Background/Objectives: Familial hypercholesterolemia (FH) is a monogenic dyslipidemia that leads to early cardiovascular events. Subclinical atherosclerosis refers to the formation of atheromatous plaques in arterial beds before any clinical events. In our study, we investigated the presence, extent, and independent predictors of subclinical atherosclerosis among patients diagnosed with FH. Methods: This was a single-center, prospective, and cross-sectional study. This original study included 215 patients diagnosed with FH from a cohort of 1145 individuals assessed according to the Dutch Lipid Clinical Network (DLCN) criteria. Carotid and femoral ultrasonography were performed, and the coronary artery calcium score was measured to screen for subclinical atherosclerosis. Apolipoprotein A-I, apolipoprotein B, and lipoprotein (a) were analyzed using the nephelometric method. Results: The study cohort comprised 136 females (63%) with a mean age of 54 (43–62) years. The stigmata rate was 18%. The rate of statin use during subclinical atherosclerosis screening was 32% and only eight patients (4%) attained LDL-C values < 70 mg/dL. Subclinical atherosclerosis was observed in 148 patients (69%), with rates of 48%, 47.5%, and 40.5% in the coronary arteries, carotid bifurcation, and femoral bifurcation, respectively. Advanced age, male sex, high pretreatment low-density lipoprotein-cholesterol (LDL-C) level, diabetes, and a low Apo A-I/Apo B ratio were identified as independent predictors of subclinical atherosclerosis. Lp(a) levels ≥ 30 mg/dL predicted coronary atherosclerosis, while diabetes and low Apo A-I/Apo B ratios predicted carotid atherosclerosis, and smoking predicted femoral atherosclerosis. Conclusions: Subclinical atherosclerosis is prevalent, and medication adherence remains suboptimal among FH patients. Screening for subclinical atherosclerosis may impact the treatment strategies, via an increase in physician commitment to treatment protocols and improving patient compliance.

This study aims to contribute to the literature by developing an advanced Long Short-Term Memory (LSTM) model that classifies and predicts the duration of patients' daily physical activities (resting, light, moderate, intense) using heart rate data. This approach is an innovative step towards personalizing cardiac rehabilitation programs and accurately monitoring patients' daily activity levels. The application of this model aims to allow healthcare professionals to objectively track patients' activity levels. Data collection was conducted at the Istanbul University - Cerrahpaşa, Cardiology Institute exercise test laboratory during the years 2023–2024. Heart rate (bpm) of the patients was recorded through a Garmin watch worn on the wrist during exercise tests conducted using the Modified Bruce Protocol. The study included patients aged between 18 and 85 with medium-risk pre-test probability for coronary artery disease. The collected data underwent preprocessing, including synchronization of heart rate data with exercise test records and removal of inconsistent or illogical data points. LSTM model was chosen for analyzing sequential data related to heart rate over time. The model consisted of two LSTM layers and one output layer, achieving a prediction accuracy of 59.1% on the test dataset. Further efforts are underway to enhance the model's performance within the project scope. This research underscores the importance of objective activity tracking and highlights the potential to fill existing gaps in this field. The developed model, based on heart rate data collected via wearables, is expected to serve as an objective tool for monitoring cardiac rehabilitation processes and daily activity levels. By evaluating data collected through wearables, the model facilitates the calculation of individuals' durations of rest, light, moderate, and high-intensity activities throughout the day, contributing to personalized health care practices.

Remnant cholesterol (RC) has been implicated in the progression of atherosclerotic cardiovascular disease. However, the impact of RC levels on the occurrence of no-reflow in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI) remains poorly understood. Patients were classified into 2 groups: those (n = 90) who developed no-reflow (+) and those (n = 350) who did not develop no-reflow (−). RC was calculated as total cholesterol minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). RC (Odds Ratio [OR] = 1.28, P < .001), diabetes mellitus (OR = 2.72, P = .002), stent length (OR = 1.07, P = .020), door-to-balloon time (OR = 1.04, P = .047), symptom-to-admission time (OR = 2.07, P = .002) and presence of thrombus (OR = 2.34, P < 0.001) were independent predictors of no-reflow. RC was shown to predict no-reflow development (Area under the curve [AUC] = 0.923, P < .001). The present study revealed a significant association between RC levels and the occurrence of the no-reflow phenomenon following pPCI in patients with STEMI. Assessment of RC levels may assist in identifying high-risk groups in STEMI patients and may prove to be an important factor to manage for cardiovascular health.

Aim: The potential effects of diabetes duration and glycemic control on ejection fraction (EF) in patients with heart failure (HF) remain unclear. We investigated the impact of diabetes duration and glycemic control on ejection fraction (EF), alongside other risk factors, in HF patients with type 2 diabetes mellitus (T2DM). Materials and methods: This single-center retrospective study included 1265 patients who were admitted and discharged with a diagnosis of HF between January 2010 and January 2022, all of whom had a known diagnosis of T2DM prior to admission. The patients included in the study were divided into two groups: those with heart failure and reduced ejection fraction (HFrEF, EF ≤ 40%) and those with or mid-range or preserved ejection fraction (HFmrEF + HFpEF, EF > 40%). Results: Among the 1265 patients, 697 had HFrEF. The duration of diabetes was significantly longer (13 vs. 7 years, p < 0.001) and HbA1c levels were higher (8.4 ± 1.6% vs. 7.7 ± 1.5%, p < 0.001) in the HFrEF group. Multivariable analysis identified diabetes duration (OR 2.23, p < 0.001), hypertension (OR:6.62, p < 0.001), and the use of oral antidiabetic agents (OR 0.74, p = 0.042) as independent predictors of reduced EF. Prolonged diabetes duration was associated with a reduction in EF (AUC = 0.780, p < 0.001). Conversely, although glycemic control was poorer in the HFrEF group, it was not an independent predictor of EF. Conclusion: Prolonged diabetes duration significantly reduces EF, among HF patients with T2DM, independent of glycemic control and other risk factors. While poor glycemic control was more prevalent in HFrEF patients, it did not independently affect EF.

Background/Objectives: Familial hypercholesterolemia (FH) is a monogenic dyslipidemia that leads to early cardiovascular events. Subclinical atherosclerosis refers to the formation of atheromatous plaques in arterial territories before any clinical events. In our study, we investigated the presence, extent and independent predictors of subclinical atherosclerosis among patients diagnosed with FH. Methods: This was a single-center, prospective and cross-sectional study involving a cohort of 215 patients diagnosed with FH. Carotid and femoral ultrasonography were performed, and coronary artery calcium score was measured to screen for subclinical atherosclerosis. Apolipoprotein A-I, apolipoprotein B and Lipoprotein (a) were analyzed using the nephelometric method. Results: The study cohort comprised 136 females (63%) with a mean age of 54 (43–62) years. The stigmata rate was 18%. The rate of statin use during subclinical atherosclerosis screening was 32% and only eight patients (4%) attained LDL-C values

New-onset atrial fibrillation (NOAF) is a frequent complication among patients with non-ST-elevation myocardial infarction (NSTEMI) and is associated with adverse outcomes, making early identification of predictors essential for risk stratification and management. This retrospective cohort study evaluated the prognostic value of the Clinical SYNTAX score (CSS) compared with the anatomical SYNTAX score (SS), GRACE, and CHA2DS2-VASc scores in predicting in-hospital NOAF and long-term outcomes among 979 NSTEMI patients undergoing coronary angiography. Predictors of NOAF, all-cause mortality, and major adverse cardiovascular events (MACEs: death, myocardial infarction, stroke) were identified using logistic and Cox regression models, with receiver operating characteristic (ROC) analysis used to compare the discriminative power of CSS against SS, GRACE, and CHA2DS2-VASc over a median follow-up of 86 months (IQR 36–100; range 0.1–144). NOAF developed in 80 patients (8.2%), with age, female gender, left atrial diameter, left ventricular diastolic dysfunction, and CSS (p = 0.014) identified as independent predictors. CSS’s AUC for predicting NOAF (0.724; 95% CI: 0.673–0.775) was significantly higher than SS’s (0.644; 95% CI: 0.588–0.699; DeLong p < 0.001) and comparable to that of the CHA2DS2-VASc and GRACE scores; a CSS threshold ≥ 17.77 predicted NOAF with 75% sensitivity and 65% specificity. In Cox regression analysis, in-hospital NOAF, age, hypertension, reduced ejection fraction (<60%), and CSS independently predicted long-term all-cause mortality, while NOAF, EF < 60%, age, early AF recurrence, hypertension, and CSS independently predicted MACEs; SS was not a significant predictor in either model. In non-overlapping multivariable models, this advantage reflected the contribution of CSS’s clinical components rather than incremental value of the composite score; CSS nonetheless remained an independent predictor of NOAF and long-term outcomes and may serve as a practical single-score tool for risk-guided management.