Background: Acute coronary syndromes are the leading cause of mortality worldwide. Electrical risk score (ERS) is a novel electrocardiographic risk scoring system. The prognostic importance of ERS in non-ST elevation myocardial infarction (NSTEMI) patients is unknown. We aimed to determine the association of ERS with in-hospital prognosis in NSTEMI patients undergoing coronary angiography (CAG). Methods: A total of 427 consecutive NSTEMI patients undergoing CAG were enrolled in this study. Six parameters comprised ERS: pulse rate >75, left ventricular hypertrophy according to Sokolow–Lyon criteria, QRS transition zone ≥V4, corrected QT (QTc) interval >450 for men and >460 for women, T peak to T end interval (Tp-e) >89 ms, and frontal QRS-T angle >90°. The ERS was calculated according to the number of abnormal findings in electrocardiogram. The study population was divided into 2 groups as ERS <3 and ≥3. Results: No significant difference was found between ERS ≥3 and <3 groups in terms of demographic characteristics. However, patients with ERS ≥3 had significantly higher maximum troponin (P < .001), thrombolysis in myocardial infarction (P = .002), and global registry of acute coronary events (P < .001) risk scores and 3-vessel disease frequency (P = .001), whereas they had lower left ventricular ejection fraction (P < .001). These patients also had higher frequency of in-hospital mortality (P < .001) and adverse events. Multiple logistic regression analysis demonstrated that ERS (OR = 1.790, 95% CI: 1.036-3.095, P = .037) was an independent predictor of in-hospital mortality. Conclusion: The frequency of in-hospital adverse events and mortality was significantly higher in NSTEMI patients with an ERS ≥3 at admission. This simple electrocardiographic risk marker may help identify patients at higher cardiac risk in patients presenting with NSTEMI and identify patients who may need early coronary intervention.

Obesity and pre-diabetes are metabolic disorders associated with insulin resistance (IR). Excess epicardial adipose tissue is also associated with increased IR. The triglyceride-glucose index (TyG) has been evaluated as an alternative measure of the IR in a variety of metabolic and cardiovascular disorders. However, its relationship with EAT thickness has not been studied yet. The study included 176 prediabetic and obese patients. EAT thickness was assessed using echocardiography. EAT thickness, TyG index, anthropometric obesity indices (body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR)), homeostatic model assessment (HOMA-IR), and biochemical parameters were compared. The following correlations between EAT thickness and related parameters were observed: WC ( r = .529), BMI ( r = .514), ALT ( r = .358), TyG index ( r = .338), and HOMA-IR ( r = .322; P < .001 for all). Multiple regression analysis showed that WC (Beta = .428; P = .004), age (Beta = .223; P < .001), BMI (Beta = .196; P = .029), ALT (Beta = .168; P = .012), and TyG index (Beta = .128; P = .049) were the strongest independent variables correlated with EAT thickness. A model based on WC, BMI, age, TyG index, and ALT provided the best R -square (.387) for estimating EAT thickness ( P < .001). The TyG index showed a significant and independent relationship with EAT, suggesting that it may be useful as an indicator of EAT thickness.

Background: Achieving target low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease (ASCVD) frequently requires combination lipid-lowering therapy. Single-pill combination (SPC) regimens may improve adherence compared with free-dose combinations (FDC) in real-world clinical practice. Methods: This retrospective observational study included 450 ASCVD patients with baseline LDL-C levels of 70–189 mg/dL who were followed in cardiology outpatient clinics between January 2023 and December 2024. Patients received atorvastatin–ezetimibe either as a single-pill combination (SPC, n = 392) or as a free-dose combination (FDC, n = 58). Primary endpoints were LDL-C reduction and treatment adherence (≥ 80% of prescribed doses). Secondary endpoints included LDL-C target attainment and adverse events. Non-parametric tests and chi-square/Fisher’s exact tests were used for statistical analysis. Results: At 1 month, LDL-C levels were significantly lower in the SPC group compared with the FDC group (90.6 vs. 119 mg/dL; p = 0.005), and adherence was higher (89.8% vs. 70.7%; p < 0.001). At 4 months, LDL-C levels were comparable between groups, while continuous adherence remained significantly higher in the SPC group (86% vs. 69%; p = 0.001). A higher proportion of SPC-treated patients achieved LDL-C < 100 mg/dL at 1 month (81.9% vs. 67.2%; p = 0.009). Conclusions: In this real-world ASCVD cohort, SPC therapy with atorvastatin and ezetimibe was associated with superior adherence and comparable lipid-lowering efficacy despite lower statin doses. Fixed-dose combination strategies may represent an effective approach to optimize adherence and cardiovascular risk management.

Coronary artery disease (CAD) is the leading cause of death worldwide. Fragmented QRS (fQRS) has emerged as a new prognostic marker in cardiovascular disease. Coronary computed tomography angiography (CCTA) is an effective method to diagnose obstructive CAD. The degree of stenosis determines the severity of the disease. A total of 120 patients admitted to the cardiology outpatient clinic with angina pectoris symptoms were included in the study. The fQRS is defined as the presence of an additional R wave, notching of the R wave, notching of the nadir of the S wave in 2 contiguous leads, or the presence of more than one R' wave without a typical bundle branch block. CCTA was performed on patients with low-moderate risk. The patients were divided into two groups based on the presence (Group 1, n = 58 patients) or the absence (Group 2, n = 62 patients) of ≥70 % coronary artery stenosis. The baseline characteristics of the patients were not significantly different. Group 1 had a higher prevalence of DM, hyperlipidemia, smoking, and fQRS compared to Group 2 (p < 0.05, for all). When the subjects were divided into two groups, fQRS (+) and fQRS (-), a statistically significant difference was revealed between the two groups (p < 0.001). A positive correlation was found between fQRS and ≥ 70 % stenosis in CCTA. In the multivariate regression analysis, smoking and fQRS were independent predictors of ≥70 % stenosis in CCTA. According to our study, fQRS, an important ECG finding, is associated with ≥70 % stenosis in CCTA and may be evaluated for the prediction of significant coronary stenosis.

Development of industry in the modern world, the number of individuals working in noisy environments is increasing with each passing day. Noise causes an increase in the incidence of cardioembolic events, yet the relevant underlying pathophysiology remains unclear. In this study, we aimed to investigate the relationship between signal peptide and complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein-1 (SCUBE-1) in the pathophysiology of cardioembolic events in individuals exposed to noisy environments. The study sample consisted of 99 textile factory workers who were exposed to loud noise and 56 volunteer office workers who were not exposed to loud noise. Hemogram values, basic biochemical parameters, and SCUBE-1 levels were measured for all participants. When the SCUBE-1 level of the group exposed to loud noise was compared with the control group, SCUBE-1 level was found to be significantly higher in the group exposed to loud noise (P < .001). The group exposed to loud noise was divided into 2 subgroups based on the duration of exposure to loud noise. The SCUBE-1 levels were significantly higher in the group exposed to loud noise for >10 years than in the group exposed to loud noise for <10 years (P < .001). In this study, we found that noise significantly increased the serum SCUBE-1 levels. Noise was also an independent predictor of serum signal peptide-complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein-1 levels. Therefore, it should be noted that individuals exposed to noise may be more prone to embolic events.

Non-dipper hypertension is defined as a decline in nighttime blood pressure (BP) of 75 bpm, presence of left ventricular hypertrophy, QRS transition zone ≥ V4, frontal QRS-T angle > 90°, corrected QT Interval (QTc) interval > 450 ms in males and > 460 ms in females, and Tp-e interval > 89 ms. The number of abnormal ECG signs was used to calculate the ERS. Baseline characteristics were comparable between the non-dipper and dipper hypertension groups. However, patients with non-dipper hypertension had significantly higher ERS compared to patients with dipper hypertension (1 [1–2] vs 2 [1–3], P < .001). In addition, ERS was positively correlated with nighttime systolic blood pressure ( r = 0.210, P < .001). Multivariate logistic regression analysis demonstrated that ERS was the independent predictor of non-dipper pattern (OR: 1.935, 95% CI: 1.543 to 2.426, P < .001). ERS is a novel and easily obtainable electrocardiographic risk scoring system. Our study shows that ERS may be used as a beneficial and effective tool for identifying the non-dipper pattern in patients with hypertension.