Aim: This study aimed to evaluate five-year clinical outcomes and investigate baseline factors associated with major adverse cardiovascular events (MACE) in patients presenting with transient ST-segment elevation myocardial infarction (STEMI).Material and Methods: This retrospective, single-center, observational study included 52 patients who presented between January 2019 and December 2020 with ST-segment elevation on the initial electrocardiogram followed by complete resolution before coronary angiography. The primary outcome was five-year MACE, defined as a composite of cardiovascular death, acute coronary syndrome, revascularization, and ischemic cerebrovascular events. Follow-up data were obtained from hospital records and the national electronic health record system. Patients with and without MACE were compared, and associated factors were examined using univariable logistic regression.Results: The median age was 54.5 years, and 80.8% of patients were male. During five-year follow-up, MACE occurred in 11 patients (21.2%). All-cause mortality was 7.7%, cardiovascular mortality was 1.9%, and acute coronary syndrome and revascularization each occurred in 15.4%. Patients with MACE were older (63.0 vs. 51.0 years; p=0.003) and more frequently had hypertension (72.7% vs. 29.3%; p=0.014) and hyperlipidemia (45.5% vs. 12.2%; p=0.025). In univariable analysis, age (OR: 1.09; 95% CI: 1.02-1.17; p=0.016), hypertension (OR: 6.44; 95% CI: 1.46-28.53; p=0.014), and hyperlipidemia (OR: 6.00; 95% CI: 1.32-27.19; p=0.020) were significantly associated with five-year MACE.Conclusion: Long-term cardiovascular risk was not negligible after transient STEMI despite resolution of ST-segment elevation. Age, hypertension, and hyperlipidemia were associated with five-year MACE in univariable analyses and may help identify patients at higher long-term cardiovascular risk.

Background: Transulnar access has emerged as a feasible alternative to transradial access for coronary angiography. However, the electrophysiological effects of proximal and distal transulnar approaches on ulnar nerve function remain insufficiently characterized. This study aimed to compare electrophysiological changes following proximal and distal transulnar coronary angiography and to evaluate their association with ulnar nerve involvement. Methods: This single-center retrospective observational study included 97 patients who underwent proximal (n = 56) or distal (n = 41) transulnar coronary angiography and developed post-procedural pain and/or paresthesia. Electroneuromyography and nerve conduction studies were performed before the procedure and at the fourth post-procedural week. Sensory and motor amplitudes, conduction velocities, and delta (Δ) changes were compared between groups. Generalized estimating equation analysis was additionally performed to evaluate longitudinal electrophysiological changes after adjustment for demographic and procedural variables. Results: No significant between-group differences were observed in pre- or post-procedural electrophysiological parameters. Although significant reductions in right ulnar sensory amplitude were observed over time, only 4 patients (4.1%) demonstrated post-procedural ulnar sensory amplitudes below the laboratory reference range, and no patient developed clinically significant ulnar neuropathy. Comparison of electrophysiological changes (Δ values) revealed no significant differences between proximal and distal transulnar access techniques. Generalized estimating equation analysis, adjusted for age and procedural characteristics, confirmed that the magnitude of electrophysiological changes over time was comparable between the two groups. Conclusions: Both proximal and distal transulnar access may be associated with mild, predominantly sensory, subclinical ulnar nerve involvement. However, distal transulnar access did not result in greater electrophysiological deterioration or additional neurological risk compared with proximal access.

INTRODUCTION AND AIM: In this study, we aimed to investigate the effects of P2Y12 inhibitors administered at the time of admission to the emergency department in patients presenting with ST-segment elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention on the thrombus score in the culprit lesion. MATERIALS AND METHODS: This retrospective study planned to compare the pre-procedural thrombus scores of 225 patients who presented with STEMI underwent primary percutaneous coronary intervention, and received different P2Y12 inhibitors within 2 hours after the onset of chest pain. RESULTS: A total of 225 patients were included in our study. Among them, 72 patients received clopidogrel, 85 received ticagrelor, and 68 received prasugrel as the P2Y12 inhibitor. The pre-procedural Grade 5 thrombus was significantly lower in the ticagrelor group compared to the other groups (Clopidogrel 77.78%, Ticagrelor 61.18%, Prasugrel 77.94%; p=0.017). CONCLUSIONS: In our study, ticagrelor among the pre-procedurally loaded P2Y12 inhibitors was found to be superior in terms of early thrombus intensity, and these results are thought to be associated with the early onset antiplatelet effect of ticagrelor. Keywords: ST segment elevation myocardial infarction, clopidogrel, prasugrel, ticagrelor, thrombus score