Objective: Atherosclerotic carotid artery stenosis is a significant contributor to ischemic strokes, and carotid artery stenting (CAS) has emerged as a pivotal treatment option. However, in-stent restenosis (ISR) remains a concern, impacting the long-term patency of CAS. This study aimed to investigate the predictive value of non-traditional lipid profiles, including the atherogenic index of plasma (AIP), in ISR development. Methods: This retrospective single-center study involved patients presenting at a tertiary healthcare facility with severe carotid artery disease between 2016 and 2020 who subsequently underwent CAS. A total of 719 patients were included in the study. The study cohort was divided into ISR and non-ISR groups based on restenosis presence, confirmed by angiography following ultrasonographic follow-up assessments. Non-traditional lipid indices, such as AIP, atherogenic index (AI), and lipoprotein combined index (LCI), were evaluated along with traditional risk factors. Results: During a 24-month follow-up, ISR occurred in 4.03% of patients. To determine the predictors of restenosis, three different models were constructed in multivariate analysis for non-traditional lipid indices. Multivariate analysis revealed AIP as a robust independent predictor of ISR (OR: 4.83 (CI 95 % 3.05–6.63, p < .001). Notably, AIP demonstrated superior predictive accuracy compared to AI and LCI, with a higher Area Under the Curve (AUC) of 0.971. Conclusion: Non-traditional lipid profiles, especially AIP, were found to be associated with an increased risk of ISR and may serve as predictors of ISR in patients undergoing CAS.

No-reflow is a critical adverse event associated with percutaneous coronary intervention (PCI), particularly during saphenous vein graft (SVG) procedures. The Naples Prognostic Score (NPS) reflects inflammatory status, but its relationship with no-reflow remains unclear. Therefore, we aimed to evaluate the relationship between NPS and no-reflow occurrence following SVG PCI. We retrospectively analyzed 286 patients who underwent SVG PCI from January 2020 to January 2024, with a median age of 65 years and 85.7% male. Participants were categorized into low NPS (0-2, 48.6%) and high NPS (3-4, 51.4%) groups. Two nested models were developed by adding NPS (continuous and categorical, respectively) to the base model. Higher no-reflow rates were noted in the high-NPS group (48.5% vs. 9.5%, p < 0.05). Multivariable regression revealed that a higher NPS significantly increased no-reflow risk, with odds ratios of 5.966 (95% CI: 3.066-11.611) for continuous NPS and 10.110 (95% CI: 3.194-32.002) for categorical NPS. Adding NPS to the base model significantly improved predictive performance (likelihood-ratio test p < 0.001). Model 1 demonstrated the best performance (X² : 84.857, R² : 0.468) and discriminative ability (AUC: 0.888). Our findings suggest that NPS is a strong predictor of no-reflow following SVG PCI.

Aim: This study aimed long-term prognostic factors for percutaneous coronary intervention (PCI) in left main coronary artery (LMCA) disease, focusing on inflammatory parameters like Pan Immune-Inflammation Value (PIV) and Systemic Immune-Inflammation Index (SII).Materials & methods: This retrospective, observational study involved 121 patients receiving unprotected LMCA PCI.The study's primary end point was MACE, including all-cause death, repeat revascularization and myocardial reinfarction.Results: The PIV and SII scores emerged as independent predictors of MACE occurrence in patients undergoing PCI for unprotected LMCA disease (p:0.045,p:0.048;respectively).In addition, age, ejection fraction, creatinine, shock presentation and the residual syntax score were identified as significant independent predictors of MACE in both models.Conclusion: This study showed a significant, independent correlation between PIV, SII and MACE in patients undergoing PCI for LMCA disease, with PIV showing slightly better predictive capability than SII.

Background Saphenous vein graft (SVG) patency remains a challenge in cases of coronary artery disease following coronary artery bypass grafting (CABG) surgery. The Naples prognostic score (NPS) constitutes a novel scoring system designed to assess both nutritional status and inflammation. Objectives Our study aimed to explore the association between the NPS and SVG disease in patients with a previous history of CABG surgery. Methods A total of 702 patients who had undergone CABG surgery and underwent coronary angiography were reviewed retrospectively. SVG disease was defined as the presence of ≥50% stenosis in at least one SVG. Patients were categorized into two groups based on the presence or absence of SVG disease. Values of p<0.05 were accepted as statistically significant. Results The study population consisted of 702 patients, with 269 (38.3%) having degenerative SVGs and 433 (61.7%) without degenerative SVGs. The NPS was higher in the group with saphenous vein degeneration and emerged as a significant predictor of SVG disease (OR: 1.596, 95% CI: 1.198-2.125, p=0.001). Additionally, hypertension (OR: 2.344, 95% CI: 1.137-4.833, p=0.02), chronic kidney disease (OR: 3.337, 95% CI: 1.554-7.168, p=0.002), statin usage (OR: 0.434, 95% CI: 0.239-0.789, p=0.006), time interval since CABG (OR: 1.138, 95% CI: 1.213-1.432, p<0.001), and number of SVGs (OR: 2.708, 95% CI: 1.902-3.855, p<0.001) were significant predictors of SVG disease. Conclusion The NPS, a useful tool for assessing inflammation and nutritional status, could provide valuable information about the patency of SVGs following CABG surgery. Patients with elevated NPS after CABG should undergo careful monitoring for the development of SVG disease.

Background: The precise etiology of hypoplasia of the posterior mitral valve leaflet (PMVL) remains incompletely elucidated; however, it has been hypothesized to stem from genetic mutations occurring during fetal development. Herein, we present the anatomical characteristics of the mitral valve and associated cardiac pathologies in patients with hypoplastic PMVL. Methods: This single-center retrospective study involved patients who presented between 2015 and 2021 at a tertiary healthcare facility. Among the cohort, 44 individuals had hypoplastic PMVL and were divided into 2 groups: those with severe mitral regurgitation (MR) and those with non-severe MR. Results: Among the patients, 11 (25%) had severe MR. The median lengths for the PMVL was 5 mm (5-6). Moreover, 10 patients had concomitant muscular formation. We found that 13 patients had bicuspid aortic valve (BAV), while the second most common concomitant cardiac congenital pathology was secundum atrial septal defect (ASD) in 7 patients. The anterior mitral leaflet (AML) length (P = .007), AML prolapse (P < .001), and A2P2 distance (P = .008) were higher in the group with severe MR. In addition, muscular formation was more common in patients with hypoplastic PMVL with severe MR (P < .001). Conclusion: Hypoplastic PMVL is a rare but significant anomaly that causes MR. While it can coexist with numerous congenital conditions, the most frequent associations include BAV and, secondly, ASD. Severe MR is particularly observed in cases accompanied by dilated mitral annulus, AML prolapse, and muscular formation.