Background/Aim. Psoriasis as multisystemic inflammatory dis-ease is related with an increased cardiometabolic risk. The aim of the study was to analyze risk biomarkers, peripheral and renal arteries ultrasonography and echocardiography for subclinical atherosclerosis and metabolic disease in 106 subjects (66 psoriasis patients and 40 controls, 20 eczema patients and 20 healthy volunteers). Methods. In all exameenes following parameters were analyzed: body mass index (BMI), C-reactive protein, D-dimer, serum amyloid A (SAA), apolipoprotein (Apo) A1, ApoB, ApoB/Apo A1 index, fasting glucose, C-peptide, fasting insulinemia, homeostatic model assessment-insulin resistance (HOMA-IR), HOMA-?-cell, lipid profile, serum uric acid concentration (SUAC), 24-h proteinuria and microalbuminuria. Carotid, brachial, femoral and renal arteries ultrasonography, as well as echocardiography was also performed. Results. Five of 66 (7.6%) psoriasis patients had metabolic syndrome (not present in both control groups). The following variables were increased in patients with psoriasis compared to both control groups: BMI (p = 0.012), insulinemia (p < 0.001), HOMA-IR (p = 0.003), HOMA-? cell (p < 0.001), SUAC (p = 0.006), ApoB/ApoA1 ra-tio (p = 0.006) and microalbuminuria (p < 0.001). Also, increased C-peptide (p = 0.034), D-dimer (p = 0.029), triglycerides (p = 0.044), SAA (p = 0.005) and decreased ApoA1 (p = 0.014) were found in the psoriasis patients compared to healthy controls. HDL cholesterol was decreased in the psoriasis patients compared to the control group of eczema patients (p = 0.004). Common carotid (CIMT) and femoral artery intima-media thickness (FIMT) was significantly greater (p < 0.001) and the maximal flow speed (cm/s) in brachial artery significantly de-creased (p = 0.017) in the patients with psoriasis in comparison to both control groups. In multivariate logistic regression analysis, after the adjustment for confounding variables, the most important predictor of CIMT and FIMT was the diagnosis of psoriasis (p < 0.001). Conclusion. Cardiometabolic risk biomarkers and ultrasonographic signs of early atherosclerosis are correlated with the diagnosis of psoriasis, and not to generalized eczema. Psoriasis was found to be an independent risk factor for subclinical atherosclerosis. This article has been corrected. Link to the correction 10.2298/VSP1803334E

Background/Aim. Previous studies have confirmed a positive correlation between homocysteine levels and a greater risk for acute coronary syndrome and stroke, but there are no available data to support an association between homo-cysteine and inflammatory markers and the severity of coronary artery disease according to the clinical SYNTAX score in patients with stable angina. The aim was to determine the association between homocysteine and inflammatory biomarker levels: interleukin (IL)-6, high sensitive C-reactive protein (hs-CRP), fibrinogen, erythrocyte sedimentation rate (ESR) and the severity of coronary artery disease according to clinical SYNTAX score. Methods. Eighty-two patients with stable angina pectoris (average age 65 ? 8 years, 28.9% females) underwent coronary angiography and were divided into three groups according to the clinical SYNTAX score: the group I < 22 (39 patients), the group II 23?32 (16 patients), the group III > 33 (27 patients). The severity and complexity of coronary artery disease were calculated by clinical SYNTAX score, multiplying the SYN-TAX score with the modified ACEF score, based on the patients? left ventricular ejection fraction, age and creatinine clearance (derived with Cockcroft?Gault equation). Results. Homocysteine levels were significantly higher in patients with high clinical SYNTAX score [the group I: median (interquartile range ? IQR): 10.20 (3.97), the group II: 10.45 (5.77), the group III: 14.70 (7.50), p = 0.005]. Patients in the group III had significantly higher homocysteine levels compared to the group I (p = 0.001). We also found a posi-tive association between inflammatory biomarkers (IL-6, hsCRP, fibrinogen, ESR) and the severity of coronary artery disease according to the clinical SYNTAX score (p = 0.017, 0.001, 0.032, 0.049 respectively). We detected significantly lower plasma levels of vitamin B12 in the group III and group II in comparison with the group I (the group I: median (IQR): 238 (160), the group II: 171 (160), the group III: 172 (102), p = 0.022), which indicates its important role in homocysteine metabolism. Conclusion. The elevated plasma levels of homocysteine, IL-6, hsCRP, fibrinogen, ESR were detected in patients with high clinical SYNTAX score (> 33). Our results showed that hyperhomocysteinemia and some inflammatory biomarkers can predict more severe and extensive coronary artery disease in stable angina patients.

Background and Objectives: Factor VIII (FVIII) and the von Willebrand factor (vWF) are key components of hemostatic balance. Disruption of the vWF-ADAMTS13 axis, characterized by elevated vWF and reduced ADAMTS13 activity has been implicated in thrombotic disorders, including COVID-19-asscoiated coagulopathy, where this imbalance correlates with disease severity and mortality. This study evaluated the relationship between plasma FVIII and vWF levels and the severity of coronary artery disease (CAD), as assessed by the SYNTAX score. Methods: We enrolled 82 patients with chronic coronary syndrome (CCS) and a positive treadmill test who underwent elective coronary angiography. Based on the SYNTAX score, patients were divided into three groups: Group I (≤22), Group II (23–32), and Group III (≥33). Results: FVIII levels varied significantly (Group I: 2.25 ± 0.75; Group III: 2.97 ± 0.95; p = 0.007), with an OR of 3.632 (95% CI: 1.116–11.826; p = 0.03). vWF levels differed significantly across SYNTAX groups (Group I: 1.16 ± 0.59; Group II: 1.52 ± 0.62; Group III: 1.49 ± 0.80; p = 0.040). vWF > 1.75 was more frequent in Groups II and III, with an odds ratio (OR) of 4.909 (95% CI: 1.429–16.864; p = 0.01) for Group III vs. Group I. Fibrinogen and C-reactive protein (CRP) were elevated in patients with SYNTAX scores ≥33. In multinomial logistic regression analysis, FVIII emerged as the sole independent predictor of CAD complexity (p = 0.004), while the vWF showed significance in pairwise comparison (Group II vs. Group I; OR = 3.433, p = 0.049). Conclusions: This study demonstrated significant differences in hemostatic and inflammatory biomarkers across SYNTAX score categories reflecting CAD severity in CCS patients. FVIII emerged as an independent predictor of CAD complexity, while the vWF demonstrated significant associations in specific subgroup comparisons. The observed vWF-ADAMTS13 axis dysregulation supports the rationale for investigating vWF-targeted therapeutics, including agents such as caplacizumab, in cardiovascular disease management. These findings require validation in larger studies.

Introduction. Stent thrombosis (ST) in clinical practice, according to time of onset, can be classified as: early (0-30 days post stent implantation): which can be divided to acute (30 days) and very late (>12 months). Myocardial reinfaction due to very late stent thrombosis (ST) in patient receiving antithrombotic therapy is very rare, and potentially fatal. Procedure alone and mechanical-related factors seems to be associated with acute/subacute ST. On the other hand, instent neoatherosclerosis, inflammation, premature cessation of anti-platelet therapy, as well as stent fracture, stent malapposition, uncovered stent struts may play role in late/very late ST. Some findings implicates that the etiology of very late ST of bare- metal stent (BMS) is a quite different from those following drug- eluting stent (DES) implantation. Case report. We have presented a case 56-years old male with acute inferoposterior STEMI related to very late stent thrombosis, 9 years after BMS implantation, despite antithrombotic therapy. We successfully performed thrombus aspiration followed by PCI with implantation of one drug-eluting stent (DES) into the previously implanted two stents to solve the in-stent restenosis. Conclusion. Very late stent thrombosis, although fortunately very rare, not completely understood, may cause myocardial reinfaction and can be successfully treated with thrombus aspiration followed by primary PCI. The reason for very late ST in our patient might be connected with neointimal plaque rupture, followed by thrombotic events.

Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization in patients with symptomatic heart failure and left bundle branch block (LBBB) on optimal drug therapy. Among all, the reasons for “non-response” to CRT pacemaker could be the failure to achieve optimal left ventricular(LV) lead position, due to severe curve or stenosis/occlusion of target vein. Case report. We present a of male patient, age 79, NYHA class III, with atrial fibrillation, chronic coronary syndrome (CCS), prior myocardial infarction, who underwent coronary artery bypass surgery and mechanical prosthetic aortic valve implantation, indicated for CRT in whom venogram revealed ostial/proximal severe curve and stenosis of posterolateral vein, the only vein of coronary sinus leaded to anatomical optimal LV segment for stimulation. After the balloon angioplasty of curved and stenotic portion of target vein with compliant balloon 4.0 x 30 mm, satisfactory and stable position of quadripolar LV lead was achieved. Conclusion. Compliant balloon angioplasty could be safe and efficient way how to override severe coronary vein stenosis in some CRT cases.

Background: Diabetic kidney disease (DKD) and diabetic retinopathy (DR) are the most frequent microvascular complications of diabetes mellitus. Although microalbuminuria is a conventional early marker of DKD, its limited sensitivity and the growing recognition of nonalbuminuric DKD highlight the need for more sensitive early detection tools. Urinary biomarkers such as type IV collagen, transferrin, and liver-type fatty acid-binding protein (L-FABP) may capture early glomerular or tubular injury before the onset of overt albuminuria. This pilot study evaluated the diagnostic performance of these biomarkers in adults with type 2 diabetes mellitus (T2DM) and explored their associations with DR.Methods: A cross-sectional per-protocol study included 80 T2DM patients and 10 healthy controls. Diabetic participants were categorised as normoalbuminuric (<30 mg/day) or microalbuminuric (30-300 mg/day). First-morning urine samples were used for final analyses. Urinary type IV collagen, transferrin, and L-FABP were quantified using ELISA and expressed in ng/mL. Group comparisons used t-tests or ANOVA for normally distributed variables, and Mann-Whitney U or Kruskal-Wallis tests for non-normally distributed data. Correlations were assessed using Pearson or Spearman coefficients. Diagnostic performance was analyzed using ROC curves.Results: The cohort (55% male; mean age 59.85± 8.87 years) had similar BMI, smoking status, and eGFR across groups. Biomarker levels differed significantly among microalbuminuric, normoalbuminuric, and control groups (p<0.001): type IV collagen (0.97 vs. 0.55 vs. 0.48), transferrin (45.51 vs. 14.83 vs. 6.57), and L-FABP (480.15 vs. 228.08 vs. 89.91). Type IV collagen demonstrated the best diagnostic ability for early DKD (AUC 90.4%). DR was present in 24 patients (30%), and transferrin levels were significantly higher in those with DR (81.38 vs. 38.12 ng/mL; p=0.03).Conclusions: Urinary type IV collagen, transferrin, and L-FABP show promise for early DKD detection, while transferrin additionally correlates with DR. Larger studies are needed to confirm these findings.