Background Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued. Objectives The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study. Methods A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%. Results Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.

Background/Objectives: Metabolic syndrome (MS) has been demonstrated to be associated with subclinical myocardial dysfunction, which develops in the early stages. It has been hypothesised that traditional echocardiographic parameters may be insufficient in detecting these changes. The frontal QRS-T angle is an electrocardiographic parameter that is easily obtained and that reflects ventricular electrical heterogeneity. This study aimed to examine the relationship between the frontal QRS–T angle and left ventricular myocardial deformation, as assessed by four-dimensional strain echocardiography (4DSE), in patients with MS. Methods: The present cross-sectional study comprised 70 patients diagnosed with MS and 61 healthy individuals matched for age and gender. All participants underwent standard transthoracic and 4DSE examination and 12-lead electrocardiography. The values of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) and global area strain (GAS) were analysed. The frontal QRS-T angle was calculated as the absolute difference between the QRS and T axes. The interrelationships between the variables were assessed using correlation and multivariate linear regression analyses. Results: Despite comparable left ventricular ejection fraction (LVEF) between the groups, 4DSE-derived myocardial deformation parameters, including GLS, GCS, GAS, and GRS, were significantly impaired in the MS group. The frontal QRS-T angle was found to be significantly higher in patients diagnosed with MS in comparison to the control group (p < 0.001). A significant correlation was identified between the frontal QRS-T angle and GLS (r = 0.498, p < 0.001). In multivariable linear regression analysis, the frontal QRS–T angle was independently associated with GLS (standardized β = 0.501, p < 0.001). In exploratory receiver operating characteristic (ROC) analysis, the frontal QRS–T angle showed moderate discriminatory ability for GLS-defined impaired myocardial deformation area under the curve (AUC) = 0.720). Conclusions: An increased frontal QRS–T angle in individuals with metabolic syndrome was independently associated with subclinical LV dysfunction despite preserved ejection fraction (EF). These findings suggest that the frontal QRS–T angle may serve as a simple and readily available electrocardiographic marker associated with impaired myocardial deformation, warranting further validation in larger prospective studies.