Introduction: Several studies suggest a potential correlation between troponin levels detected in serum and saliva. However, prior investigations have not adequately addressed the critical aspect of collecting samples upon admission, which is essential for timely troponin level determination. This study aimed to evaluate the relationship between troponin levels in serum and saliva among patients admitted for chest pain evaluation.Methods: This observational study was conducted at the Interventional Cardiology Department of the University Medical Center HCMC. Patients presenting with chest pain were enrolled, and unstimulated saliva samples were collected using the Navazesh method simultaneously with the initial blood collection. These samples were then analyzed for levels of salivary troponin I, serum troponin I, and serum high-sensitive troponin T.Results: Among the 48 patients included, 22 (46%) exhibited myocardial injury, while 12 (25%) were diagnosed with acute myocardial infarction. No significant difference was observed in salivary troponin I levels between the non-myocardial injury and myocardial injury groups (p = 0.425). Moreover, no correlation was found between salivary troponin I levels and either serum troponin T or serum troponin I levels (Pearson correlation p = 0.761, 0.500; Spearman correlation p = 0.857, 0.136, respectively). The ROC curve for salivary troponin I in predicting myocardial injury displayed an AUC of 0.566 (95% CI: 0.402–0.731), indicating poor discriminatory power.Conclusions: In our investigation, salivary troponin I failed to demonstrate a meaningful correlation with serum troponins, thereby limiting its practical utility in diagnosing myocardial injury or myocardial infarction. Further research is warranted to explore its diagnostic reliability and clinical applicability.

During the Coronavirus disease 2019 (COVID-19) pandemic, vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has proven to be an important measure to help control disease spread and improve patient outcome. There are four distinct vaccine categories: inactivated viral vaccines, messenger RNA (mRNA) vaccines, adenovirus vector–based vaccines, and adjuvanted protein vaccines. In 2021, increased cases of myocarditis and pericarditis were reported after mRNA and adenovirus vector–based COVID-19 vaccination. A similar reporting pattern has not been observed after receipt of inactivated virus vaccines. Here, we present a case of clinically suspected acute myocarditis in a 26-year-old female, occurring 11 days after the administration of Sinopharm Vero Cell, an inactivated virus COVID-19 vaccine. This event led to acute heart failure, with marked clinical resolution observed within 34 days.

Although guideline-directed medical therapy (GDMT) improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF), multiple real-world studies - such as CHAMP-HF (USA) and ASIAN-HF (Asia-Pacific) - have reported that a large proportion of patients fail to reach target doses. This global gap between recommendations and practice highlights the need to better understand country-specific barriers, particularly in low- and middle-income settings such as Vietnam. This cross-sectional study included adult outpatients diagnosed with HFrEF who had received at least three months of continuous therapy at the Heart Failure Clinic, University Medical Center Ho Chi Minh City, between February and August 2023, and aimed to (1) determine the prevalence of use, (2) evaluate typical dosages, and (3) examine the sequence of initiation of foundational therapies in this population. Among 181 patients, 98.9% were prescribed at least one foundational drug class, and 74.6% received all four classes. Patients who did not receive all four therapies were typically older females with higher systolic blood pressure and reduced renal function. SGLT2 inhibitors and MRAs had the highest rates of target dose achievement, whereas ARNI and beta-blockers were more frequently underdosed. Dose escalation was commonly limited by hypotension, advanced age, renal impairment, and low body weight. Notably, 82% of patients were initiated on three or four drug classes concurrently at the start of treatment, most commonly including RAS inhibitors, MRAs, and beta-blockers, with a preference for ARNI over ACE inhibitors or ARBs. Foundational therapies were widely prescribed and frequently initiated concurrently in the management of HFrEF at a tertiary care hospital in Vietnam. However, achieving target doses remains a challenge, highlighting the gap between clinical guidelines and real-world practice due to factors such as low blood pressure, advanced age, and renal dysfunction.