Background/Objectives: To evaluate the prognostic role of the inflammatory prognostic index (IPI) value at admission in major adverse cardiovascular and cerebrovascular events (MACCEs) in individuals with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). Methods: A total of 1142 NSTEMI patients with a mean age of 61.9 ± 12.5 years were included. Admission C-reactive protein level, serum albumin level, and complete blood counts of participants were collected from hospital records. The IPI was calculated based on the following formula: C-reactive protein/albumin ratio (CAR) x neutrophil-to-lymphocyte ratio (NLR). An aggregate index of systemic inflammation (AISI) value was calculated using the ‘‘neutrophil count x monocyte count x platelet/lymphocyte count’’ formula. The study cohort was divided into two groups according to the median IPI value. Results: Patients with higher IPI values were statistically more likely to suffer from MACCEs within one year (p < 0.001), thus the admission IPI value was found to be associated with future development of MACCEs. Furthermore, it had sufficient discrimination power (AUC = 0.70) and predictive accuracy in identifying MACCEs compared to other inflammatory parameters such as the CAR (AUC = 0.64), the NLR (AUC = 0.64), and the AISI (AUC = 0.59). Adding the IPI to the baseline multivariable logistic regression model significantly improved the model’s discrimination and net clinical benefit effect for identifying patients who would suffer from MACCEs, with a C-index of 0.84 (95% CI: 0.82–0.86) and explanatory power of 23.2% (R² = 0.232, DeLong test p = 0.001). High-risk patients with an IPI value greater than 2.43 had significantly more adverse events (p < 0.001). Conclusions: The IPI may be a promising inflammatory index for use in clinical practice to determine the risk prediction of MACCEs in NSTEMI patients undergoing PCI.

In this study, we aimed to compare the management and clinical outcomes of patients with acute coronary syndrome (ACS) before and during pandemic. A total of 239 patients with ACS were enrolled into the study. Patients who were admitted during pandemic were compared with pre-pandemic patients according to their demographic, biochemical, angiographic features, revascularisation strategies and clinical outcomes. During the pandemic period, we observed an increase in total number of patient with ST elevation myocardial infarction patients compared to the pre-pandemic period. Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients (1953 pg/ml versus 259 pg/ml for troponin I and 14 ng/ml versus 6 ng/ml for CK-MB p < 0.0001, p = 0.02, respectively). Type 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative to the pre-pandemic group (10 versus 0, p = 0.003). Post-procedural TIMI flow grade was lower in the pandemic group and distal embolisation and TIMI thrombus score were significantly higher in the pandemic group compared to the pre-pandemic group (p = 0.001, p = 0.02, and p = 0.002, respectively). The number of patients who underwent bypass surgery was much lower compared to pre-pandemic period (27 versus 8, p < 0.0001). There was no statistically significant difference in hospital mortality and short-term all-cause mortality among groups (p > 0.05). Although clinical, laboratory, and angiographic features were worse in ACS patients during pandemic, the mortality rate of ACS was similar in both pre-pandemic and pandemic era. It is important to keep coronary intensive care units and catheter labs open and fully-functioning during the pandemic.

Postoperative atrial fibrillation (POAF), the pathophysiology that includes inflammation and oxidative stress, is associated with increased hospital length of stay, mortality, and complications. The uric acid-to-albumin ratio reflects the inflammatory status of the body. We sought to evaluate whether there is an association between POAF and uric acid-to-albumin ratio in patients undergoing cardiac surgery. Five hundred forty-three patients who developed POAF and 166 patients who did not formed our control and study groups, respectively. Patients who had an episode of atrial fibrillation lasting > 30 seconds were considered to have POAF. The uric acid-to-albumin ratio was calculated for each patient. Patients who developed POAF were older; had higher rates of hypertension, carotid artery disease, left atrial diameter, urea, creatinine, uric acid, and C-reactive protein levels; and had lower hemoglobin and albumin levels. The uric acid-to-albumin ratio of patients with and without POAF was 1.65 ± 0.63 and 1.26 ± 0.39, respectively (P < 0.001). Compared with uric acid and albumin, uric acid-to-albumin ratio had the highest area under the curve for predicting POAF (0.681, 0.449, and 0.702, respectively). Age and hemoglobin concentration were predictors of POAF. Although uric acid and albumin did not reach statistical significance for predicting POAF, the uric acid-to-albumin ratio had predictive value for the development of POAF. The ability of the uric acid-to-albumin ratio to predict POAF in cardiac surgery patients and its nonnegligible benefits justify its use in clinical practice.

Objectives: Rheumatoid arthritis (RA) is the most common chronic, systemic, rheumatic, autoimmune disease in adults, which has unknown etiology and targets primarily synovial tissue. Those patients have increased cardiovascular mortality based on inflammation and atherosclerosis. In our study, we evaluated great artery mechanics in newly diagnosed RA patients with inactive disease. Great artery mechanics, referred as arterial distensibility, elasticity, and compliance can be evaluated by pulse wave propagation time and pulse wave velocity. Methods: Our study included newly diagnosed and in inactive stage 25 RA patients ( mean age: 39.4±9.8 years, 21–63 years, 19 female, 6 male) and 29 healthy subjects (mean age: 36.9±9.9 years, 18–59 years, 13 female, 16 male). Aortic pulse wave propagation time and pulse wave velocitiy were determined using an automatic device, the Complior Colson (France), which allowed online recording and automatic calculation. Results: Height, waist circumference, and waist/hip ratio values were significantly higher in healthy objects. (p=0.006, p=0.030, p=0.004, respectively) pulse wave propagation time and pulse wave velocity were significantly lower and higher, respectively, in RA patients compared to healthy subjects (p=0.000, p=0.041, respectively). Conclusion: RA patients have decreased pulse wave propagation time and higher pulse wave velocity.