No-reflow phenomenon (NRP) after primary PCI in STEMI is strongly linked to early mortality and adverse events. Conventional indices such as the systemic immune-inflammation index (SII), the CRP to albumin ratio (CAR), and the SYNTAX 1 score (SXscore) appear to provide only moderate discrimination for NRP. The endothelial activation and stress index (EASIX), calculated as LDH × creatinine / platelet count, reflects endothelial dysfunction and microvascular stress and may add to risk stratification. This two-center retrospective cohort study included 983 consecutive STEMI patients undergoing primary PCI. NRP was defined as the failure to achieve distal TIMI 3 flow despite a fully patent epicardial artery, or the need for pharmacological therapy to reverse NRP. We evaluated the relationships of EASIX, SII, CAR and SXscore with NRP; key exclusion criteria were non-ticagrelor P2Y12 loading, advanced renal/hepatic failure, active infection/inflammatory–hematologic disease or malignancy, shock/arrest (Killip ≥ 2), door-to-balloon time > 60 min, prior CABG/PCI, and pre-PCI fibrinolytic therapy. NRP occurred in 267 patients (27.2%). EASIX, SII, CAR and SXscore were significantly higher in the NRP (+) group (all p < 0.001). In multivariable models, EASIX (OR 18.97, 95% CI 11.83–30.43; p < 0.001), CAR (OR 2.45, 95% CI 1.90–3.16; p < 0.001), SII (OR 1.000, 95% CI 1.000–1.000; p = 0.003), and SXscore (OR 1.04, 95% CI 1.03–1.06; p < 0.001) were independently associated with NRP. In ROC analysis, EASIX demonstrated the highest discriminative ability for predicting NRP (AUC = 0.835). The optimal cut-off value of 1.248 provided 62.2% sensitivity and 93.6% specificity. In comparison, CAR, SII, and SXscore showed lower discrimination (AUC = 0.687, 0.562, and 0.583, respectively). EASIX demonstrated a stronger association with NRP than CAR, SII, and the SXscore. Easily derived from routine laboratory tests, EASIX may represent a practical and readily applicable index for early NRP risk stratification in STEMI.

Background: Infective endocarditis (IE) remains associated with high morbidity and mortality despite advances in diagnostic and therapeutic strategies. Markers reflecting both inflammatory burden and nutritional status may improve early risk stratification. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is a composite index integrating hematologic and nutritional parameters; however, its prognostic value in IE has not been well established. Methods: This two-center retrospective cohort study included 218 adult patients hospitalized with IE between January 2016 and January 2025. HALP score was calculated from admission laboratory values. The primary outcome was in-hospital mortality, and 1-year mortality was evaluated as a secondary outcome. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value. Patients were categorized into low- and high-HALP groups, and survival was assessed using Kaplan–Meier analysis. Cox regression analyses were performed to identify independent predictors of in-hospital mortality. Results: A total of 218 patients were analyzed. In-hospital mortality occurred in 38.5% of patients. HALP score was significantly lower in non-survivors and was independently associated with in-hospital mortality. ROC analysis demonstrated good discriminatory performance (AUC 0.784), with an optimal cut-off value of 15.1 (sensitivity 73.9%, specificity 73.8%). Low HALP scores were associated with more advanced functional status, more frequent intracardiac complications, and higher rates of acute heart failure, renal failure, and septic shock. One-year mortality was also higher in the low-HALP group (42.9% vs. 18.2%, p = 0.005). Conclusions: HALP score is independently associated with in-hospital mortality in patients with IE and identifies a subgroup with more severe disease and worse outcomes. As an easily calculated parameter, it may serve as a complementary tool for risk stratification and clinical decision-making.

Hypertrophic cardiomyopathy (HCM) is the leading cause of sudden cardiac death in young individuals. Lumican, is an indicator of fibrosis. We aimed to evaluate the relation between serum Lumican levels and presence and extent of myocardial fibrosis in HCM. The patients diagnosed with HCM between June 2022 and March 2023 were enrolled consecutively in this prospective study. Age and gender-matched healthy individuals formed control group. Two groups were generated according to extent of late gadolinium enhancement (LGE) in HCM patients. A total of 114 patients were enrolled. Serum Lumican, NT-proBNP levels and maximum wall thickness were revealed as independent risk factors associated with LGE. A cut-off value of 9.06 for Lumican was associated with 67.8% sensitivity and 65.5% specificity in prediction of LGE. Myocardial fibrosis is one of the important mechanisms in HCM pathophysiology. LGE on cardiac magnetic resonance imaging allows comprehensive evaluation of myocardial fibrosis, the support of diagnosis with a biomarker would be beneficial in clinical practice. Our study revealed that serum Lumican level is an independent predictor of severe LGE in HCM patients. Further studies with larger patient numbers may clarify the importance of Lumican in HCM pathophysiology.

Introduction: Heart failure (HF) risk stratification can lead to misinterpretations, particularly in individuals perceived as being at risk. Patients without structural heart disease but with HF risk factors may perceive themselves as already having the disease, potentially resulting in health anxiety. This study aimed to evaluate the clinical consequences of such misperceptions in patients with resistant hypertension (HT) who believed they had HF despite lacking a formal diagnosis. Methods: This retrospective observational study included patients aged ≥18 years who presented to the emergency department between June 1, 2023, and July 31, 2024. Group 1 consisted of 248 individuals with resistant HT, preserved ejection fraction (EF ≥50%), and no HF diagnosis, yet who believed themselves to have HF. Group 2 included 47 patients with systolic HF (EF ≤40%) receiving sacubitril/valsartan therapy. Emergency department (ED) admissions frequency and 24-hour ambulatory blood pressure monitoring (ABPM) data were compared between groups. Results: Annual ED admissions were significantly higher in Group 1 (p <0.001), and nocturnal ABPM values were higher for both systolic and diastolic blood pressure (p = 0.009 and p = 0.046). No hospitalizations occurred in Group 1, while 25.5% of Group 2 patients were hospitalized. The younger age, preserved oxygen saturation, and normal heart function in Group 1 suggest that ED visits may be psychological rather than physiological in origin. Conclusion: Misinterpreting the risk associated with HF can lead to increased healthcare utilization and elevated blood pressure in patients with resistant HT. Effective communication and psychological support are essential.