Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents 5% to 10% of acute myocardial infarction cases. The Fibrosis-4 (FIB-4) index and non-alcoholic fatty liver disease (NAFLD) are emerging markers of systemic inflammation and metabolic dysfunction, yet their prognostic role in MINOCA remains unexplored. This prospective cohort study included 472 consecutive MINOCA patients from a tertiary cardiac center between September 2022 and October 2025. Patients were stratified by FIB-4 index (high ≥1.3, low <1.3). NAFLD was diagnosed using hepatic steatosis index. The primary endpoint was major adverse cardiovascular events (MACE): cardiovascular death, recurrent myocardial infarction, urgent revascularization, or hospitalization for heart failure or arrhythmia during 36-month follow-up. High FIB-4 index was independently associated with increased MACE risk (hazard ratio [HR]: 2.34, 95% confidence interval [CI]: 1.45-3.78, P < .001). NAFLD presence further augmented this risk (HR: 1.89, 95% CI: 1.23-2.91, P = .004). Patients with both high FIB-4 and NAFLD demonstrated worst outcomes (HR: 3.12, 95% CI: 1.87-5.21, P < .001). FIB-4 showed good discriminative ability for MACE prediction (AUC: 0.712, 95% CI: 0.665-0.759). FIB-4 index and NAFLD are independent predictors of adverse outcomes in MINOCA patients, offering simple, cost-effective tools for risk stratification.

Acute myocardial infarction,coronary artery disease,preventive cardiology,PTCA/PCI

Objectives: To investigate the diversity and average values of bifurcation angles in a large population to help develop new methods. Methods: One thousand five individuals (504 females, 501 male) who visited the Cardiology Polyclinic of Firat University Hospital with the complaint of chest pain between 2010 and 2015 were evaluated retrospectively. Bifurcation angle measurements between LMCA-CX, CX-LAD, LMCA-LAD, CX-OM1, CX-OM2, LAD-D1, LAD-D2, RCA-RMD, RCA-RVD and PDA-PL were evaluated in all cases. Results: Bifurcation angles between LMCA-LAD, LMCA-Cx and LAD-Cx branches with "> 90 wide angle bifurcations", and Cx-OM1, Cx-OM2, LAD-D1, LAD-D2, RCA-RMD and PDA-PL with "<70 Y type bifurcation angle" were found to be high in male and female individuals. The RCA-RVD in female individuals was " 70-90 T-type bifurcation" in 209 (41.5%) people, and "> 90 wide angle bifurcation" in 281 (55.8%) people. Results for male subjects were compatible with this. The correlations of all angles were examined. Robust positive correlations (p <= 0.001) were found for the angular measurements between the main branches and the side branches (Cx-OM1, Cx-OM2, LAD-D1, LAD-D2 and RCA-RMD, PDA-PL). Conclusion: With the help of developing technology, we believe that all this coronary angiography data will guide bifurcation stent techniques, which are essential alternatives to bypass.

Background: Residual arrhythmic risk persists in recipients of implantable cardioverter-defibrillators (ICDs) despite guideline-based selection, and inexpensive markers that refine this risk are needed. The monocyte-to-high-density-lipoprotein ratio (MHR) integrates a pro-inflammatory (monocyte) and an anti-inflammatory/antioxidant (HDL) signal in a single index derived from routine blood work. We examined whether MHR is associated with ventricular arrhythmia in ICD patients. Methods: In this cross-sectional study we assessed 382 ICD recipients attending a device outpatient clinic and classified them by a composite ventricular arrhythmia outcome (non-sustained ventricular tachycardia, sustained ventricular tachycardia, or ventricular fibrillation) documented on device interrogation. MHR and comparator inflammatory markers were measured at the same visit. Discrimination was assessed by receiver operating characteristic (ROC) analysis, the optimal threshold by the Youden index, and independence by multivariable logistic regression; internal validity was examined with repeated cross-validation, bootstrap optimism correction, and calibration testing. Results: The ventricular arrhythmia outcome was present in 58 patients (15.2%). MHR was higher in patients with the outcome (median 16.3 vs. 12.3, p < 0.001) and discriminated it with an area under the curve (AUC) of 0.756 (95% CI 0.673–0.828). At the optimal threshold of 15.71, sensitivity was 63.8% and specificity was 83.3%, with a negative predictive value of 92.8%; the outcome was present in 40.7% of patients above versus 7.2% below this cut-off. MHR remained independently associated with the outcome after adjustment for age, left ventricular ejection fraction, etiology, and renal function (odds ratio 1.23 per unit, 95% CI 1.16–1.32; p < 0.001) and outperformed high-sensitivity C-reactive protein (DeLong p < 0.001). Discrimination was preserved in both ischaemic and non-ischaemic cardiomyopathy without interaction by etiology (p = 0.67). The model was stable on internal validation (cross-validated AUC 0.761; optimism 0.021; Hosmer–Lemeshow p = 0.66). Conclusions: MHR is independently associated with documented ventricular arrhythmia in ICD patients and, being derived from routine tests, may warrant prospective evaluation as a low-cost adjunct for risk stratification.