Background/Objectives: Acute decompensated heart failure (ADHF) presents a significant clinical challenge characterized by frequent hospitalizations, high mortality rates, and substantial healthcare costs. The united index of hemoglobin, albumin, lymphocytes and platelets (HALP) is a new indicator that reflects systemic inflammation and nutritional status. This study aimed to investigate the prognostic utility of the HALP score and hematological parameters in predicting short-term mortality among ADHF patients admitted to the coronary care unit (CCU). Methods: This investigation adopts a retrospective observational design, encompassing a cohort of patients with ADHF who were followed in the CCU at our medical institution between January 2019 and April 2024. Results: The cohort of 227 individuals was dichotomized into two subsets based on the presence or absence of short-term mortality in the hospital, resulting in 163 (71.8%) and 64 (28.2%) individuals in the survivor and exitus groups, respectively. Age was significantly higher in the exitus group (p-value = 0.004). Hemoglobin, lymphocyte count, platelet count, albumin, and HALP score were significantly higher in the survivor group (all p-values < 0.001). No significant difference was observed between the groups in terms of gender, diabetes mellitus (DM), coronary artery disease (CAD), or ejection fraction (EF), although hypertension (HT) prevalence was significantly higher in the exitus group (p-value = 0.038). ROC analysis demonstrated that hemoglobin, lymphocyte, albumin, and HALP score had significant discriminative power, with albumin showing the highest AUC (0.814). Conclusions: In conclusion, the HALP score and hematological parameters represent valuable prognostic feature for short-term mortality prediction in ADHF patients admitted to the CCU. These findings underscore the importance of early risk stratification and targeted interventions guided by comprehensive biomarker assessments in optimizing patient outcomes.

Viscum album L. has favorable cardiovascular effects including antihypertensive and vasorelaxant activity, and the nitric oxide (NO) pathway upregulation has been proposed to be the underlying mechanism. NO also plays an important role in the pathophysiology of heart failure. However, its effects on cardiac systolic function are unclear. A total of 30 male Wistar albino rats at 12 weeks of age were randomly divided into three groups: control, isoproterenol-induced heart failure group (ISO), and isoproterenol-induced heart failure + V. album treatment group (VA) groups (n=10 in each group). V. album was orally given at a dose of 250 mg/kg/day by gavage. Parameters of heart failure were compared among the groups. Tamhane's T2 test, paired sample t-test, and Bonferroni methods were used for statistical analysis. V. album resulted in an improvement in all parameters of heart failure including left ventricular diameters (6.34±0.23 mm, 6.98±0.35 mm, and 6.71±0.10 mm for left ventricular end-diastolic diameter in control, ISO, and VA groups, respectively, p<0.05), ejection fraction (73.3±3.1%, 56.7±2.6%, and 65.2±1.5% for control, ISO, and VA groups, respectively, p<0.05), serum NT-proBNP levels, and histopathological changes. V. album treatment resulted in a statistically significant attenuation of increased levels of NO and iNOS (p<0.0001). The levels of hs-CRP were also found to be lower in the VA group compared with the controls and ISO groups (p<0.01). V. album exerted favorable effects on left ventricular function in isoproterenol-induced heart failure rats. Upregulation of the NO pathway seems to be the possible pathophysiological mechanism. Favorable vascular outcomes can also be speculated considering the reduction in serum hs-CRP levels.

Background and aim: We aimed to investigate the role of the Duke treadmill score (DTS) in predicting the presence and severity of coronary artery disease (CAD) by using the SYNTAX score (SS), and also to determine the cut-off value of DTS for both the presence and severity of CAD. Methods: The study population consisted of 267 patients admitted to the outpatient clinic with chest pain, who under­went coronary angiography after a positive treadmill stress test. First the patients were divided into two groups: SS = 0 and SS > 0. Then the SS > 0 patients were classified into two subgroups with low (1–22) and high (> 22) SS. Results: There was a strong negative correlation between DTS and SS (r = –072, p < 0.001). The area under the receiv­er-operating curve of DTS was 0.83 (0.77–0.88, p < 0.001) for predicting a significant presence of CAD. The optimal cut-off value of DTS to predict the significant presence of CAD was –3.7 (sensitivity of 74% and specificity of 73%). The area under the receiver-operating curve of DTS was 0.84 (0.78–0.90, p < 0.001) for predicting high SS. The optimal cut-off value of DTS to predict high SS was –11.2 (sensitivity of 81% and specificity of 80%). DTS was found to be an independent predictor of high SS in multivariate analysis. Conclusions: DTS can predict the presence and severity of stable CAD before coronary angiography and may enable the estimation of the revascularisation method that will be required after the procedure. Background and aim: We aimed to investigate the role of the Duke treadmill score (DTS) in predicting the presence and severity of coronary artery disease (CAD) by using the SYNTAX score (SS), and also to determine the cut-off value of DTS for both the presence and severity of CAD. Methods: The study population consisted of 267 patients admitted to the outpatient clinic with chest pain, who under­went coronary angiography after a positive treadmill stress test. First the patients were divided into two groups: SS = 0 and SS > 0. Then the SS > 0 patients were classified into two subgroups with low (1–22) and high (> 22) SS. Results: There was a strong negative correlation between DTS and SS (r = –072, p < 0.001). The area under the receiv­er-operating curve of DTS was 0.83 (0.77–0.88, p < 0.001) for predicting a significant presence of CAD. The optimal cut-off value of DTS to predict the significant presence of CAD was –3.7 (sensitivity of 74% and specificity of 73%). The area under the receiver-operating curve of DTS was 0.84 (0.78–0.90, p < 0.001) for predicting high SS. The optimal cut-off value of DTS to predict high SS was –11.2 (sensitivity of 81% and specificity of 80%). DTS was found to be an independent predictor of high SS in multivariate analysis. Conclusions: DTS can predict the presence and severity of stable CAD before coronary angiography and may enable the estimation of the revascularisation method that will be required after the procedure.

To analyze (1) the sex-specific and age-bracket defined all-cause and coronary mortality in the 23-years' follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes Association without the use of glycated hemoglobin. Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket 45-74 years disclosed coronary mortality to be 7.5/1000 person-years in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in overall mortality seemed to halt as well. Of greatest concern was the finding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually. Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies.

Aortic stiffness increases in patients with erectile dysfunction (ED) but it is not known whether aortic stiffness affects the degree of ED. In the present study, we aimed to determine whether there is any relationship between aortic stiffness and the severity of ED. Patients with ED were divided into 3 groups according to the International Index of Erectile Function (IIEF) scores. Mild ED was named as group 1, moderate ED as group 2 and severe ED as group 3. The values of fasting blood glucose (FBG), serum lipid values, total testosterone (T. tes), and free testosterone (F tes) were recorded. Aortic stiffness was determined by pulse wave velocity (PWV) and augmentation index (AIX) measurements. The mean or median values of the laboratory parameters among the groups were similar (p > .05). No statistical difference was found between the groups in terms of AIX value (p = .386). Mean PWV values were calculated as 7.26, 8.30 and 8.78 in group 1, group 2 and group 3 respectively. PWV values were significantly different between groups (p < .0001). PWV values were found to be increased with increasing severity of erectile dysfunction.

Objective Our study is designed to evaluate the plasma BNP levels in patients with pure MS and its possible correlation with clinical and echocardiography parameters of the disease. Methods and results The study included 29 patients (27 women, 2 men, mean age 43.4 ± 11.8 y) with pure mitral valve stenosis in sinus rhythm and 24 age-and gender-matched healthy voluteers (17 women, 7 men, mean age 42 ± 13 y). Plasma BNP levels were significantly higher in the mitral stenosis group compared to controls (91.1 ± 69.6 pg/ml vs 14.4 ± 9.2 pg/ml, P < 0.0001). In univariate analysis, plasma BNP levels correlated positively with left ventricular end-systolic diameter (r = 0.439, P=0.041), left atrial diameter (r = 0.772, P < 0.001), peak diastolic transmitral gradient (r = 0.621, P=0.003), mean diastolic transmitral gradient (r = 0.751, P < 0.001), peak systolic pulmonary artery pressure (r = 0.467, P=0.044), functional capacity (r = 0.819, P < 0.001) and negatively with left ventricular ejection fraction (r = -0.482, P=0.020) and planimetric mitral valve area (r = -0.494, P=0.006). No significant correlation existed between age, end-diastolic diameter and right ventricular diameter (r=0.185, P = 0.337; r=0.227, P = 0.309; r=0.319, P = 0.092; respectively). A receiver operating characteristic (ROC) curve identified a BNP value of 32 pg/ml as the best cut-off for the identification of patients with mitral stenosis with a positive predictive value of 100% and a negative predictive value of 75%. Conclusions In this study we found elevated plasma BNP levels in patients with pure MS in sinus rhythm. Plasma BNP levels correlated with disease severity and this can have potential clinical implications, for example in patients undergoing percutaneous balloon mitral valvuloplasty or in patients with poor echocardiographic windows.