Background: Acute myocardial infarction (AMI) constitutes a major health problem with high mortality rates worldwide. In patients with ST-segment elevation myocardial infarction (STEMI), no-reflow phenomenon is a condition that adversely affects response to therapy. Previous studies have demonstrated that the CALLY index, calculated using C-reactive protein (CRP), albumin, and lymphocytes, is a reliable indicator of mortality in patients with non-cardiac diseases. The objective of this study is to investigate the potential utility of the CALLY index in detecting no-reflow patients and to determine the predictability of this phenomenon using machine learning (ML) methods. Methods: This study included 1785 STEMI patients admitted to the clinic between January 2020 and June 2024 who underwent percutaneous coronary intervention (PCI). Patients were in no-reflow status, and other clinical data were analyzed. The CALLY index was calculated using data on patients’ inflammatory status. The Extreme Gradient Boosting (XGBoost) ML algorithm was used for no-reflow prediction. Results: No-reflow was detected in a proportion of patients participating in this study. The model obtained with the XGBoost algorithm showed high accuracy rates in predicting no-reflow status. The role of the CALLY index in predicting no-reflow status was clearly demonstrated. Conclusions: The CALLY index has emerged as a valuable tool for predicting no-reflow status in STEMI patients. This study demonstrates how machine learning methods can be effective in clinical applications and paves the way for innovative approaches for the management of no-reflow phenomenon. Future research needs to confirm and extend these findings with larger sample sizes.

Although the pathophysiology of paroxysmal atrial fibrillation (PAF) is not fully known, oxidative stress (OS) and atrial remodeling seem to be important triggers. Autophagy and apoptosis which are the types of cell death are fundamental processes in the human body. Although they investigated in many diseases, no study evaluated these parameters in PAF patients. We aimed to investigate autophagy and apoptosis which may be associated with atrial remodeling, and to show whether these factors are associated with OS in PAF patients. In this study, 44 PAF patients admitted to our clinic and 44 healthy volunteers were included. Serum total oxidative stress (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and ATG5 for autophagy and serum M30 for apoptosis were studied. Serum TOS, OSI, ATG5, M30 and left atrium (LA) diameter were higher, while TAS was lower in PAF group than the control group (p < 0.001, for all). ATG5 was positively correlated with TOS, OSI and LA, whereas negatively correlated with TAS. Also, M30 was positively correlated with TOS and OSI, whereas negatively correlated with TAS. Logistic regression analysis showed that TOS (P = 0.002), ATG5 (p = 0.013) and M30 (p = 0.006) were independent predictors of the PAF. It also found that ATG5 was the only independent predictor of LA enlargement in linear regression analysis. Our study showed that ATG5 and M30 were increased, and they were correlated with OS in patients with PAF. Therefore, we suggest that autophagy and apoptosis may play an important role in the PAF process.

Background: Acute coronary syndromes are the leading cause of mortality worldwide. Electrical risk score (ERS) is a novel electrocardiographic risk scoring system. The prognostic importance of ERS in non-ST elevation myocardial infarction (NSTEMI) patients is unknown. We aimed to determine the association of ERS with in-hospital prognosis in NSTEMI patients undergoing coronary angiography (CAG). Methods: A total of 427 consecutive NSTEMI patients undergoing CAG were enrolled in this study. Six parameters comprised ERS: pulse rate >75, left ventricular hypertrophy according to Sokolow–Lyon criteria, QRS transition zone ≥V4, corrected QT (QTc) interval >450 for men and >460 for women, T peak to T end interval (Tp-e) >89 ms, and frontal QRS-T angle >90°. The ERS was calculated according to the number of abnormal findings in electrocardiogram. The study population was divided into 2 groups as ERS <3 and ≥3. Results: No significant difference was found between ERS ≥3 and <3 groups in terms of demographic characteristics. However, patients with ERS ≥3 had significantly higher maximum troponin (P < .001), thrombolysis in myocardial infarction (P = .002), and global registry of acute coronary events (P < .001) risk scores and 3-vessel disease frequency (P = .001), whereas they had lower left ventricular ejection fraction (P < .001). These patients also had higher frequency of in-hospital mortality (P < .001) and adverse events. Multiple logistic regression analysis demonstrated that ERS (OR = 1.790, 95% CI: 1.036-3.095, P = .037) was an independent predictor of in-hospital mortality. Conclusion: The frequency of in-hospital adverse events and mortality was significantly higher in NSTEMI patients with an ERS ≥3 at admission. This simple electrocardiographic risk marker may help identify patients at higher cardiac risk in patients presenting with NSTEMI and identify patients who may need early coronary intervention.

Background: Vitamin D deficiency has been found to be associated with various cardiovascular disorders, including hypertension, coronary artery disease, heart failure, peripheral vascular diseases, and sudden cardiac death. In the literature, it has been reported that many electrocardiographic parameters have been developed to predict ventricular arrhythmias. In recent studies, it is noteworthy that the index of cardio-electrophysiological balance (iCEB) and correct cardioelectrophysiological balance (iCEBc), which are electrocardiographic parameters, can be used as new, easy, cheap and non-invasive parameters to predict ventricular arrhythmias. Objective: This study aimed to investigate the relationship between vitamin D deficiency and iCEB and iCEBc values in children. Methods: A total of 186 patients were included in this study. Group 1 included 114 patients with vitamin D levels below 20 ng/ml; 50 patients with vitamin D levels of 21-29 ng/ml were included in Group 2; Group 3 consisted of 36 patients with a vitamin D level above 30 ng/ml. iCEB and iCEBc values were calculated by taking 12-lead ECG from all individuals and comparing them between groups. Results: A total of 186 children, 114 subjects in Group 1, 36 subjects in Group 2, and 36 subjects in Group 3, were included in the study. Demographic characteristics and height-weight values of the groups were similar. Significant differences were found between the groups in terms of QT, QTc, QT/QRS, and QTc/QRS levels (p: 0.003, 0.028, 0.001, and 0.001, respectively). In the correlation analysis, a negative correlation was found between QTc/QRS and vitamin D level (r=-0.320, p=<0.001) and between QT/QRS and vitamin D level (r=-0.268, p=<0.001). Moreover, vitamin D level (β=0.389, p<0.001) was determined as an independent predictor of QTc/QRS in multivariate logistic regression analysis. Conclusion: iCEB and iCEBc parameters increase significantly in children with low vitamin D levels. These parameters are also evaluated during the follow-up of children with vitamin D deficiency in terms of the risk of ventricular arrhythmia. iCEBc can be used as an easy, inexpensive, non-invasive, and reproducible parameter.

Background and Objectives: Major depressive disorder (MDD) is a prevalent psychiatric illness increasingly recognized as a systemic condition with implications for cardiovascular diseases. Growing evidence indicates that individuals with MDD have an elevated risk of cardiovascular mortality, underscoring the need for reliable, non-invasive biomarkers to assess cardiac risk. While underlying mechanisms remain unclear, electrocardiogram (ECG)-based markers offer a promising, non-invasive means of evaluation. Among these, the electrical risk score (ERS), a composite derived from specific ECG parameters, has emerged as a predictor of adverse cardiac outcomes. This study aimed to investigate the association between ERS and MDD, and whether ERS correlates with depression severity and illness duration. Materials and Methods: In this retrospective cross-sectional study, 12-lead ECGs were evaluated to calculate the ERS based on six ECG parameters: heart rate, corrected QT interval, Tp-e interval, frontal QRS-T angle, QRS transition zone, and presence of left ventricular hypertrophy according to Sokolow–Lyon criteria. The Hamilton Depression Rating Scale (HAM-D) was utilized. Results: The study included 102 patients with MDD and 62 healthy controls. No significant differences were observed in baseline or laboratory parameters between the groups. However, heart rate, Tp-e interval, frontal QRS-T angle, and ERS were significantly higher in the depression group. ROC analysis identified ERS as the strongest predictor of depression. ERS was significantly higher in patients with severe depression compared to those with mild symptoms and showed a positive correlation with both disease duration and HAM-D score. Conclusions: Here, we show that the ECG-derived ERS is significantly elevated in patients with MDD and is associated with increased cardiac risk. ERS outperformed conventional ECG parameters in identifying individuals with depression and demonstrated positive associations with both illness duration and symptom severity. These findings suggest that ERS may serve as a practical, non-invasive biomarker for assessing cardiovascular vulnerability in this population.

Kardiyovasküler hastalıklarda diyet tedavisi, tedavinin en önemli basamaklarından biridir. Diyet tedavisinde günlük tuz alımı kısıtlanmalı, doymuş yağ tüketiminden kaçınılmalı, çoklu doymamış yağların ve beyaz etlerin tüketimi artırılmalı, margarin ve ilave şekerli gıdaların tüketimi yasaklanmalı, taze sebze ve meyve tüketimi sağlanmalıdır. Alkollü içki ve tütün ürünlerinin kullanımından kaçınılmalıdır. İdeal kiloyu koruyacak, aşırı kiloları ve obeziteyi önleyecek şekilde uygun kalori içerikli bireyselleştirilmiş diyet düzenlenmelidir. Farmakolojik ve girişimsel tedavi yöntemleri ile karşılaştırıldığında diyet tedavisi ile elde edilecek faydalar hem daha etkin hem de daha az maliyetli olacaktır.