Background/Objectives: Contrast-induced nephropathy (CIN) is a well-documented complication following coronary angiography and percutaneous coronary intervention (PCI). This study aims to evaluate the predictors of CIN and its effect on outcomes in patients with acute coronary syndrome (ACS). Methods: A retrospective study included 1579 patients who underwent coronary angiography or PCI. Results: The overall incidence of in-hospital CIN was 6.8%, with the highest incidence in the group with eGFR <30 mL/min/1.73 m² at 21.6%. Non-radial vascular access was an independent predictor of CIN occurrence (OR = 2.06 [1.37–3.08]; p < 0.001). The risk of death within 30 days was influenced by history of stroke (OR = 4.94 [1.58–15.51]; p = 0.006), glucose level on admission (per 10-unit increase) (OR = 1.07 [1.04–1.1]; p < 0.001), occurrence of CIN (OR = 5.64 [2.49–12.79]; p < 0.001), and hemoglobin level (OR = 0.77 [0.65–0.92]; p = 0.003). The risk of death within 365 days was increased by age (OR = 1.05 [1.02–1.07]; p < 0.001), history of stroke (OR = 2.45 [1.02–5.89]; p = 0.046), glucose levels on admission (per 10-unit increase) (OR = 1.05 [1.03–1.08]; p < 0.001), occurrence of CIN (OR = 2.62 [1.42–4.84]; p = 0.002), and hemoglobin concentration (OR = 0.78 [0.7–0.88]; p = 0.003). An independent predictor of hospitalization for acute or exacerbation of chronic renal failure was baseline creatinine concentration (OR = 3.44 [2.4–4.93]; p < 0.001). Conclusions: The incidence of CIN is significant, particularly in patients with severe pre-existing renal impairment. Non-radial vascular access is an independent predictor of CIN. The occurrence of CIN is a strong independent predictor of both short-term and long-term mortality.

(1) Background: Since the treatment of chronic total occlusion (CTO) with percutaneous coronary intervention (PCI) is associated with high procedural complexity, it has been suggested to use a multi-operator approach. This study was aimed at evaluating the procedural outcomes of single (SO) versus dual-operator (DO) CTO-PCI approaches. (2) Methods: This retrospective analysis included data from the Polish Registry of Invasive Cardiology Procedures (ORPKI), collected between January 2014 and December 2020. To compare the DO and SO approaches, propensity score matching was introduced with equalized baseline features. (3) Results: The DO approach was applied in 3604 (13%) out of 27,788 CTO-PCI cases. Patients undergoing DO CTO-PCI experienced puncture-site bleeding less often than the SO group (0.1% vs. 0.3%, p = 0.03). No differences were found in the technical success rate (successful revascularization with thrombolysis in myocardial infarction flow grade 2/3) of the SO (72.4%) versus the DO approach (71.2%). Moreover, the presence of either multi-vessel (MVD) or left main coronary artery disease (LMCA) (odds ratio (OR), 1.67 (95% confidence interval (CI), 1.20–2.32); p = 0.002), as well as lower annual and total operator volumes of PCI and CTO-PCI, could be noted as factors linked with the DO approach. (4) Conclusions: Due to the retrospective character, the findings of this study have to be considered only as hypothesis-generating. DO CTO-PCI was infrequent and was performed on patients who were more likely to have LMCA lesions or MVD. Operators collaboratively performing CTO-PCIs were more likely to have less experience. Puncture-site bleeding occurred less often in the dual-operator group; however, second-operator involvement had no impact on the technical success of the intervention.

Introduction: Erectile dysfunction (ED) is strongly associated with metabolic and cardiovascular diseases and may serve as a marker of vascular pathology. Phosphodiesterase type 5 (PDE-5) inhibitors are the mainstay of treatment. Considering this link, cardiologists and internists might be expected to play a key role in therapy initiation. Purpose: This study evaluated prescription patterns of PDE-5 inhibitors in Poland, focusing on physician specialization and consultation type. Methods: We performed a retrospective analysis of electronic health records from over 300 outpatient clinics (2014–2024). Men >18 years with newly diagnosed ED were included. Data on the first prescriptions of sildenafil and tadalafil were assessed. Ethical approval was obtained. Results: A total of 11,998 patients were identified (mean age 42 years; mean BMI 26.54 kg/m²). Common comorbidities included hypercholesterolemia (67.0%), hypertension (58.5%), obesity (31.5%), and diabetes (12.4%). PDE-5 inhibitors (predominantly tadalafil (≈67%)) were prescribed in 71.5% of cases. Urologists accounted for 51.0% of prescriptions, sexologists 14.9%, internists 20.4%, and cardiologists only 0.10%. Treated patients were younger and had a lower BMI, fewer comorbidities, and more favorable metabolic profiles (all p < 0.05). Conclusions: Contrary to expectations, cardiologists and internists rarely initiate PDE-5 therapy. Prescribing is dominated by urologists despite high rates of cardiovascular comorbidities. A multidisciplinary approach incorporating metabolic and cardiovascular risk assessment is warranted.

Introduction: Many factors related to the switch to summer/winter time interfere with biological rhythms. Objectives: This study aimed to analyze the impact of time change on clinical outcomes of patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Patients and methods: Electronic data of 874,031 patients with ACS who underwent invasive procedures were collected from the Polish National Register of Interventional Cardiology Procedures (ORPKI) between 2014 and 2021. We determined the number of patients undergoing PCI and periprocedural mortality during the day of spring or autumn time change and within the first 3 and 7 days after the time change. Results: We demonstrated the impact of time changes on the periprocedural mortality of ACS patients within 1 day and the period of 3 and 7 days from the time change. We observed that the occurrence of all ACS and NSTEMI on the first day was lower for both time changes and higher in the case of UA and spring time change. The autumn time change significantly reduced the occurrence of all types of ACS. A significant decrease in the number of invasive procedures was found after autumn transition in the period from the first day to 7 days for ACS, NSTEMI, and UA. Conclusions: The occurrence of ACS and the number of invasive procedures were lower for both changes over time. Autumn time change is associated with increased periprocedural mortality in ACS and a less frequent occurrence of UA and NSTEMI within 7 days.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a major contributor to ischemic stroke, heart failure, hospitalization, and mortality. AF-related strokes account for approximately 20–30% of all ischemic strokes and are typically associated with more severe neurological deficits and poorer long-term outcomes. As the prevalence of AF continues to rise with population aging, optimizing both stroke prevention and post-stroke management has become increasingly important. This narrative review summarizes current evidence on AF in the context of ischemic stroke, with particular emphasis on anticoagulation, acute stroke management, and early neurorehabilitation. Special attention is given to the unique challenges of AF-associated stroke, including hemodynamic instability, recurrent embolic risk, bleeding risk during anticoagulation, and the need for individualized rehabilitation strategies. We also discuss interdisciplinary care models, including the Hemodynamic Gating Matrix and the Heart–Brain Team approach, as potential frameworks for integrating cardiovascular and neurological management during recovery. AF-related stroke requires coordinated care across cardiology, neurology, and rehabilitation medicine. A physiology-guided and interdisciplinary approach may improve functional recovery while maintaining cardiovascular safety in this high-risk population.