Background: Acute kidney injury (AKI) is a frequent complication following transcatheter aortic valve implantation (TAVI) and has been linked to increased mortality. However, the temporal pattern of this association remains uncertain. This study aimed to evaluate the time-dependent impact of AKI on mortality after TAVI using advanced survival analyses. Methods: We retrospectively analyzed 381 consecutive patients who underwent transfemoral TAVI between December 2016 and October 2024 at two tertiary cardiovascular centers. AKI was defined according to the Acute Kidney Injury Network (AKIN) criteria. The primary outcome was all-cause mortality. Patients were categorized into AKI and non-AKI groups. Clinical outcomes, including 30-day, 1-year, and overall mortality, were evaluated. Results: Among 381 patients who underwent TAVI, 59 (15.5%) developed AKI according to the AKIN criteria. During a 33.9 months (18.0–59.2) median follow-up of overall mortality was significantly higher in the AKI group compared with those without AKI. In the multivariate Cox regression analysis, AKI was significantly associated with long-term mortality (HR: 2.07, 95% CI 1.32–3.25; p = 0.002). The time-varying hazard ratio curve demonstrated that the excess mortality risk associated with AKI was most pronounced in the early period and gradually declined thereafter. In time-interval–specific analyses, AKI was strongly associated with mortality within the first month (HR 6.30, 95% CI 3.03–13.08, p < 0.001) and remained significant up to 12 months (HR 2.18, 95% CI 1.32–3.59, p = 0.002). Beyond the first year, this association attenuated and lost statistical significance at 12–36 months (HR 0.90, p = 0.79), 36–60 months (HR 0.57, p = 0.24), and >60 months (HR 0.43, p = 0.13). Conclusions: AKI is an important predictor of early and mid-term mortality following TAVI, but its long-term prognostic impact is less pronounced. Preventive strategies and early management of AKI may improve outcomes in this high-risk population.

Parkinson’s disease (PD) is the second most common degenerative disease which may cause blood pressure abnormalities due to autonomic dysfunction. Early morning rise of blood pressure which is called morning surge is found to be related with some cardiovascular diseases when it is exaggerated. We wanted to search the relation of Morning blood pressure surge (MBPS) and inflammation in PD. Method: Ambulatory blood pressure monitoring for 24 hours, fibrinogen to albumin ratio, hs-CRP are used in this retrospective study. Fifty idiopathic PD patients and 50 age and sex matched control cases were included. MBPS, it has been defined as the difference between morning BP (measured 2 hours after awakening) and the lowest night-time BP. Body mass index (BMI) is used as an independent variable. Results: Median value of MBPS for PD group (21,63) was significantly different from the control group values (18,63) (p

Background/Objectives: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with significant morbidity, including stroke, heart failure, and increased mortality, necessitating oral anticoagulant (OAC) therapy to reduce thromboembolic risk. However, OACs, including warfarin and non-vitamin K antagonist oral anticoagulants (NOACs), increase the risk of gastrointestinal (GI) bleeding, a serious complication requiring precise risk stratification in the emergency department (ED). Methods: This retrospective cohort study was conducted in the Emergency Department of Balikesir University Hospital in Turkey between 2019 and 2023 and evaluates systemic inflammatory markers as predictors of GI bleeding in AF patients receiving OACs. A total of 155 patients were divided into case (GI bleeding) and control (no GI bleeding) groups, comparing demographics, comorbidities, CHA₂DS₂-VASc and HAS-BLED scores, and inflammatory indices (uric acid/albumin ratio, neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune inflammation index [SII]). Results: For patients receiving NOACs, the case group exhibited significantly higher uric acid/albumin ratio, NLR, PLR, and SII (p < 0.05). For patients receiving warfarin, only the uric acid/albumin ratio was significantly elevated (p < 0.001). Hypolipidemia and elevated uric acid were associated with bleeding risk in patients receiving NOACs, while hypoalbuminemia and elevated urea predicted bleeding in patients receiving warfarin. HAS-BLED scores were significantly higher in bleeding groups, unlike CHA₂DS₂-VASc scores. Conclusions: These findings suggest that inflammatory indices, particularly in patients taking NOACs, are associated with GI bleeding risk stratification. Integrating these biomarkers into clinical practice could optimize personalized anticoagulation strategies, reducing morbidity and mortality in AF patients.

Background and Objectives: The Naples Prognostic Score (NPS), a composite index indicative of nutritional and inflammatory status, has been suggested as an important prognostic marker. Uric acid, an indicator of oxidative stress and endothelial impairment, is also associated with cardiovascular risk. This study sought to examine the synergistic value of NPS and uric acid levels in forecasting long-term major adverse cardiovascular and cerebrovascular events (MACCE) in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI), using time-varying hazard ratio and time-dependent Receiver Operating Characteristic (ROC) analyses. Materials and Methods: A retrospective analysis was conducted on 288 patients diagnosed with CCS from January 2020 to November 2023. The NPS was determined utilizing serum albumin, total cholesterol, the neutrophil-to-lymphocyte ratio (NLR), and the lymphocyte-to-monocyte ratio (LMR). Cox regression, time-varying hazard ratio models, and time-dependent ROC curve analyses were performed to assess both temporal risk patterns and predictive performance. The principal endpoint was the incidence of MACCE. Results: Major adverse cardiovascular and cerebrovascular events (MACCE) occurred in 69 individuals, representing 23.4% of the total cohort. Both high NPS and elevated uric acid were independently associated with an increased risk of MACCE. The integration of the NPS with uric acid showed superior discriminative and reclassification capabilities compared to the use of each marker independently (p < 0.05 for all). Time-varying hazard ratio analyses demonstrated that the prognostic impact of the NPS was more pronounced in the early follow-up, while the effect of uric acid became stronger in the late phase. Time-dependent ROC analyses confirmed that the combined use of the NPS and uric acid provided superior predictive accuracy compared with either parameter alone across the follow-up period. Conclusions: NPS and uric acid offer complementary prognostic information in CCS. Their combined assessment improves long-term risk stratification, while time-varying and time-dependent analyses reveal that their predictive effects evolve dynamically throughout follow-up. This integrated evaluation may improve clinical decision-making and risk stratification in routine practice.

Background/Objectives: One of the most prevalent reasons for attending the emergency department (ED) is chest pain. There are many causes of its etiology. Recent studies indicate that coronary slow flow should be considered not only an angiographic phenomenon but also a clinical syndrome. In our study, we aimed to identify laboratory parameters indicative of coronary slow flow. Methods: Patients who presented to the Emergency Department of Balikesir University Hospital with chest pain and underwent coronary angiography between 2019 and 2023 were evaluated. A group of 107 patients with primary coronary slow flow was included as the patient group, while 108 patients without any pathology were included as the control group. Demographic, laboratory, clinical, and angiographic parameters were compared between the two groups to determine the predictors of coronary slow flow. Results: In our study, RCA dominance was detected in the control group, while Cx dominance was detected in our patient group (p < 0.001). CRP and the CRP/albumin ratio were observed to be higher in the patient group (p < 0.001). Conclusions: The inflammatory markers CRP and CRP/albumin ratio were found to be statistically significantly higher in the patient group. These parameters can be used to predict coronary slow flow in the emergency department.

Objective: Coronary artery tortuosity (CAT) is frequently observed in invasive angiography, though its aetiology and clinical significance remain ambiguous. The aim of our study was to investigate the parameters affecting CAT in patients without normal coronary artery disease (CAD). Materials and Methods: 110 patients with CAT and no CAD and and 140 patients with no CAT and CAD were evaluated retrospectively. CAT was defined by ≥3 bends with a change in vessel direction of ≥45° present in both systole and diastole along the main trunk of at the least one coronary artery. Demographic, biochemical, echocardiogrphic and angiographic parameters were compared between groups. Results: Patients with CAT were older and more often female gender. 24 (21.8%) were males and 86 (78.2%) were females in patients with CAT. The mean age of the patients with CAT were 61.4±10.6 years and the control group was 55.9±10.9 years. Among the patients with CAT, 62.7% had hypertension, 27.3% had diabetes mellitus and 30% were smokers. But, there was not significant difference between groups (p=0.469, p=0.446, p=0.242, respectively) . Left anterior descending artery (LAD) was the most commonly affected tortuous coronary artery (86.4%). Multivariate analysis showed significant relationship between age (p=0.019), female gender (p