Introduction: In-stent restenosis (ISR) still constitutes a major problem after percutaneous vascular interventions and the inflammation has a pivotal role in the pathogenesis of such event. The C-reactive protein/albumin ratio (CAR) is a newly identified inflammatory biomarker, and it may be used as an indicator to predict ISR in subjects with coronary artery stenting. In light of these data, our main objective was to investigate the relationship between the preprocedural CAR and ISR in patients undergoing successful iliac artery stent implantation. Methods: In total, 138 consecutive patients who had successful iliac artery stent implantation in a tertiary heart center between 2015 and 2018 were enrolled in the study. The study population was categorized into two groups; patients with ISR and those without ISR during follow-up. The CAR was determined by dividing CRP by serum albumin. Results: In the multivariable regression analysis; the CAR (HR: 2.66, 95% CI: 1.66-4.25, P0.29 predicted ISR with sensitivity of 97.5% and specificity of 88.8% (AUC 0.94, P<0.01). Conclusion: Our findings provide evidence that the CAR may be an applicable inflammatory biomarker in predicting ISR in subjects undergoing iliac artery stenting for the treatment of peripheral artery disease (PAD). Also, the stent length and poor glycemic control were found to be associated with ISR.

Background: New-onset atrial fibrillation (NOAF) during acute ST-elevation myocardial infarction (STEMI) is common and linked to adverse outcomes. This study aimed to assess the predictive value of the age–creatinine–ejection fraction (ACEF) score for NOAF in STEMI patients. Methods: We retrospectively analyzed 951 STEMI patients who underwent primary percutaneous coronary intervention (PCI) at out tertiary center between 2020 and 2023. Patients with prior atrial fibrillation (AF), AF on admission, cardiogenic shock, heart failure, significant valvular disease, or failed PCI were excluded. Clinical, laboratory, and echocardiographic data were collected, and ACEF scores were calculated. NOAF was defined as any AF episode during hospitalization in patients without prior AF. The optimal ACEF cutoff was determined using receiver operating characteristic (ROC) curve analysis (Youden’s index), and multivariate logistic regression identified independent predictors of NOAF. Results: NOAF occurred in 63 patients (6.6%). These patients were older, more often female, and had lower systolic blood pressure, lower left ventricular ejection fraction, and higher C-reactive protein and creatinine levels (all p < 0.05). In-hospital major adverse cardiac events (MACE) and mortality were significantly higher in the NOAF group than patients in without NOAF group (22.2% vs. 6.2%, and 15.9% vs. 4.3%, respectively; p < 0.001). The ACEF score was significantly higher in patients with NOAF (1.73 ± 0.74 vs. 1.42 ± 0.64, p < 0.001). ROC analysis showed an area under curve (AUC) of 0.643 (95% CI: 0.571–0.715; p < 0.001). An ACEF score ≥1.32 predicted NOAF with 73% sensitivity and 55.6% specificity. In multivariate analysis, ACEF remained an independent predictor of NOAF (OR ~1.5, p = 0.02), but among its components, only age was independently associated with NOAF (OR ~1.03 per year, p = 0.01). Conclusions: The ACEF score modestly predicts NOAF in STEMI patients, but its predictive power only incremental to age alone. Further studies are warranted for this field.

Background and Objectives: and Objectives: Admission hyperglycemia (AH) is common in acute ST-elevation myocardial infarction (STEMI) and linked to poor prognosis. The stress hyperglycemia ratio (SHR) reflects relative hyperglycemia and may more accurately predict outcomes. This study examined AH, SHR, and in-hospital stent thrombosis (ST) in STEMI patients undergoing primary percutaneous coronary intervention (p-PCI). Material and Methods: Retrospective analysis included 1034 patients. AH was defined as glucose ≥ 11.1 mmol/L at admission. SHR was calculated as admission glucose divided by estimated average glucose derived from hemoglobin A1c (HbA1c). The primary outcome was in-hospital stent thrombosis. Patients were grouped by the occurrence of in-hospital ST. Univariable, multivariable, and LASSO (Least Absolute Shrinkage and Selection Operator) logistic regression identified predictors of ST. Results: In-hospital ST occurred in 1.5% of patients. ST patients had higher Killip class, heart rate, white blood cell, platelet counts, creatinine, AH, and SHR. SHR was an independent predictor of ST (OR 3.15, 95% CI 1.88–5.27, p < 0.001), whereas AH was not (p = 0.182). Neutrophil count, correlated with WBC, was also a significant risk factor. ROC analysis showed SHR ≥ 1.26 as an optimal cutoff predicting ST. Conclusions: SHR is a strong independent predictor of in-hospital ST after STEMI, superior to AH. Monitoring and managing stress-induced hyperglycemia play a crucial role in the setting of STEMI. Further studies are needed.

Background and Objectives: Contrast-induced nephropathy (CIN) remains a significant complication following invasive coronary procedures. The HALP score—a composite index derived from hemoglobin, albumin, lymphocyte, and platelet counts—reflects nutritional and inflammatory status and may serve as a predictive biomarker for CIN. The aim of our study is to evaluate the relationship between the HALP score and the development of CIN in non-ST segment elevation myocardial infarction (NSTEMI) patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Materials and Methods: This retrospective study included 577 NSTEMI patients who underwent CAG or PCI between December 2022 and June 2025. Patients were divided into two groups based on CIN development. The HALP score was calculated and compared between groups. Results: Of the 577 NSTEMI patients included, 74 (12.8%) developed CIN. Patients who developed CIN were significantly older and had a higher prevalence of diabetes mellitus (DM), worse baseline renal function, and lower levels of hemoglobin, albumin, HDL cholesterol, and lymphocytes (p < 0.001). They also showed higher neutrophil counts, troponin-T levels, and received greater volumes of contrast media (CM). Oral antidiabetic drug (OAD) use was positively associated with CIN, while angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use showed a negative association in univariate analysis. The HALP score was significantly lower in the CIN (+) group than CIN (−) group (15.88 ± 28.48 vs. 53.86 ± 28.48, p < 0.001). Multivariate analysis identified older age, DM, reduced left ventricular ejection fraction, elevated creatinine, increased neutrophils, lower hemoglobin, albumin, and lymphocytes, and higher CM volume as independent predictors of CIN. The HALP score remained a strong inverse predictor of CIN (OR: 0.895; 95% CI: 0.865–0.924; p < 0.001) and the Mehran score was positively associated with CIN risk (OR: 1.578; 95% CI: 1.154–2.087; p < 0.001). Covariate-adjusted receiver operating characteristic (AROC) analysis demonstrated that the HALP score showed good predictive accuracy (AUC: 0.780), with 74.3% sensitivity and 83.3% specificity at a cutoff of 24.1. Conclusions: The HALP score is a simple, accessible, and cost-effective biomarker with strong predictive value for CIN in NSTEMI patients undergoing invasive coronary procedures.

BACKGROUND Electrocardiography can predict development of postoperative atrial fibrillation (POAF). In renal transplant (RT) recipients, atrial fibrillation is associated with an increased risk of mortality, allograft failure, and stroke. Our study investigated whether P-wave dispersion (PWD) and P-wave peak time (PWPT) can predict the development of POAF in renal transplant recipients. MATERIAL AND METHODS We included 166 patients who underwent RT, divided into 2 groups based on the presence (POAF +) or absence (POAF -) of POAF. Preoperative PWD and PWPT were measured for each patient. RESULTS Smoking, hypertension (HT), chronic obstructive pulmonary disease, and coronary artery disease (CAD) were significantly more common in the POAF (+) group compared to the POAF (-) group. PreopPWD, PWPTDII, and PWPTV1 were significantly higher in the POAF (+) group compared to the POAF (-) group. Univariable logistic regression analysis showed that hypertension, chronic obstructive pulmonary disease, coronary artery disease, and electrocardiographic parameters, including preopPWD, PWPTDII, and PWPTV1, were significantly associated with POAF. Penalized regression analysis showed that HT, CAD, and preoperative PWD were independent predictors of POAF. CONCLUSIONS The integration of these non-invasive, cost-efficient, and readily accessible electrocardiographic parameters into preoperative evaluation protocols could substantially augment risk stratification paradigms, thereby facilitating the timely identification and preemptive management of patients predisposed to POAF.

Fistula from left internal mammary artery (LIMA) to pulmonary artery (PA) is rarely encountered in daily practice. In recent years, endovascular therapy options have emerged for the treatment of fistula formations and replaced with surgery. A 53-year-old man admitted to our outpatient clinic with symptoms of typical angina and shortness of breath despite optimal medical therapy. In his relevant history, he had a coronary artery bypass graft (CABG) operation in 2009 in which his LIMA was anastomosed to left anterior descending (LAD) and ramus artery sequentially. Coronary angiography including selective imaging of LIMA demonstrated a fistula formation originating from the proximal portion of the LIMA and draining to PA. After successful closure of fistula with transcatheter coil embolization, the patient was discharged without any complication and symptom. In conclusion, although LIMA to PA fistula is an infrequent clinical condition, it should be considered as a potential cause of persistent angina after CABG operation. Treatment options include conservative medical therapy, surgical ligation and endovascular interventions. The best therapy should be individualised for each patient in respect to patient's symptoms, surgical compatibility and anatomy of fistula.