Introduction: The Naples prognostic score (NPS) is a novel indicator of nutritional and inflammatory statuses in cancer patients. Development of atrial fibrillation after cardiac surgery (POAF) is a common complication that increases the incidence of adverse events. Numerous studies have investigated predictors of POAF. Yet, this study is the first to evaluate the prognostic value of NPS in predicting the development of POAF. Materials and methods: The population of this retrospective single-center case–control study consisted of all consecutive patients who underwent cardiac surgery between January 2021 and December 2023. The patients included in the study sample were divided into two groups according to whether they had POAF (group POAF) or remained in sinus rhythm (group RSR). Univariate and multivariate analyses were conducted to identify the variables that significantly predicted the development of POAF. Results: This study consisted of 860 patients with a mean age of 61.77 ± 9.13 years and 77.5% (n = 667) were male. The incidence of POAF in the sample was 24.8% (n = 214). NPS was significantly higher in group POAF than in group RSR (2.18 ± 0.99 vs. 1.96 ± 1.02, P = 0.008). Multivariate analysis revealed age [odds ratio (OR): 1.242, 95% confidence interval (CI): 1.020–1.304, P < 0.001] and high NPS (OR: 1.698, 95% CI: 1.121–1.930, P < 0.010) as independent predictors of POAF. Conclusion: High NPS values, along with advanced age, were found to be strongly associated with an increased risk of developing POAF. Therefore, it is concluded that NPS is a significant and independent predictor of POAF in patients undergoing cardiac surgery.

Purpose: Immune checkpoint inhibitors (ICIs) can induce subclinical cardiac dysfunction that often goes undetected by conventional monitoring. This study evaluated whether echocardiographic global longitudinal strain (GLS) and electrocardiographic (ECG) repolarization parameters could detect early, subclinical cardiotoxicity in patients with cancer and without pre-existing cardiovascular disease undergoing ICI therapy.Methods: A observational cohort study included 74 patients with cancer treated with ICIs between January 2023 and August 2024. Echocardiographic GLS measurements and detailed ECG analyses were performed at baseline and repeated at 6 months. Cardiotoxicity was defined as a significant reduction in GLS or left ventricular ejection fraction. Correlations between GLS and ECG repolarization parameters were statistically assessed.Results: At 6 months, significant subclinical myocardial impairment was observed, with GLS decreasing from 19.40 ± 1.07% to 17.70 ± 1.62% (p<0.001). Notable ECG changes included increased QT dispersion (40.10 ± 10.55 ms to 50.20 ± 15.30 ms, p=0.001), QTc prolongation (420.45 ± 20.60 ms to 430.75 ± 25.40 ms, p=0.013), increased Tp-e interval (80.21 ± 10.45 ms to 85.30 ± 12.40 ms, p=0.021), and elevated heart rate (72.21 ± 8.40 bpm to 75.35 ± 9.15 bpm, p=0.037). GLS was negatively correlated with QT dispersion (r = -0.845, p < 0.05) and Tp-e intervals (r = -0.478, p = 0.052).Conclusion: GLS and ECG repolarization parameters, particularly QT dispersion and Tp-e intervals, effectively detect subclinical myocardial dysfunction in patients with cancer undergoing ICI therapy. These findings underscore the importance of comprehensive cardiac monitoring to enable early intervention and mitigate cardiotoxicity risk during immunotherapy.

Background: Infective endocarditis (IE) is a heterogenous infection that affects the endothelial surface of the intracardiac structures and other implanted intracardiac devices. We aimed to compare demographical characteristics, causative microorganisms, treatment, and prognosis of prosthetic and native valve endocarditis diagnosed in two separate hospitals. Material and methods: Between 2010 and 2020, patients admitted with the diagnosis of IE were retrospectively included in our multicenter study. Patients' demographic and epidemiological data, clinical characteristics, infected intracardiac structure and sort of valve, culprit microorganisms, laboratory findings, treatment manifestations and in-hospital outcomes with a period of 6 months were obtained from an electronic medical record system. Results: A total of 173 consecutive patients had diagnosed IE, 60.1% (104 patients) of them native valve endocarditis (NVE) and 39.8 % (69 patients) of them prosthetic valve endocarditis (PVE). Baseline demographic properties were not different except hypertension and atrial fibrillation. Patients with prior hypertension were 25% (26 patients) in NVE; 39.1% (27 patients) in PVE and the difference was statistically significant. Septic shock was significantly higher in the PVE group than the NVE group (7.4% versus 1%; P = .036), and also recurrent endocarditis occurred more frequently in the PVE group than the NVE group (8.8% versus 1%; P = .016). Conclusion: In our study, although we detected higher mean age, HT, RDW and atrial fibrillation rates compared with NVE, we did not detect a significant difference in mortality and morbidity.

Introduction: Coronary slow flow (CSF) is a condition commonly encountered during angiography. Recent studies have shown the adverse effects of CSF on left ventricular diastolic functions. CSF reportedly increases the novel ventricular repolarization parameters. Ranolazine is a preparation with a prominent anti-anginal activity that has positive effects on anti-arrhythmic and diastolic parameters. In this context, this study was carried out to investigate the effects of ranolazine on left ventricular diastolic functions and repolarization in patients with CSF.Material and methods: Forty-six patients with CSF and 29 control subjects were included in the patient and control groups, respectively. Both groups received ranolazine for one month and were evaluated using 12–lead electrocardiography, conventional echocardiography, and tissue Doppler imaging at the baseline and after one month of ranolazine treatment.Results: Corrected P, QT dispersion, and Tp-e interval values were significantly higher in the patient group than in the control group. There was a significant decrease in isovolumic relaxation time (IVRT) and deceleration time (DT) values after the ranolazine treatment compared to the baseline values in the patient group but not the control group. A significant increase was observed in the mean E and A velocities and the mean E/A ratio after the ranolazine treatment compared to the baseline values in the patient group. Additionally, there was a significant difference between the Tp-e interval and corrected P dispersion values measured after the ranolazine treatment compared to the baseline values in the patient group but not in the control group.Conclusion: This study's findings demonstrated that ranolazine positively affected impaired diastolic functions and repolarization parameters, particularly in patients with CSF.

Aims: Low molecular weight lipoprotein (LDL) and triglyceride (Tg), among cardiovascular disease risk factors, are replaced by markers with higher sensitivity and specificity. The atherogenic plasma index (API) has a strong predictive power for cardiovascular diseases. In our study, we aimed to compare the predictive power of API and other lipid parameters in detecting carotid artery disease (CAS) in patients with ischemic stroke. Methods: A total of 878 individuals were analyzed, and 583 patients with ischemic stroke were enrolled in this study. The patients were divided into two groups according to the presence or absence of carotid artery disease in the Doppler ultrasound examination. Demographic data and lipid parameters were compared between both groups. Results: The mean age of the patients with CAS was statistically significantly higher than the other group (74.33±11.27 vs 70.11±13.57; p=0.002). The Tg/HDL ratio was higher in patients with CAS than those without (3.80±2.83 vs 3.69±2.57; p=0.048). API was found to be statistically significantly higher in the group of patients with CAS compared to the other group (0.67±0.32 vs 0.48±0.25; p=0.024). Tg/HDL ratio and API were determined as predictive parameters for CAS in patients with ischemic cerebrovascular stroke. [OR: 1.345 (0.712-1.437); p=0.048, OR: 7.21 (0.881-8.056); p=0.023]. Conclusion: Conflicting results regarding the relation between atherosclerosis and conventional lipid parameters led to more specific subgroups being investigated. API shows a good correlation with the highly sensitive LDL subfraction in terms of atherosclerosis. API is a feasible variable predicting the presence of CAS in patients with ischemic stroke.

Resumo Fundamento A fibrilação atrial (FA) de início recente é uma complicação típica em pacientes com infarto do miocárdio com elevação do segmento ST (IAMCSST) submetidos à intervenção coronária percutânea primária (ICPp). Estudos anteriores investigaram a inflamação como um preditor de FA de início recente. O escore prognóstico de Nápoles (EPN) é um novo marcador de inflamação e estado nutricional. Objetivo O objetivo deste estudo foi avaliar o poder preditivo do EPN para FA de início recente. Métodos Este estudo incluiu 1537 pacientes com IAMCSST consecutivos submetidos a ICPp. Os pacientes que apresentaram FA de início recente durante a admissão hospitalar e aqueles que permaneceram em ritmo sinusal (RS) foram comparados em termos de características basais. Análises univariadas e multivariadas foram realizadas para identificar variáveis que predizem o desenvolvimento de FA de início recente, e p < 0,05 foi considerado estatisticamente significativo. Resultados FA de início recente foi detectada em 7,74% (n: 119) dos participantes. A idade média (67,03±13,48 vs 57,84±11,31; p <0,001) e EPN (2,53±1,17 vs 2,25±1,10, p=0,008) foram significativamente maiores no grupo FA de início recente. A análise multivariada revelou idade (razão de chances [OR]: 1,045 para um ano, intervalo de confiança [IC] de 95%: 1,019–1,071, p=0,001), EPN (OR: 1,645, IC de 95%: 0,984–2,748, p=0,037) e dimensões do átrio esquerdo (OR: 2,542 para cm, IC de 95%: 1,488–4,342, p=0,001) como preditores independentes de FA de início recente. Conclusões O EPN foi um preditor independente de FA de início recente em pacientes com IAMCSST, além de fatores clássicos como idade e dimensões do átrio esquerdo. Esse escore, principalmente relacionado a uma carga inflamatória, pode ajudar a prever a incidência de FA de início recente e selecionar melhores terapias potenciais voltadas para reduzir a inflamação após o infarto do miocárdio.