Coronary artery disease (CAD) is the leading cause of death worldwide. Fragmented QRS (fQRS) has emerged as a new prognostic marker in cardiovascular disease. Coronary computed tomography angiography (CCTA) is an effective method to diagnose obstructive CAD. The degree of stenosis determines the severity of the disease. A total of 120 patients admitted to the cardiology outpatient clinic with angina pectoris symptoms were included in the study. The fQRS is defined as the presence of an additional R wave, notching of the R wave, notching of the nadir of the S wave in 2 contiguous leads, or the presence of more than one R' wave without a typical bundle branch block. CCTA was performed on patients with low-moderate risk. The patients were divided into two groups based on the presence (Group 1, n = 58 patients) or the absence (Group 2, n = 62 patients) of ≥70 % coronary artery stenosis. The baseline characteristics of the patients were not significantly different. Group 1 had a higher prevalence of DM, hyperlipidemia, smoking, and fQRS compared to Group 2 (p < 0.05, for all). When the subjects were divided into two groups, fQRS (+) and fQRS (-), a statistically significant difference was revealed between the two groups (p < 0.001). A positive correlation was found between fQRS and ≥ 70 % stenosis in CCTA. In the multivariate regression analysis, smoking and fQRS were independent predictors of ≥70 % stenosis in CCTA. According to our study, fQRS, an important ECG finding, is associated with ≥70 % stenosis in CCTA and may be evaluated for the prediction of significant coronary stenosis.

Background/Objectives: Radial artery spasm (RAS) is an important complication during transradial coronary angiography that may negatively affect procedural success and reduce patient comfort. The aim of this study was to comparatively evaluate the effects of intravenous (IV) and intra-arterial (IA) heparin administration on the development of RAS. Methods: This prospective, case-control study included a total of 223 patients undergoing transradial coronary angiography. Patients were divided into two groups as received either IV heparin (n = 77) or IA heparin (n = 146). All patients received a standard dose of unfractionated heparin (5000 IU) and an IA spasmolytic cocktail consisting of 2.5 mg verapamil and 100 mcg nitroglycerin. RAS was defined as pain during the procedure, resistance during catheter manipulation, or the need for crossover. Logistic regression analysis and receiver operating characteristic (ROC) curve analyses were performed. Results: RAS developed in 40 of 223 patients (17.9%). The incidence of RAS was significantly higher in the IA heparin group than in the IV heparin group (22.6% [33/146] vs. 9.1% [7/77]; p=0.004). Crossover to femoral access due to severe spasm was observed only in the IA group (6.2% [9/146] vs. 0% [0/77]; p=0.026). Patients who developed RAS were younger, required a greater number of catheters, had longer angiography duration, and were exposed to a higher total radiation dose (p<0.05 for all). Correlation analysis demonstrated a positive association of RAS with the number of catheters used and IA heparin administration, and a negative association with age. In ROC analysis, IA heparin administration, number of catheters used, and angiography duration showed comparable performance in predicting RAS. In multivariable logistic regression analysis, IA heparin administration and the number of catheters used were identified as independent predictors of RAS. Conclusions: During transradial coronary angiography, intravenous heparin administration significantly reduces the frequency of RAS and the associated need for femoral crossover compared with intra-arterial administration. IV heparin may be considered an easily applicable and effective strategy in clinical practice to prevent RAS.

Metabolic remodeling is increasingly recognized as a key component of cardiomyopathy, yet the circulating organic acid profile associated with this condition remains incompletely characterized. In this case–control study, we investigated differences in circulating organic acid profiles between patients with cardiomyopathy and control participants using targeted liquid chromatography–tandem mass spectrometry (LC-MS/MS). A total of 160 participants were enrolled, including 80 patients with cardiomyopathy and 80 age- and sex-comparable control participants. Circulating organic acids were quantitatively analyzed, and between-group differences were assessed using the two-sided Mann–Whitney U test with Benjamini–Hochberg false discovery rate correction; effect sizes were estimated using Cliff’s delta. Detection rates were also examined because several metabolites included values below the assay limit of detection. Sixteen metabolites remained significant after correction. Among these, 3-hydroxyisovaleric acid demonstrated the largest increase, followed by 2-oxoglutaric acid and 2-methylcitric acid. Additional elevations were observed in citric acid, malic acid, N-acetylaspartic acid, fumaric acid, and suberic acid, whereas 2-oxoadipic acid was reduced. These alterations are consistent with perturbations in mitochondrial intermediary metabolism, branched-chain amino acid catabolism, ketone body metabolism, and tricarboxylic acid cycle-related pathways. However, because comorbidities, renal function, glycemic status, and medication use differed between groups, the findings should be interpreted as phenotype-associated metabolic signals rather than cardiomyopathy-specific causal effects or validated diagnostic biomarkers. In conclusion, targeted LC-MS/MS-based organic acid profiling reveals an altered circulating metabolic pattern in cardiomyopathy, although further prospective studies with individual-level adjustment and external validation are required to determine its clinical relevance.

Background/Objectives: Radial artery spasm (RAS) is an important complication during transradial coronary angiography that may negatively affect procedural success and reduce patient comfort. The aim of this study was to comparatively evaluate the effects of intravenous (IV) and intra-arterial (IA) heparin administration on the development of RAS. Methods: This prospective, observational parallel-group cohort study included a total of 223 patients undergoing transradial coronary angiography. Patients were divided into two groups, receiving either IV heparin (n = 77) or IA heparin (n = 146). All patients received a standard dose of unfractionated heparin (5000 IU) and an IA spasmolytic cocktail consisting of 2.5 mg verapamil and 100 mcg nitroglycerin. RAS was defined as pain during the procedure, resistance during catheter manipulation, or the need for crossover. Logistic regression analysis and receiver operating characteristic (ROC) curve analyses were performed. Results: RAS developed in 40 of 223 patients (17.9%). The incidence of RAS was significantly higher in the IA heparin group than in the IV heparin group (23.3% [34/146] vs. 7.8% [6/77]; p = 0.004). Crossover to femoral access due to severe spasm was observed only in the IA group (6.2% [9/146] vs. 0% [0/77]; p = 0.026). Patients who developed RAS were younger, required a greater number of catheters, had longer angiography duration, and were exposed to a higher total radiation dose (p < 0.05 for all). In ROC analysis, the number of catheters used and angiography duration showed comparable performance in predicting RAS. In multivariable logistic regression analysis, IA heparin administration and the number of catheters used were identified as independent predictors of RAS. Conclusions: During transradial coronary angiography, intravenous heparin administration is associated with a significantly lower frequency of RAS and a reduced need for femoral crossover compared with intra-arterial administration. IV heparin may represent an easily applicable strategy for RAS prevention, although causality cannot be established from this observational study.