Background and Objectives: Excessive coronary thrombus burden is known to cause an increase in mortality and major adverse cardiac events (MACEs) in NSTE-ACS (non-ST acute coronary syndrome) patients. We investigated the association between the systemic immune-inflammation index (SII) and coronary thrombus burden in patients with non-ST segment elevation myocardial infarction (NSTEMI) who underwent coronary angiography and percutaneous coronary intervention (PCI). Materials and Methods: A total of 389 patients with the diagnosis of NSTEMI participated in our study. Coronary thrombus burden was classified in the TIMI (thrombolysis in myocardial infarction) thrombus grade scale and patients were divided into two groups: a TIMI thrombus grade 0–1 group (n = 209, 157 males) and a TIMI thrombus grade 2–6 group (n = 180, 118 males). Demographics, angiographic lesion images, coronary thrombus burden, clinical risk factors, laboratory parameters, and SII score were compared between the two groups. Results: The high thrombus burden patient group had a higher neutrophil count, WBC count, platelet count, and systemic immune-inflammation index (SII) (p < 0.001). The receiver operating characteristic (ROC) curve analysis showed that at a cutoff of 1103, the value of SII manifested 74.4% sensitivity and 74.6% specificity for detecting a high coronary thrombus burden. Conclusions: Our study showed that the SII levels at hospital admission were independently associated with high coronary thrombus with NSTEMI.

Resumo As fístulas coronário-camerais, embora consideradas em sua maioria como entidades congênitas, também têm sido encontradas como complicações de grandes traumas e intervenções coronárias percutâneas (ICPs). Por outro lado, o hematoma do septo interventricular (SIV) pode potencialmente surgir principalmente durante intervenções de oclusão total crônica retrógrada (OTC) e tem um curso benigno nesse contexto. Aqui, descrevemos uma complicação desafiadora da ICP (e sua estratégia de manejo) apresentando hematoma do SIV, fístula ventricular direita e obstrução da via de saída do [...] Resumo As fístulas coronário-camerais, embora consideradas em sua maioria como entidades congênitas, também têm sido encontradas como complicações de grandes traumas e intervenções coronárias percutâneas (ICPs). Por outro lado, o hematoma do septo interventricular (SIV) pode potencialmente surgir principalmente durante intervenções de oclusão total crônica retrógrada (OTC) e tem um curso benigno nesse contexto. Aqui, descrevemos uma complicação desafiadora da ICP (e sua estratégia de manejo) apresentando hematoma do SIV, fístula ventricular direita e obstrução da via de saída do

Background and objectives: Despite being within the normal reference range, changes in thyroid stimulating hormone (TSH) levels have negative effects on the cardiovascular system. The majority of patients admitted to hospital with acute coronary syndrome (ACS) are euthyroid. The aim of this study was to investigate the effect of TSH level on the prognosis of in-hospital and follow-up periods of euthyroid ACS patients. Materials and Methods: A total of 629 patients with acute coronary syndrome without thyroid dysfunction were included in the study. TSH levels of patients were 0.3–5.33 uIU/mL. Patients were divided into three TSH tertiles: TSH level between (1) 0.3 uIU/mL and <0.90 uIU/mL (n = 209), (2) 0.90 uIU/mL and <1.60 uIU/mL (n = 210), and (3) 1.60 uIU/mL and 5.33 uIU/mL (n = 210). Demographic, clinical laboratory, and angiographic characteristics were compared between groups in terms of in-hospital and follow-up prognosis. Results: Mean age was 63.42 ± 12.5, and 73.9% were male. There was significant difference between tertiles in terms of TSH level at admission (p < 0.001), the severity of coronary artery disease (p = 0.024), in-hospital mortality (p < 0.001), in-hospital major hemorrhage (p = 0.005), total adverse clinical event (p = 0.03), follow-up mortality (p = 0.022), and total mortality (p < 0.001). In multivariate logistic regression analysis, the high–normal TSH tertile was found to be cumulative mortality increasing factor (OR = 6.307, 95%; CI: 1.769–22.480; p = 0.005) during the 6-month follow-up period after hospitalization and discharge. Conclusions: High–normal TSH tertile during hospital admission in euthyroid ACS patients is an independent predictor of total mortality during the 6-month follow-up period after hospitalization and discharge.

Objective: The study aimed to evaluate the incidence of in-hospital infections and the clinical and laboratory factors that may contribute to infection development in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), and to compare these findings with those in patients with myocardial infarction due to obstructive coronary artery disease (MI-CAD). Methods: In this prospective, single-center study, 1120 patients who presented with a preliminary diagnosis of acute myocardial infarction between October 2019 and October 2020 were evaluated; those with a history of coronary artery disease were excluded. A total of 104 patients who met the diagnostic criteria for MINOCA and 601 patients diagnosed with MI-CAD were included in the analysis. C-reactive protein (CRP) levels at admission, laboratory findings, and in-hospital complications were recorded. Multivariable logistic regression analysis was performed to identify factors associated with infection. Results: C-reactive protein levels were significantly higher in the MINOCA group compared with the MI-CAD group (3.0 [1.0–9.0] mg/L vs. 0.7 [0.3–2.3] mg/L; p<0.001). Infection occurred in 21.2% of MINOCA patients and 11.3% of MI-CAD patients (p=0.010). In multivariable models, despite adjustment for CRP and other confounders, MINOCA remained an independent risk factor for infection (Model 3 OR 4.206; 95% CI: 2.040–8.670; p=0.001). Longer hospital stays, diabetes mellitus, and heart failure increased infection risk, whereas hyperlipidemia showed a protective association. Conclusion: The higher infection rates observed in MINOCA patients suggest a distinct inflammatory and immunologic profile in this group. These findings indicate that infection risk should be considered in the clinical management of MINOCA and support the need for a comprehensive, multidisciplinary approach.

Pentoz monofosfat yolu aracılığı ile glukoz-6-fosfat dehidrogenaz (G6PD) enzimi eritrositleri ve hemoglobin moleküllerini oksidatif strese karşı korur. Dünyadaki en sık enzim eksikliği olarak görülen G6PD enzim eksikliğinde; akut hemolitik anemi, yenidoğan sarılığı, favizm ve kalıtsal sferositik olmayan hemolitik anemi gibi klinik durumlar görülür. Akut koroner sendrom esnasında genel klinik duruma bağlı oluşan oksidatif ajanlar ve koroner anjiyografi öncesi ve sırasında uygulanan medikasyonlar hemolitik ve trombotik krize neden olabilirler. Bu yazıda G6PD eksikliği bulunan 64 yaşındaki kadın hastaya akut koroner sendrom tanısı ile perkütan koroner girişim (PKG) sırasında ve takibinde gelişen yaygın koroner tromboz vakasını sunduk.

Multidisipliner Kardiyoloji Yoğun Bakım Tanımı ve Teknik Özellikleri Servet Altay Kardiyoloji Yoğun Bakımda Fizik Muayene Esasları Sena Sert Şekerci Kardiyoloji Yoğun Bakımında İnvaziv Hemodinamik Ölçümler Songül Usalp Arter Kan Gazı Değerlendirme Ethem Yıldız Yoğun Bakımda Beslenme Esasları Hande Özportakal Hipo/Hiperglisemi ve Diyabetik Komalara Yaklaşım Seydahmet Akın Songül Aktaş Koroner Yoğun Bakımda Akut Koroner Sendrom Hastalarının Yönetimi Efe Yılmaz Muhammet Gürdoğan Akut Koroner Sendrom Mekanik Komplikasyonları Mustafa Ferhat Keten Akut Kalp Yetersizliği ve Kardiyojenik Şok Yusuf Bilen Akut Fulminan Miyokardit Ertan Ekici Havva Tuğba Gürsoy Takotsubo Kardiyomiyopatisi Melik Demir Yoğun Bakım Ünitesinde Ventriküler Taşikardilere Yaklaşım Gökay Taylan Supraventriküler Taşiaritmilere Yaklaşım Çağan Yıldırım Alper Kepez Digoksin İntoksikasyonu Tuğba Kayhan Altuner Akut Doğal Kapak Yetersizlikleri Semih Kalkan Akut Protez Kapak Patolojileri Mustafa Ozan Gürsoy Hipertansif Aciller Mehmet Murat Yiğitbaşı Hülya Çiçekçioğlu Akut Aortik Sendromlar Hasan Ali Sinoplu Ersan Oflar Pulmoner Emboli ve Kateter Bazlı Tedavi Yöntemleri Ümit Öztürk Halil Ataş İnotrop ve Vazopressör Ajanlar Mehmet Ali Astarcıoğlu Yoğun Bakımda Diürez ve Aldığı Çıkardığı Takibi Esasları Flora Özkalaycı Kaçar Burcu Candan Renal Replasman Tedavisi Serap Yadigar Elif Arı Bakır Kardiyorenal Sendrom Ferdi Karagöz İlhan Kurultak Yoğun Bakımda Terapötik Hipotermi Mustafa Ebik Kardiyak Travma Safa Özçelik Elektriksel Fırtınaya Yaklaşım Abdulkadir Uslu Perikardiyal Efüzyon ve Kardiyak Tamponad Kadriye Memiç Sancar Gamze Babur Güler Yoğun Bakımda Geçici Kalp Pili Uygulamaları Sedat Sakallı Veysel Özgür Barış Geçici Mekanik Destek Cihazları Ahmet Can Topçu Şeyhmus Külahçıoğlu Ventriküler Destek Cihazları Hakan Hançer Mehmet Kaan Kırali Kalp Nakli Sonrası Takip, Tedavi ve Hasta Yönetimi Mustafa Mert Özgür Antikoagülan ve Antiplatelet Tedavi Altında Kanamaya Yaklaşım Tuba Unkun Vasküler Giriş Yeri Komplikasyonları Doğancan Çeneli Kadir Bıyıklı TAVI Sonrası Komplikasyonlar Mehmet Aytürk Münevver Sarı Yoğun Bakımda Deliryum Yönetimi Mengühan Araz Altay Akut İskemik İnmeye Yaklaşım Ayşenur Önalan Erdem Gürkaş Akut Solunum Yetmezliğine Yaklaşım Nezihe Çiftaslan Gökşenoğlu Nalan Adıgüzel Yoğun Bakımda Enfeksiyonun Kontrol ve Önlenmesi İnşa Gül Ekiz İşcanlı Acil Bronkoskopi Barış Yılmaz Gökay Güngör Akut Respiratuar Distres Sendromu Temel Güner Esra Adıyeke Kardiyoloji Yoğun Bakımda Sedasyon ve Analjezi Münire Deniz Mustafa Emre Gürcü