Our study compared the effect of P2Y12 receptor inhibitors in combination with abciximab on clinical outcomes in patients with acute coronary syndrome (ACS). Our study is retrospective, consisting of 852 consecutive ACS patients who presented to our clinic between 2015 and 2021, underwent primary percutaneous coronary intervention (PCI), and received abciximab in addition to dual antiplatelet therapy. The P2Y12 receptor inhibitors were compared in terms of in-hospital and 1-year major adverse cardiac events (MACE), and clinically significant in-hospital and 1-year bleeding complications. The patients' mean age was 60.4 ± 11 years, and 702 (82.4%) were male. In-hospital MACE, in-hospital mortality, 1-year MACE, and 1-year mortality were significantly higher in the clopidogrel group compared to the ticagrelor group. There was no significant difference in the development of in-hospital and 1-year bleeding between clopidogrel and the more potent P2Y12 receptor inhibitors. According to the BARC score, there was no difference in major bleeding between ticagrelor and clopidogrel (p = 0.641), but minor bleeding was significantly lower in the ticagrelor group (p < 0.001). In logistic regression analysis, the 1-year MACE rate was lower in the potent P2Y12 receptor inhibitors group compared to clopidogrel. At the same time, no association was found with short- and long-term mortality, bleeding, or in-hospital MACE. In our study, potent P2Y12 receptor inhibitors combined with abciximab decreased 1-year MACE without significantly increasing bleeding in ACS patients undergoing PCI compared to clopidogrel. This study suggests that potent P2Y12 receptor inhibitors can be safely used with abciximab, considering the bleeding risk.

1. Chronic coronary syndrome (CCS) represents the stable clinical manifestation of coronary artery disease, yet it continues to be associated with a considerable risk of long-term major adverse car...

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous clinical entity in which coronary microvascular dysfunction plays a central pathophysiological role. The coronary slow flow phenomenon (CSFP) represents an angiographic manifestation of microvascular dysfunction; however, reliable and practical biomarkers for its identification remain limited. The stress hyperglycemia ratio (SHR) reflects acute metabolic stress beyond chronic glycemic status. This study aimed to investigate the association between SHR and CSFP in patients with MINOCA. Methods: In this single-center retrospective cohort study, 2073 patients undergoing coronary angiography for suspected myocardial infarction between 1 January 2020 and 1 December 2025 were screened. 354 patients with MINOCA were included. Patients with CSFP were matched 1:2 with controls according to age and sex using exact matching. SHR and other laboratory parameters were assessed. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent predictors of CSFP. Results: Among the study population, 118 patients (33.3%) had CSFP. Patients with CSFP had significantly higher SHR levels, along with increased C-reactive protein, triglycerides, low-density lipoprotein cholesterol, and uric acid, whereas HbA1c and serum albumin levels were lower (all p < 0.05). In multivariable logistic regression analysis, SHR emerged as the strongest independent predictor of CSFP (OR: 1.48, 95% CI: 1.30– 1.69; p < 0.001). In ROC analysis, SHR demonstrated the highest discriminative performance for CSFP (AUC: 0.74), with an optimal cut-off value of 0.998, yielding a sensitivity of 66.1% and a specificity of 64.3%. Conclusion: SHR is independently associated with CSFP in patients with MINOCA, suggesting that acute metabolic stress plays a key role in coronary microvascular dysfunction. SHR may serve as a simple and readily available marker for identifying high-risk microvascular phenotypes in MINOCA patients.

Objective: Contrast-induced nephropathy (CIN) remains a common complication after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The BUN-to-albumin ratio (BAR) has recently emerged as a composite biomarker reflecting inflammation, renal function, and nutritional status. To evaluate the predictive value of BAR for CIN in NSTEMI patients undergoing PCI.Material and Methods: This retrospective study included 1,540 NSTEMI patients treated with PCI between 2020 and 2024. Patients were divided into CIN (+) and CIN (-) groups. Clinical, laboratory, and procedural variables were analyzed. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors and assess discriminative performance.Results: CIN developed in 204 patients (13.2%). BAR was significantly higher in the CIN group (5.2±1.5 vs. 4.0±1.2, p<0.001). In multivariate analysis, BAR emerged as an independent predictor of CIN (OR: 1.943, 95% CI: 1.703-2.217, p<0.001). ROC analysis showed that BAR had the highest discriminative ability (AUC: 0.726), outperforming NLR (AUC: 0.654) and the Mehran score (AUC: 0.599). A cut-off value of 4.5 yielded 69.1% sensitivity and 63.8% specificity.Conclusion: BAR is a simple, inexpensive, and effective predictor of CIN in NSTEMI patients undergoing PCI and may serve as a practical tool for risk stratification in clinical practice.

Background and Objectives: Patients with a prior history of coronary artery bypass grafting (CABG) who present with non-ST-segment elevation myocardial infarction (NSTEMI) represent a complex, high-risk subgroup due to advanced comorbidity burden and challenging coronary anatomy. Whether an invasive strategy offers meaningful benefit over conservative management in this population remains unclear. Therefore, this study aimed to compare long-term outcomes of percutaneous coronary intervention (PCI) versus medical therapy in NSTEMI patients with previous CABG and to identify independent predictors of major adverse cardiovascular events (MACE) and all-cause mortality. Materials and Methods: This retrospective cohort study included 286 NSTEMI patients with prior CABG (PCI: 112; medical therapy: 174). Baseline demographic, clinical, laboratory, and angiographic characteristics were assessed. The primary endpoint was MACE, while the secondary endpoint was all-cause mortality. Kaplan–Meier analysis evaluated survival differences, and multivariable Cox regression identified independent predictors. Results: During follow-up, MACE rates were comparable between PCI and medical therapy (14.3% vs. 18.9%; p = 0.305). All-cause mortality was likewise similar (9.8% vs. 10.3%; p = 0.541). Kaplan–Meier analysis showed no survival benefit with PCI (log-rank p = 0.334). Hypoalbuminemia independently predicted both MACE and mortality, while CKD and HF were major determinants of long-term mortality. Conclusions: In NSTEMI patients with prior CABG, no long-term superiority of PCI over medical therapy was observed with respect to MACE or mortality. Prognosis appears more closely linked to hypoalbuminemia, CKD, and HF than to the chosen management strategy. These findings underscore the importance of individualized and risk-adapted clinical decision-making in this complex population.

Background: Radial artery occlusion (RAO) is the most common vascular complication of transradial coronary procedures. The Systemic Coagulation–Inflammation Index (SCII), which integrates platelet count, fibrinogen, and white blood cell count, jointly reflects coagulation activation and systemic inflammation, two central mechanisms in RAO. We aimed to evaluate the association between SCII and RAO and its predictive value. Methods: This single-center, retrospective cohort study included 2,055 patients who underwent elective transradial coronary angiography or percutaneous coronary intervention between January 2021 and December 2025. Radial artery patency was assessed by Doppler ultrasonography before discharge, and RAO was defined as the absence of antegrade flow. SCII was calculated as (platelet count × fibrinogen)/(white blood cell count × 100). Predictors of RAO were identified using logistic regression, and the discriminative performance of SCII was assessed by receiver operating characteristic (ROC) analysis. Results: RAO occurred in 96 patients (4.7%). Patients who developed RAO were younger (55.4 ± 11.4 vs. 60.5 ± 12.1 years, P < 0.001), more frequently diabetic (11.5% vs. 5.0%, P = 0.008), and had higher SCII values (120.7 ± 36.4 vs. 93.1 ± 41.5, P < 0.001). In multivariable analysis, age (odds ratio (OR): 0.966; 95% confidence interval (CI): 0.949–0.983; P < 0.001), diabetes mellitus (OR: 2.342; 95% CI: 1.203–4.560; P = 0.012), and SCII (per 10-unit increase; OR: 1.174; 95% CI: 1.120–1.228; P < 0.001) were independent predictors of RAO, whereas sex, percutaneous coronary intervention, C-reactive protein, and creatinine lost significance. SCII showed a moderate discriminative ability (AUC: 0.730; 95% CI: 0.686–0.774; P < 0.001) with a greater AUC than other inflammatory indices. A cut-off of 101.2 yielded 70.4% sensitivity and 57.7% specificity. Conclusions: SCII is an independent predictor of RAO and shows moderate discriminative ability in patients undergoing transradial coronary procedures. As a marker readily derived from routine laboratory parameters, SCII may serve as a useful adjunct to existing clinical and procedural risk factors for the early identification of patients at increased risk of RAO. Multicenter, prospective studies are warranted to confirm these findings.