Elderly patients with acute syndrome are frailer due to the burden of comorbidity. Comorbidities that increase with age result in an increased risk of mortality in patients with acute coronary syndrome (ACS). Many scales have been developed to assess the burden of comorbidity, including the Charlson Comorbidity Index (CCI). The aim of our study is to show the effect of the CCI on 1-year mortality and poor clinical outcomes in elderly patients who underwent percutaneous coronary intervention due to ACS. This single-center retrospective study included 704 patients aged 75 years and older. The study population consisted of patients who were admitted to the hospital with ACS between April 2017 and September 2021 and underwent successful percutaneous intervention. The patients were divided into 3 groups according to their CCI scores as CCI 0 (n:156), 1 (n:266), and ≥2 (n:282). Stroke development was significantly higher in patients with CCI scores ≥ 2 compared to the other 2 groups (P = .005). Mortality rates were found to be 28.4%, 7.5%, and 2.6% in patients with CCI ≥ 2, CCI 1, and CCI 0, respectively. The mortality rate of the CCI ≥ 2 group was significantly higher than those of the other 2 groups (P < .001). The multivariate Cox proportional hazard regression model showed that CCI was an independent predictor for 1-year all-cause mortality (hazard ratio: 1.632; 95% confidence interval: 1.403–1.898; P < .001). CCI may contribute to treatment and follow-up management, as it indicates a poor prognosis in elderly patients who have undergone percutaneous coronary intervention.

Objectives: Coronary slow flow (CSF) is characterized by delayed opasification of the coronary arteries in the absence of obstructive coronary disease. Catestatin has several cardiovasculer actions, in addition to diminihed sympato-adrenal flow. The study was to investigated associations between CSF and plasma catestatin levels. Method: This study included 45 CSF patients (37 male, mean age 48 ± 9.5 years) and 30 control individuals (24 male, mean age 48.4 ± 9 years). Coronary flow was quantified according to the TIMI (Thrombolysis in Myocardial Infarction) frame count method for coronary arteries. Serum catestatin levels taken from blood samples were measured by ELISA method. These parameters were compared between the groups. Results: When compared with to the control group the serum catestatin levels was found higher in the CSF group. In addition to this, mean platelet volume was also significantly higher in patients with coronary slow flow. Conclusions: Our study revealed that catestatin levels are increased in patients with CSF. Coronary slow flow that increased catecholaminergic sympathetic system activities seem to be among the reasons of endothelial dysfunction.

Objectives: Atherosclerosis represents an active inflammation that leukocytes play a major role. Neutrophil-lymphocyte ratio (NLR) has been shown as an indicator of systemic inflammation. Our aim was to evaluate inflammatory markers in obstructive coronary artery disease (CAD) and cardiac syndrome X (CSX) and to evaluate NLR in predicting CAD in patients with typical chest pain and coronary risk factors.Methods: Eighty patients with CSX, 80 patients with obstructive CAD with unstable angina pectoris and a control group of 80 subjects were recruited into the study. Hematologic and biochemical parameters were investigated.Results: High-sensitive C-reactive protein (hs-CRP) was increased in CAD group and CSX group compared to the control group (p < 0.001); however it was comparable between CAD and CSX groups (p = 0.065). Mean NLR was higher in CAD group than CSX group and control group that the lowest value was in the control group. In CAD group, hs-CRP was positively correlated with NLR (r = 0.43, p < 0.001), and Gensini score (r = 0.54, p < 0.001). NLR was also linearly correlated with Gensini score (r = 0.49, p < 0.001). In ROC curve analysis, for the NLR of 2.26, NLR values attained 85.5% sensitivity and 43.9% specificity (p < 0.001). When cut-off value was taken as 3.05 mg/dL for CRP, CRP values attained 78.7% sensitivity and 43.6% specificity (p < 0.001). When cut-off value was taken as 9.5 (×109 /L) for white blood cell (WBC), WBC values attained 58.8% sensitivity and 34.3% specificity (p < 0.001). Conclusions: NLR seems to be usefull in prediction of obstructive CAD and can be implemented in planning for diagnostic procedures in patients with typical chest pain. Increased CRP, WBC and NLR may give insight about main pathology of CSX. Despite absence of obstructive narrowing in epicardial coronaries, it appears be salutary to treat CSX due to the similar underlying pathophysiology with obstructive CAD.

Aims: This study investigated the relationship between Naples prognostic score (NPS) and 1-year poor clinical outcomes in patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI). Methods: The study included 121 patients who had NSTEMI and received successful PCI treatment. The researchers calculated NPS using the neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, serum albumin level, and total cholesterol. The patients were divided into two groups based on their NPS scores: those with scores of 0.1 and 2 and those with scores of 3 and 4. The study compared the occurrence of major cardiovascular events (MACE) such as 1-year all-cause mortality, 1-year nonfatal recurrent MI, and stroke between the two groups. Results: Patients with high NPS scores were observed to have significantly higher all-cause mortality than those with low NPS scores (23.9% vs. 9.3%, p=0.029). When the MACEs of the patients were compared, significantly higher MACE was observed in the high NPS group (39.1% vs. 18.7%, p=0.013). In multivariate logistic regression analysis, creatinine (OR:4,914, CI 95%: 1.310-18,433, p=0.018) and NPS 3-4 (OR:2.565, CI 95%: 1.093-6.017, p=0.030) were independent predictors of MACE. Conclusion: Composite MACEs of non-fatal recurrent MI, cerebrovascular accident, and all-cause death were higher at one year in patients with high NPS who underwent successful percutaneous intervention. High NPS is an indicator of MACE.

Koroner arter anomalileri (KAA'lar), 3 ana koroner arterden herhangi birinin anormal kökeni veya seyri ile karakterize edilen konjenital durumları içerir. Epikardiyal arterlerin seyri önemli ölçüde bireyler arası değişkenlik gösterebilir. 63 yaşında anjina, dispne ile acil servise başvuran kadın hastada yapılan koroner anjiografide Sağ koroner arter’in (RCA) sol sinüs valsalvadan köken aldığı görüldü. Hasta yapılan işlemlerin ardından medikal tedavi düzenlenerek taburcu edildi. Girişimsel müdahaleye ihtiyaç duyulmadı. KAA’ların çoğunun klinik önemi yoktur ancak bazılarında potansiyel ciddi sekeller olabilmektedir. RCA’nın sol kökenli olması ve aort ile pulmoner arter arasında seyretmesi "malign seyir" olarak adlandırılır. Bu anomalinin ateroskleroz yokluğunda anjina, dispne ve daha önemlisi ani kardiyak ölüme neden olabileceği unutulmamalıdır.

An inflammatory condition affecting the pancreatic parenchyma is called acute pancreatitis. Alcohol consumption and gallstones are the most frequent etiological factors. Patients with acute pancreatitis can appear clinically in a variety of ways. While individuals with acute pancreatitis may experience ECG abnormalities that resemble acute myocardial infarction, it is uncommon for acute pancreatitis to coexist with actual acute myocardial infarction. Our goal was to present a case of acute pancreatitis exacerbated by acute coronary syndrome. The patient arrived at the emergency room with 60 minutes of epigastric abdominal pain that was prominent there and radiating to the back.