Ventricular arrhythmias following acute coronary syndrome (ACS) range from benign to life-threatening fatal arrhythmias. Tpeak-end (Tp-e) interval has been shown to be an important parameter in the assessment of repolarization dispersion. We aimed to evaluate the relationship between SYNTAX and Global Registry of Acute Coronary Events (GRACE) risk score calculated on admission and Tp-e interval and Tp-e/QTc ratio. A total of 421 patients were included in the study. The patients were divided into 2 groups as low SYNTAX score (≤22) and moderate and high risk SYNTAX score (>22). According to the GRACE risk score, the patients were divided into 2 groups; high-risk patients ≥140 and 22, the Tp-e interval (p<0.001) and Tp-e/QTc ratio (p<0.001) was found to be significantly higher than in the group with a SYNTAX score ≤22. Tp-e interval (p<0.001) and Tp-e/QTc ratio (p=0.002) was higher in patients with GRACE risk score ≥140 compared with patients with a GRACE risk score <140. The correlation between Tp-e interval and Tp-e/QTc ratio and SYNTAX score (r=0.489; p<0.001) and GRACE risk score (r=0.274; p<0.001) were found to be significant. A significant and independent correlation was found between the SYNTAX score and Tp-e/QTc ratio (β=0.385; p<0.001). Tp-e interval and Tp-e/QT ratio increased in patients with severe coronary artery disease assessed with SYNTAX score. Tp-e interval and Tp-e/QT ratio increased in patients with a high GRACE risk score.

Amaç: Pulmoner tromboemboli (PTE), etkin tedavisi olmasına rağmen mortalitesi yüksek acil bir durumdur. Ölümlerin çoğu ilk bir saatte görülmektedir. Bu nedenle erken tanı hayat kurtarıcıdır. Serum immun-inflamasyon indeksi (Sİİ), nötrofil, lenfosit ve trombositten türetilen bir parametredir. İskemik hastalıklarda mortaliteyi belirleyen önemli bir biyobelirteç olduğu bildirilmiştir. Bu makalede kolay ulaşılabilir ve hızlı sonuçlanan Sİİ’nin trombolitik tedaviyi ön görmedeki rolünün değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu çalışma, tek merkezli Sağlık Bilimler Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Acil Servisi’nde, 01.10.2020 ve 01.08.2022 tarihleri arasında orta ve yüksek riskli PTE tanısı alan hastalarda retrospektif olarak gerçekleştirildi. Hastaların başvuru anındaki vital bulguları, rutin bakılan kan tetkikleri değerlendirildi. Görüntüleme ve ekokardiyografi bulguları ile birlikte risk grupları belirlendi. PTE için uygulanan tedavi ve sonlanım durumları kaydedildi. Bulgular: Çalışmaya 204 hasta dahil edildi. Hastaların %63.7’si kadındı. Hastaların ortalama yaşı 71,7 idi. Hastaların 33’ü (%16.1) takipleri sırasındaki 30 gün içerisinde vefat etti. Hastaların %28.9’u yüksek risk grubuna dahil edildi. %30’u orta yüksek ve %41.1’i orta düşük riskli gruptaydı. Çalışmaya dahil edilen 49 (%24) hastanın trombolitik tedaviye ihtiyacı oldu. Sİİ için %34.7 sensitivite ve %96.1 spesifisite ile sınır değer 2187 olarak belirlendi. Sİİ’nin trombolitik tedavi ihtiyacında belirleyici olduğu saptandı (AUC: 0.615, %95 CI 0.513-0.717, p

Aim. We aimed to compare post-interventional angiographic outcomes of ticagrelor versus clopidogrel according to glycosylated hemoglobin (HbA1c) levels in patients with ST-elevation myocardial infarction.Material and methods. The study included a total of 532 patients, with 334 receiving ticagrelor (62,8%) and 198 clopidogrel (37,2%). Diabetic status of the patients was assessed with HbA1c. TIMI flow grade and TIMI frame count were calculated and compared between two groups.Results. TIMI flow grade 3 was higher and TFC was lower after percutaneous coronary intervention of the infarct-related artery in patients treated with ticagrelor compared to clopidogrel (89,2% vs. 73,7%; p< 0,001, 20 vs. 24; p< 0,001). There was a positive correlation between the increases in HbA1c and TFC levels in the whole group (r=0,225; p=0,004). In subgroup analysis, higher HbA1c levels did not affect TFC in patients using ticagrelor (r=-0,060; p=0,326 for patients with noreflow, r=-0,133; p=0,321 for patients with TIMI-3 flow). While level of HbA1c did not affect TFC in patients with TIMI-3 flow, the presence of post-procedural no-reflow caused worsening of TFC in patients using clopidogrel as HbA1c levels increased (r=0,374; p=0,005).Conclusion. Ticagrelor was found to be better in terms of angiographic parameters regardless of diabetes.

Intravascular imaging (IVI) was introduced 35 years ago to assess coronary artery pathology and plaque vulnerability. However, from its first applications it became apparent that it can also be useful in percutaneous coronary intervention (PCI) planning and optimizing PCI results. In the early days of PCI, IVI was used to examine the efficacy of emerging endovascular devices and the vessel wall response to therapy, while in the drug-eluting stent (DES) era, IVI was used to guide DES implantation and assess final results post-intervention. The first studies assessing the role of IVI in guiding PCI with DES have failed to demonstrate a prognostic benefit for the use of IVI; however, more recent large-scale randomized trials have underscored its value in this setting. IVI, with its high resolution, allows optimal stent sizing, prompt identification and correction of common causes of stent failure, and it has been shown that it improves outcomes in complex procedures. This review summarizes the evidence supporting the role of IVI in PCI planning in DES era, synopsizes the studies that have highlighted the value of IVI in predicting stent failure, discusses the limitations of the first randomized trials that failed to demonstrate a prognostic benefit from its use, and presents the results of the more recent large-scale outcome studies that underscored its role in complex PCI planning.