Introduction: This study aims to compare the addition of SGLT2 inhibitors or doubling the diuretic dose in patients receiving treatment with beta-blockers, angiotensin-converting enzyme inhibitors (ACEi), or angiotensin receptor blockers (ARB), as well as mineralocorticoid receptor antagonists (MRA), for heart failure with reduced ejection fraction (HFrEF) who present to the emergency department with decompensated heart failure. Methods: This study is a single-center and prospective analysis. A total of 980 decompensated heart failure (HFrEF) patients receiving optimal medical therapy (OMT) according to the 2021 European heart failure guidelines were randomized in a 2:1 ratio into the furosemide and empagliflozin treatment arms. The analysis includes patient clinical characteristics, laboratory results, and echocardiographic data. Factors influencing rehospitalization were identified through multivariate Cox regression analysis. Log-rank analysis was employed to assess factors affecting rehospitalization. Results: The mean age of the patients was 67.9 years, with 52.1% being men. There was no significant impact of demographic, clinical, or echocardiographic factors on rehospitalization at 1 month; only the effect of treatment subgroups on rehospitalization was observed ( p = 0.039). Significant echocardiographic and clinical improvements were seen in both treatment arms. The empagliflozin group exhibited significant improvements in 6-min walk distance, heart rate, body weight, NT-pro BNP levels, and eGFR level compared to the furosemide group. The rate of rehospitalization in the first month was significantly lower in those receiving empagliflozin (28.7%) compared to those receiving a double dose of furosemide (40.2%) (log-rank p = 0.013). Discussion and conclusion: This study provides valuable insights into the management of decompensated HFrEF and demonstrates that SGLT2 inhibitors offer benefits beyond glycemic control in this patient group. The significant reduction in rehospitalization rates and improvements in echocardiographic parameters underscore the potential of SGLT2 inhibitors in reducing acute heart failure episodes.

Background/Objectives: The only intravenous P2Y12 inhibitor used in the management of acute and chronic coronary syndromes is cangrelor. Previous studies have demonstrated the efficacy of cangrelor. However, limited real-world data are available for cangrelor usage. This study aimed to investigate the use of cangrelor in large-volume percutaneous coronary intervention (PCI) centers in Türkiye, and examine the indications, patient characteristics, bleeding, and ischemic events. The efficacy and safety of cangrelor in this high-risk group were evaluated. Methods: This study was conducted retrospectively in 14 high-volume centers in Türkiye with extensive cangrelor experience. Cangrelor indications, patient clinical characteristics, periprocedural and postprocedural treatments, in-hospital and follow-up bleeding, ischemic events, and mortality were analyzed. Results: This study recruited 411 patients (mean age: 63.8 ± 12.7 years; 76% male). The most common conditions in which cangrelor is used in Türkiye are cardiogenic shock, intubation and nausea/vomiting, where P2Y12 cannot be used adequately due to impaired oral intake. The incidence rate of any bleeding within 48 h was 6.4% (n = 26), with major bleeding accounting for 1.7% of all cases (n = 7). The bleeding rates were similar between patients aged <75 years and those aged ≥75 years (6.0% vs. 8.8%, p = 0.326), as well as between patients with chronic kidney disease (CKD) and those without CKD (6.3% vs. 7.9%, p = 0.600). Conclusions: This is the first multicenter, large-cohort study to examine cangrelor use in Türkiye, providing real-world evidence for the efficacy and safety in high-risk patients with complex clinical features and lesion characteristics.

OBJECTIVE: Coronary artery disease is still one of the leading health problems. This causes an increase in the diagnosis and treatment procedures for heart diseases. However, it also causes an increase in complications associated with these procedures. One of these complications is pseudoaneurysms. In this study, we aimed to discuss whether hematological and biochemical parameters can be useful in predicting the development of pseudoaneurysm according to the results of peripheral whole blood counts taken before coronary angiography in patients who underwent pseudoaneurysm surgery in our clinic.MATERIAL AND METHODS: The data of 7368 patients who underwent elective coronary angiography with a preliminary diagnosis of coronary artery disease in our hospital between January 2017 and December 2019 were retrospectively reviewed. Data of 88 patients who met the inclusion criteria in our study were examined.RESULTS: Pseudoaneurysm was more frequently located in the male gender (% 60), right lower externity (% 76.4) and the common femoral artery (%71.4). When compared to Group 1, in Group 2, which developed pseudoaneurysm, The patients in group 2 who developed pseudoaneurysm compared to group 1, white blood cell count (WBC) (p: 0.042), Neutrophil to Lymphocite Ratio (NLR) (p: 0.029) and blood urea nitrogen (BUN) (p: 0.050) values were higher before the procedure, Hemoglobin (Hb) (p<0.001), Hematocrit (htc) (p<0.001), and albumin (p: 0.026) values were lower and there was a statistically significant difference. There was no statistically significant difference between Platelet to Platecrite Ratio (PPR) (p: 0.205), Platelet to Neutrophil Ratio (PNR) (p: 0.205), platelet (p: 0.103), total protein (p: 0.061), creatine (p:0.060) and Platecrit (p: 0.151) values.