Systemic immune-inflammation index (SII; platelet count × neutrophil-to-lymphocyte ratio), a novel marker, predicts adverse clinical outcomes in coronary artery diseases (CAD). We hypothesized that SII could provide more valuable information in assessing the severity of CAD than ratios obtained from other white blood cell subtypes. Patients (n = 669) who underwent coronary angiography were analyzed in this retrospective study. We analyzed the relation between the SII and the angiographic severity of CAD. The severity of coronary atherosclerosis was determined by the SYNTAX score (SxS). Patients with CAD were divided into 3 groups according to the SxS. Multivariate logistic analysis was used to assess risk factors of CAD. In multivariate logistic regression analysis, the SII (odds ratio: 1.004; 95% CI: 1.001-1.007; P = .015) was an independent predictor of high SxS. Additionally, there was a positive correlation between SII and SxS (Rho: 0.630, P ≤ .001). In the receiver-operating characteristic curve analysis, SII with an optimal cutoff value of 750 × 10 ³ predicted the severe coronary lesion with a sensitivity of 86.2% and specificity of 87.3%. The SII, an inexpensive and easily measurable laboratory variable, was significantly associated with the severity of CAD and high SxS in patients with stable angina pectoris.

Prolonged hospital stays for patients with heart failure (HF) are associated with increased morbidity and mortality. In this study, we investigated the relationship between the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index, a new marker in patients with decompensated HF, and the length of hospital stay. Consecutive patients ( n = 4745) who were hospitalized with decompensated HF between January 2016 and January 2024 (COVID-19 period was excluded) were included in the study. The CALLY index ([albumin × lymphocyte]/[CRP × 104]) was calculated. A relationship was found between the CALLY index and the length of hospital stay in the patients with HF in linear regression analysis. Also, the CALLY index was an independent predictive variable of the length of hospital stay (odds ratio: 0.327; 95% CI: 0.278–0.385; P < .001). CALLY index value of 0.258 can predict long-term hospitalization with 69.2% sensitivity and 70.1% specificity (area under the curve [AUC]: 0.729, 95% CI = 0.714–0.743, P < .001). In addition, the CALLY index was negatively correlated with the length of hospital stay ( r = −.47, P < .001). In conclusion, the CALLY index, an inexpensive and easily measured laboratory variable, may be a valuable for estimating the length of hospital stay in decompensated HF.

Pathophysiology and prognosis are not clearly determined in patients with the coronary slow flow phenomenon (CSFP). These patients present with various clinical conditions ranging from being asymptomatic to being admitted with sudden cardiac death. We aimed at assessing the findings of late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (CMR) as an indicator of myocardial fibrosis. We also aimed at determining the relationship between the presence of myocardial fibrosis and NT-proBNP levels in patients with CSFP in the left anterior descending coronary artery (LAD). A total of 35 patients were enrolled within an age range of 31-75. The study patients (n=19) had normal epicardial coronary arteries at angiography, but they presented with CSFP in the LAD. The control group patients (n=16) had normal epicardial coronary arteries and TIMI scores at normal levels in angiography. In both groups, the patients were examined with CMR for the presence of myocardial fibrosis. In addition, plasma NT-proBNP levels were measured. A p-value < 0.05 was considered significant. The rate of myocardial fibrosis was significantly higher in CMR in the patients with CSFP (p=0.018). A variable amount of myocardial scar tissue was detected at the left ventricular apex in 7 patients and at the inferior and inferolateral regions in 3 patients. There was no difference in the level of NT-proBNP in patients with CSFP. However, the NT-proBNP levels were higher in patients with CSFP, who had scar tissue in CMR (p=0.022). In conclusion, LGE in CMR showed that ischemic myocardial scarring may exist in patients with CSFP. These results indicate that CSFP may not always be innocent. (Arq Bras Cardiol. 2020; 114(3):540-551).

Neurohumoral alterations in heart failure (HF) affect blood pressure variability (BPV) and vascular compliance, but little is known about this subject among patients admitted to hospital with decompensated HF. This study sought to investigate in-hospital 24-hour blood pressure monitoring (HBPM) derived BPV parameters and vascular compliance in patients with decompensated HF and to explore the association of these parameters with hospitalization length and in-hospital adverse events. A 24-hour blood pressure monitor was applied during the first 6 hours of admission to the hospital in patients with decompensated HF. Circadian patterns were determined by the study patients. Average real variability (ARV), pulse pressure index (PPI), pulse stiffening ratio (PSR), and ambulatory arterial stiffness index (AASI) values were calculated from HBPM recordings. Admission and discharge N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, length of hospitalization, and in-hospital adverse events were recorded. A total of 167 decompensated HF patients were included in the study. The dipper group exhibited a greater NT-proBNP decrease with the treatment compared to the non-dipper group and reverse dipper group. Hospitalization length was lower in the dipper group than in the non-dipper and reverse dipper groups. While ARV, AASI, and PSR were independently associated with the length of hospitalization, ARV, AASI, and PPI were independently associated with in-hospital adverse events. Post-admission HBPM-derived parameters (dipper pattern, ARV, PPI, PSR, AASI) of patients admitted to hospital with decompensated HF provide important prognostic information and predict the length of hospital stay.

Gamma-glutamyl transferase (GGT) to albumin ratio (GAR) has been shown to be helpful to diagnose and determine the severity of coronary artery disease (CAD). Coronary computed tomography angiography (CCTA) is a guide recommended non-invasive test that provides information about the presence, severity, and morphology of coronary plaques. In this study, our main aim was to investigate the relationship between the presence, morphology, and severity of coronary plaques detected via CCTA and GAR in patients with low to moderate risk for undiagnosed CAD. Nine hundred and sixty six patients were included who underwent CCTA. The severity of CAD and plaque morphology were investigated. CT-adapted Leaman score (CT-LeSc) was calculated to determine the extent of the CAD. The study population was further evaluated in three groups according to tertiles of GAR. Atherosclerotic plaques were more common in the male gender and older patients with conventional cardiovascular risk factors. GAR was significantly lower in patients with normal CCTA than in patients with a non-obstructive plaque or obstructive plaque on CCTA. Patients in upper GAR tertiles had a higher coronary calcium score (CACS) and CT-LeSc. GAR was one of the independent predictors to predict severe stenotic plaque and high CACS. GAR can independently predict the presence, extent, and severity of CAD determined by CT-LeSc. We believe as a cheap, safe, and widely available tool, GAR would be useful in the diagnosis of CAD.