Objective: Despite improvements in the technology of catheter ablation of atrial fibrillation (AF), recurrences are still a major problem, even after a successful procedure. The uric acid/albumin ratio (UAR), which is an inexpensive and simple laboratory parameter, has recently been introduced in the literature as a predictor of adverse cardiovascular events. Hence, we aimed to investigate the relationship between the UAR and AF recurrence after catheter ablation. Methods: A total of 170 patients who underwent successful catheter ablation for AF were included. The primary outcome was the late recurrence after treatment. The recurrence (+) and recurrence (−) groups were compared for clinical, laboratory and procedural characteristics as well as the predictors of recurrence assessed by regression analysis. Results: In our study population, 53 (26%) patients developed AF recurrence after catheter ablation. Mean UAR was higher in the recurrence (+) group compared to recurrence (−) group (2.4 ± 0.9 vs. 1.8 ± 0.7, p < 0.01). In multivariable regression analysis, left atrial diameter (HR: 1.08, 95% CI: 1.01–1.16, p = 0.01) and UAR (HR:1.36, 95% CI: 1.06–1.75, p = 0.01) were found to be independent predictors of recurrence. In ROC analysis, the UAR > 1.67 predicted recurrence with a sensitivity of 77% and a specificity of 57% (AUC 0.68, p < 0.01). Conclusion: For the first time in the literature, the UAR were found to be correlated independently with AF recurrence after catheter ablation.

Pulmonary embolism (PE) remains a major cause of cardiovascular mortality, and early identification of high-risk patients is essential. The uric acid-to-albumin ratio (UAR) has emerged as a marker reflecting systemic inflammation. This study aimed to evaluate the prognostic value of UAR for in-hospital mortality in patients with acute PE. This single-center, retrospective study included 1052 consecutive patients diagnosed with acute PE. Clinical characteristics, laboratory parameters, echocardiographic findings, and pulmonary imaging results were obtained from hospital records. Multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. The discriminative performance of UAR was assessed using receiver operating characteristic (ROC) curve analysis. Overall, 70 patients (6.7%) died during hospitalization. Non-survivors had significantly higher UAR values compared with survivors (2.33 vs 1.57, P < .001). In multivariable analysis, UAR C-Reactive Protein, and Pulmonary artery severity index (PESI) score independently predicted in-hospital mortality. UAR demonstrated acceptable discriminative ability (Area under the curve .728; 95% CI: .649-.807; P < .001), with an optimal cut-off of 2.12. The combined use of UAR and PESI demonstrated a modest improvement in predictive performance. UAR is an independent predictor of in-hospital mortality in patients with acute PE. Its combination with the PESI score may provide incremental value for early risk stratification.

Plaque rupture at the left main coronary artery (LMCA) ostium is a clinically important lesion that requires accurate assessment and tailored intervention. A 75 year-old woman with non-ST-segment elevation myocardial infarction underwent coronary angiography. Initial imaging suggested a catheter-induced dissection at the LMCA ostium. However, intravascular ultrasound (IVUS) revealed a lipid-rich plaque rupture. IVUS-guided percutaneous intervention was performed, with optimal expansion and apposition. This case illustrates the critical role of IVUS in differentiating between dissection and plaque rupture. IVUS provided detailed plaque characterization and ensured appropriate stent deployment, highlighting its superiority over angiography alone in complex LMCA lesions. IVUS is essential for diagnosing and managing complex LMCA lesions. Early use of IVUS can clarify ambiguous angiographic findings and guide appropriate strategy.

Background and Objectives: Patients with heart failure (HF) are at risk of increased morbidity and mortality related to pneumococcal pneumonia, and routine vaccination with a conjugated pneumococcal vaccine (PCV) for HF patients is strongly endorsed by all major international guidelines. Despite this, data on the factors associated with vaccine uptake remain scarce. The aim of this study was to understand the demographic and clinical factors associated with vaccine uptake in patients with HF and analyze the all-cause mortality in the vaccinated and unvaccinated cohorts. Materials and Methods: Four hundred and fifty patients with HF and a reduced ejection fraction followed up at a single center were enrolled. Patients were followed up for a median of 164.0 (148.0–181.0) days. Results: In total, 193 of the 450 patients (42.9%) were vaccinated with PCV-13 at enrollment. Vaccinated patients were more likely to have an implantable device, namely an implantable cardioverter/defibrillator (ICD), cardiac resynchronization treatment (CRT) or left ventricular assist device (LVAD), and less likely to have a past medical history of hypertension and chronic obstructive pulmonary disease (COPD) at baseline. After multivariable adjustment, the presence of an ICD (OR: 3.17, 95% CI: 1.98–5.08), CRT (OR: 2.75, 95% CI: 1.45–5.20) and COPD (OR: 0.42, 95% CI: 0.19–0.94) remained as determinants of vaccination. All-cause mortality was not different across vaccinated or unvaccinated patients either in the unmatched (log-rank p = 0.67) or matched (log-rank p = 0.52) cohorts. Conclusions: The presence of implantable devices and coexisting COPD was associated with a higher and lower likelihood of vaccination with PCV-13, respectively. No difference in mortality across cohorts was observed in this observational analysis.