BACKGROUND:This study assessed the association between a novel inflammatory marker, uric acid (UA)-to-albumin ratio (UAR), and preprocedural intracoronary artery thrombus (ICAT) in ST elevation myocardial infarction (STEMI). MATERIAL AND METHODS:A total of 171 STEMI patients treated by primary percutaneous coronary intervention between February and December 2023 were evaluated prospectively in this cross-sectional study. The patients were stratified into 2 groups as low (grades 1 to 3) and high-(ICAT) groups (grades 4 and 5). To determine the independent predictors of lower and higher ICAT, multivariate regression analysis was performed. RESULTS:C-reactive protein (CRP), UA, and UAR were significantly higher in the high ICAT group (1.11 (0.3-2.8) vs 0.80 (0.10-2.8), P=0.037; 5.4 (3.5-7.2) vs 4.9 (3.4-5.6), P<0.001; 1.78 (0.82-3) vs 1.48 (0.77-2.57), P<0.001, respectively). However, albumin levels were similar between groups (3.1 (2.1-4.4) vs 3.3 (2.1-4.4), P=0.243). Higher UAR (OR: 3.95% CI: 1.23-12.7, P=0.021), lower left ventricular ejection fraction (LVEF) (OR=0.802; 95% CI 0.7537-0.872; P<0.001), longer pain-wire crossing time (OR=1; 95% CI: 1-1.02; P<0.001), and diabetes mellitus (OR=0.181; 95% CI 0.46-0.7; P<0.001) were independent predictors of ICAT. CONCLUSIONS:UAR, a marker of inflammation, is an independent predictor of ICAT in patients with STEMI.

Background. Although scoring systems showing liver fibrosis using non-invasive methods have been accepted as effective tools for predicting cardiovascular risk, their role in predicting coronary ectasia (CAE) has not been evaluated. This study investigated whether aprison (APRI) and fibrosis-4 indices (FIB-4), which are indicators of fibrosis in nonalcoholic fatty liver disease (NAFLD), are associated with CAE. Material and methods. A retrospective, cross-sectional study consisted of 215 patients, 108 with CAE and 107 without CAE, as diagnosed by angiography. The mean age of all patients was 61.8±9.9 yrs, and 171 (78.8 %) were males. The relationships between APRI, FIB-4, NAFLD, and Bard scores and CAE were evaluated. Results. APRI, FIB-4, NAFLD, and Bard scores were independent predictors of CAE. Fib 4, APRI, NAFLD, and Bard scores were higher in the CAE patients. There were a moderate, positive correlations for FIB-4, APRI, and NAFLD scores with coronary ectasia (r=0.55, p<0.001; r=0.52, p<0.001; r=0.51, p<0.001, respectively). A weak-moderate positive correlation was observed between the Bard score and CAE (r=0.34, p<0.001). Univariate and multivariate regression analysis showed that APRI score, low HDL, and Bard score were independent risk factors for CAE ectasia (p<0.001). Cut-off values to predict CAE as determined by ROC curve analysis were: FIB-4 index ≥1.43 (AUC=0.817, 95 % confidence interval (CI): 0.762 to 0.873, p<0.001), APRI index ≥0.25 (AUC=0.804, 95 % CI: 0.745 to 0.862, p<0.001), NAFLD score ≥–0.92 (AUC=0.798, 95 % CI: 0.738 to 0.857.p<0.001), Bard score ≥2 (AUC=0.691, 95 % CI: 0.621 to 0.761, p<0.001). Conclusion. APRI, FIB-4, NAFLD, and Bard scores are associated with CAE.

Objectives: The inflammation-based Glasgow prognostic score (GPS), which comprises elevated serum C-reactive protein (CRP) and decreased albumin concentration, is the most valid inflammatory risk score in cancer. New prognostic markers are needed to predict high-risk infective endocarditis (IE) patients. In the present study, we investigated the in-hospital mortality estimation of GPS in infective endocarditis patients. Methods: The retrospectively designed study included 53 IE patients diagnosed according to Duke criteria. Demographic and clinical data of the patients were recorded and GPS levels were measured. Patients were divided into two groups according to in-hospital mortality outcomes. Glasgow prognostic score was rated as 0, 1, or 2 points based on serum albumin and C-reactive protein levels. Results: The nonsurvivor group was older and the number of patients with kidney failure or diabetes was higher in this group. Glasgow prognostic score was higher in the nonsurvivor group, while albumin levels were lower. Thirty-four patients died during intensive care unit follow-up, and the mean follow-up period was 24.1 ± 18.6 days. ROC analysis showed that the Glasgow prognostic score had a sensitivity of 82.4% and a specificity of 36.8% at a cut-off value of ≥1.5 in predicting in-hospital mortality. Chronic renal failure (OR: 6.720; 95% CI: 1.907-23.684; p = 0.003) and age (OR: 1.040; 95% CI: 1.001-1.081; p = 0.044) were the independent variables of the mortality prediction in univariate logistic regression analysis. In multivariate logistic regression analysis, only chronic renal failure (OR: 0.153; 95% CI: 0.036-0.653; p = 0.011) was found to be a significant predictor of mortality. Kaplan–Meier survival analysis revealed that long-term survival was reduced in patients with a high GPS (Log-rank: p = 0.003). Conclusions: Glasgow prognostic score level is associated with increased in-hospital mortality in IE patients. Chronic renal failure and GPS are the independent predictors of mortality.

Background: Familial Mediterranean Fever (FMF) is a chronic autoinflammatory disorder that is characterized by increased arterial stiffness and subtle cardiovascular dysfunction. Colchicine remains the mainstay of treatment and may provide vascular benefits that extend beyond its anti-inflammatory effects. However, the association between colchicine therapy and ventriculoarterial coupling (VAC), a hemodynamic marker of cardiovascular efficiency, has not been previously studied. Methods: In this cross-sectional study, 97 patients with FMF receiving colchicine therapy for at least one year and 81 colchicine-naive individuals without FMF were consecutively enrolled from a tertiary rheumatology outpatient clinic. The VAC was evaluated using the Chen method, calculated as the ratio of arterial elastance (Ea) to end-systolic elastance (Es), based on echocardiographic measurements and noninvasive brachial blood pressure. Correlation analyses and stepwise multivariate linear regression analyses were performed to identify independent predictors of VAC. Results: Patients with FMF demonstrated significantly lower VAC values compared to controls (1.23 ± 0.34 vs. 1.40 ± 0.57; p = 0.001). The colchicine dose was inversely correlated with VAC (r = −0.243; p = 0.001) and remained an independent predictor in multivariate analysis (β = −0.186, p = 0.018). Beta-blocker use was positively associated with VAC (β = 0.194, p = 0.014), whereas female sex showed a borderline inverse association. Conclusions: Colchicine use in patients with FMF was associated with more favorable VAC in a dose-dependent manner. These findings suggest that colchicine may exert cardiovascular effects beyond the control of inflammation. VAC may be a useful noninvasive marker for assessing vascular–ventricular interactions in FMF.

Background: Ischemic heart disease is the primary contributor to global mortality. The QRS-T angle at the anterior aspect of the heart serves as a significant biomarker of the heterogeneity in myocardial repolarization and the electrophysiological instability of the cardiac myocytes. A wide frontal QRS-T angle is associated with proximal vascular disease, coexistence of three-vessel disease, and increased mortality. Hereby, we aimed to examine the relationship between collateral circulation and frontal QRS-T angle in patients with chronic total occlusion (CTO). Methods: A cohort comprising 120 patients (17 females, 14.1%) who received a diagnosis of chronic total occlusion (CTO) subsequent to the administration of coronary angiography conducted for the evaluation of stable angina pectoris was incorporated into the investigation. The electrocardiographs of the patients were evaluated in detail, and the frontal QRS-T angle was calculated. The patients were categorized into two groups: subjects exhibiting an increased frontal QRS-T angle (>110° for men, >90° for women) and those presenting with a normative frontal QRS-T angle. Coronary angiographies of the patients were analyzed, and coronary collateral circulation was classified according to Rentrop classification. Results: Serum albumin level (OR = 0.711, 95% CI 0.564–0.896; p = 0.004) and poor collateral flow (OR = 17.7, 95% CI 12.2–85.3; p < 0.001) were significant predictors of raised frontal QRS-T angle. Conclusions: The frontal QRS-T angle is a novel parameter that is more reliable, consistent, and less sensitive to miscalculation and misidentification than other conventional electrocardiographic myocardial repolarization parameters. Revealing the bad collateral relationship with the frontal QRS-T angle may enable physicians to take more stringent precautions and change the risk factors related to the increased QRS-T angle in advance.