığı 1.00 -1.05, p = 0.02) ve yüksek duyarlı kardiyak troponin I (olasılık oranı 1.00,% 95 güven aralığı 0.99-1.00, p = 0.009) COVID-19 hastalarında sırasıyla EKG skoru ≥10' nun ve mortalitenin anlamlı bağımsız prediktörleridir.

BACKGROUND:In this study, we aimed to compare the management and clinical outcomes of patients with acute coronary syndrome (ACS) before and during pandemic. METHODS:A total of 239 patients with ACS were enrolled into the study. Patients who were admitted during pandemic were compared with pre-pandemic patients according to their demographic, biochemical, angiographic features, revascularisation strategies and clinical outcomes. RESULTS:During the pandemic period, we observed an increase in total number of patient with ST elevation myocardial infarction patients compared to the pre-pandemic period. Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients (1953 pg/ml versus 259 pg/ml for troponin I and 14 ng/ml versus 6 ng/ml for CK-MB p < 0.0001, p = 0.02, respectively). Type 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative to the pre-pandemic group (10 versus 0, p = 0.003). Post-procedural TIMI flow grade was lower in the pandemic group and distal embolisation and TIMI thrombus score were significantly higher in the pandemic group compared to the pre-pandemic group (p = 0.001, p = 0.02, and p = 0.002, respectively). The number of patients who underwent bypass surgery was much lower compared to pre-pandemic period (27 versus 8, p < 0.0001). There was no statistically significant difference in hospital mortality and short-term all-cause mortality among groups (p > 0.05). CONCLUSION:Although clinical, laboratory, and angiographic features were worse in ACS patients during pandemic, the mortality rate of ACS was similar in both pre-pandemic and pandemic era. It is important to keep coronary intensive care units and catheter labs open and fully-functioning during the pandemic.

BACKGROUND:The novel coronavirus disease (COVID-19) may lead to severe disease that can cause death. COVID-19 is known to affect the cardiovascular system. Early detection of the progression to the severe disease stage that affects the cardiovascular system may play a critical role in the treatment of COVID-19.OBJECTIVES:To explore the possible relationship between the COVID-19 pneumonia and right ventricular strain findings on electrocardiography (ECG).METHODS:We conducted a retrospective study of 141 hospitalized patients with COVID-19. Spearman's correlation and logistic regression analyses were applied to assess relationships between ECG manifestations of right ventricular strain and levels of biomarkers and other laboratory and chest imaging findings. The significance level was considered as < 0.05.RESULTS:The ECG signs of right ventricular stress were significantly more frequent and the levels of fibrinogen, CRP, and ferritin were significantly higher in COVID-19 patients with elevated levels of hs-cTnI, procalcitonin and D-dimer. The univariate analysis showed there are significant relations between the presence of bilateral pneumonia, most of the ECG signs of right ventricular strain and cardiac injury and inflammatory and thrombotic biomarkers. The multivariate analysis revealed that ST-segment elevation in V1and the S1Q3T3pattern are independent predictors of cardiac damage (odds ratio=0.23; 95% CI, 0.06 to 0.90; p=0.035) and elevated procalcitonin levels (odds ratio=0.19; 95% CI, 0.06 to 0.62; p=0.006), respectively.CONCLUSION:The findings of the present study suggest that right heart damage is prevalent in COVID-19. In addition, our study shows the clinical value of ECG in evaluating and monitoring the patients with COVID-19 pneumonia.

Objective: Microvascular angina (MVA) is a coronary microcirculation disease. Research on microcirculatory dysfunction has revealed several biomarkers involved in the etiopathogenesis of MVA. Platelet-derived growth factor receptor β (PDGFR-β) and brain-derived neurotrophic factor (BDNF) are 2 biomarkers associated with microcirculation, particularly pericytes function. The aim of this study was to investigate the role of PDGFR-β and BDNF in MVA. Methods: Ninety-one patients (median age, 56 y; age range, 40–79 y; 36 men) with MVA and 61 control group subjects (median age, 52 y; age range, 38–76 y; 29 men) were included in the study. Serum concentrations of PDGFR-β and BDNF were measured with commercially available enzyme-linked immunosorbent assay kits. Results: PDGFR-β [2.82 ng/ml; interquartile range (IQR), 0.57–7.79 ng/ml vs. 2.27 ng/ml; IQR, 0.41–7.16 ng/ml; p<0.0005] and BDNF (2.41 ng/ml; IQR, 0.97–7.97 ng/ml vs. 1.92 ng/ml; IQR, 1.07–6.67 ng/ml; p=0.023) concentrations were significantly higher in patients with MVA compared with the controls. PDGFR-β correlated positively with age (r=0.26, p=0.001), low-density lipoprotein (r=0.18; p=0.02), and BDNF (r=0.47; p<0.001), and BDNF showed a significant positive correlation with age (r=0.20; p=0.01). In binary logistic regression analysis, high-sensitivity C-reactive protein, uric acid, and PDGFR-β values were found to be independent predictors of MVA. Conclusion: MVA is associated with higher PDGFR-β and BDNF levels. This association may indicate an abnormality in microvascular function. Future studies are required to determine the role of these biomarkers in the pathogenesis of MVA. (Anatol J Cardiol 2020; 24: 397-404)

Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p<0.0001, p=0.02 respectively). TYPE 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative top re-pandemic group (10 vs 0 p=0.003). Post procedural TIMI flow grade was lower in pandemic group and distal embolization and TIMI thrombus score were significantly higher in the pandemic group compared top re-pandemic group (, p=0.001, p=0.02 ,p=0.002 respectively). However; there was no statistically significant difference in hospital mortality and short –term all cause mortality, among groups (p>0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.

Background Atrial fibrillation (AF) prevalence in patients with acute myocardial infarction (MI) ranges from 3% to 25%. However demographic, clinical, and angiographic characteristics of AF patients who admitted with de novo MI are unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. Methods The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to presenting cardiac rhythm. Results A total of 1793 patients were screened and 1626 were included in the study. The mean age was 61.5 (12.5) years. 70.7% of patients were men. The prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p<0.001] than non-AF patients. The proportion of women to men in the AF group was also higher than in the non-AF group (43.1% vs. 28.7%, p=0.027). Only 1 out of every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants (OAC). Conclusions AF prevalence in patients presenting with de novo MI was lower than previous studies that issued on AF prevalence in MI cohorts. The majority of AF patients did not have any knowledge of their arrhythmia and were not undergoing OAC therapy at admission, emphasizing the vital role of successful diagnostic strategies, patient education, and implementations for guideline adaptation.

Abstract Aim: The prevalence of atrial fibrillation (AF) in patients with myocardial infarction (MI) ranges widely and has been reported to be as high as 21%. However, the demographic, clinical, and angiographic characteristics of AF patients with de novo MI is unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. Methods: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to their presenting cardiac rhythm. Results: A total of 1793 patients were screened and 1626 were included in the study. Mean age was 61.5 (12.5) years. 70.7% of patients were men. Prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p<0.001] than non-AF patients. The proportion of women to men in the AF group was also higher than in the non-AF group (43.1% vs. 28.7%, p=0.027). Dramatically, the minority of patients were previously diagnosed with AF (14 patients, 27.4%) and only 1 out of every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants (OAC). Conclusions: AF prevalence in patients presenting with de novo MI was lower than reported in previous studies. The majority of AF patients did not have any knowledge of their arrhythmia and were not undergoing OAC therapy at admission, emphasizing the vital role of successful diagnostic strategies, patient education, and implementations for guideline adaptation.