Objectives. Frontal plane QRS-T angle is a novel marker of myocardial repolarization, and an increased frontal plane QRS-T angle is associated with adverse cardiac outcomes. Slow coronary flow may cause fatal cardiac arrhythmias by causing electrical abnormalities and altering ventricular repolarization. We aimed to evaluate the frontal plane QRS-T angle in patients with slow coronary flow. Design. A total of 60 consecutive patients with slow coronary flow and 60 consecutive patients with normal coronary flow were enrolled into the study. Laboratory and some electrocardiography parameters including frontal plane QRS-T angle were compared between the two groups. Results. We have found that the angle of frontal QRS-T was higher in the group with slow coronary flow (p < .001). In addition, there was a negative correlation between thrombolysis in myocardial infarction frame count and frontal QRS-T angle (r = −0.496, p < .001). Conclusions. In conclusion, increased frontal plane QRS-T angle might be an important indicator of slow coronary flow.

Background: Bifurcation lesions pose unique challenges during percutaneous coronary intervention (PCI) and are associated with suboptimal outcomes. The standard approach involves provisional stenting of the main branch (MB) with plain balloon angioplasty (BA) for compromised side branches (SBs). It remains unclear whether drug-coated balloon (DCB) or plain balloon angioplasty pose a better strategy to treat SB in bifurcation lesions. This systematic review and meta-analysis compared the efficacy of DCB versus BA in managing SBs of bifurcation lesions. Methods: MEDLINE, Cochrane, and EMBASE databases were searched for randomized controlled trials (RCTs) comparing DCB and BA for treating bifurcation lesions. Outcomes included SB late lumen loss (LLL), major adverse cardiovascular events (MACE), all-cause mortality, myocardial infarction (MI), and target lesion revascularization (TLR). Results: Five RCTs were included, encompassing 1,255 patients, of whom 628 (50.4%) underwent DCB angioplasty; 946 (75.4%) were male, and the mean age was 63.5 years. Drug-coated balloons significantly reduced MI risk (risk ratio [RR] = 0.56, 95% CI: 0.35-0.88, P = .010). DCB use resulted in similar LLL in the SB compared with BA (mean difference (MD) = −0.12 mm, 95% CI: −0.24-0.01, P = .070). No significant differences were observed in TLR (RR = 1.19, 95% CI: 0.45-3.14, P = .720), MACE (RR = 0.70, 95% CI: 0.48-1.02, P = .070), and all-cause mortality (RR = 2.35, 95% CI: 0.61-9.00, P = .210). Conclusion: In this meta-analysis of RCTs, DCB significantly reduced MI without affecting LLL, TLR, MACE, and all-cause mortality compared with BA in the SB of bifurcation lesions.

Empagliflozin and Dapagliflozin Therapies Favorably Alter QRS-T Angle and Cardiac Repolarization Parameters in Patients with Heart Failure

Background: Naples Prognostic Score (NPS), a composite index incorporating inflammatory and nutritional markers, has emerged as a potential prognostic tool in various cardiovascular conditions; however, no meta‐analysis has yet pooled the available evidence to comprehensively assess its prognostic utility. Objectives: To evaluate the association of NPS with clinical outcomes, including all‐cause mortality, in‐hospital mortality, no‐reflow (NR) phenomenon, and left ventricular ejection fraction (LVEF), in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Methods: MEDLINE, Cochrane, and EMBASE databases were searched for studies comparing high and low NPS groups in ACS patients undergoing PCI. Random‐effects models were used to pool risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes. Heterogeneity was assessed with I² statistics. Statistical analyses were performed using Review Manager 5.4, and R, version 4.2.2. Results: We included seven studies comprising 13 268 patients, with 5628 (42.4%) patients in the low NPS group. Low NPS was significantly associated with decreased all‐cause mortality (RR: 0.42; 95% CI: 0.32–0.55; I² = 48%) and decreased incidence of NR (RR: 0.60; 95% CI: 0.40–0.88; I² = 83%). Patients with low NPS also had higher LVEF (MD: −2.69%; 95% CI: −3.41 to −1.97; I² = 99%). No significant difference was observed in in‐hospital mortality (RR: 0.54; 95% CI: 0.28–1.05; I² = 94%). Conclusion: In ACS patients undergoing PCI, elevated NPS was associated with worse clinical outcomes. These findings support the use of NPS as a practical, biomarker‐based tool for risk stratification in this population.