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: 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.

ObjectiveThe Fibrosis-4 (FIB-4) index is a simple, non-invasive marker originally developed to estimate hepatic fibrosis and has recently emerged as a potential indicator of systemic inflammation and atherosclerosis. This study investigated the association between the preprocedural FIB-4 index and previous cerebrovascular events in patients undergoing carotid artery stenting (CAS).Materials and MethodsThis retrospective observational study included 221 consecutive patients who underwent CAS for significant carotid artery stenosis. Patients were categorized according to the presence or absence of previous cerebrovascular events. Demographic, clinical, and laboratory characteristics were compared between groups. Multivariable logistic regression analysis was performed to identify independent predictors of previous cerebrovascular events. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminative ability of the FIB-4 index, and the optimal cut-off value was determined using the Youden index, based on the best balance between sensitivity and specificity.ResultsAmong the 221 patients, 133 (60.2%) had a history of previous cerebrovascular events. Compared with patients without previous cerebrovascular events, those with previous cerebrovascular events had significantly lower platelet counts and HDL cholesterol levels and significantly higher fasting glucose and FIB-4 index values (all p < 0.05). In multivariable logistic regression analysis, chronic kidney disease (OR: 3.06, 95% CI: 1.46–6.39, p = 0.003), lower HDL cholesterol (OR: 0.96 per 1 mg/dL increase, 95% CI: 0.93–0.99, p = 0.011), and a higher FIB-4 index (OR: 2.19 per 1-unit increase 95% CI: 1.29–3.73, p = 0.004) were independently associated with previous cerebrovascular events. ROC analysis demonstrated modest discriminatory performance of the FIB-4 index (AUC: 0.611, 95% CI: 0.535–0.687, p = 0.005). A FIB-4 value of 1.54 yielded a sensitivity of 51.1% and a specificity of 64.8% for identifying patients with previous cerebrovascular events.ConclusionAn elevated preprocedural FIB-4 index was independently associated with previous cerebrovascular events in patients undergoing carotid artery stenting. Although its discriminatory performance was modest, the FIB-4 index may serve as an inexpensive and readily available biomarker that may provide complementary information regarding systemic vascular risk. Larger prospective multicenter studies are warranted to validate this association and determine the potential clinical utility of FIB-4 in this population.

Amaç: Pan-immün-inflamasyon değeri (PIV), kardiyovasküler hastalıklarda araştırılan bileşik bir inflamatuvar biyobelirteçtir. Bu çalışmada, karotis arter stentleme (KAS) uygulanan hastalarda PIV ile vasküler komorbidite yükü arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntemler: Retrospektif çalışmaya 2010–2025 yılları arasında KAS uygulanan 221 hasta dahil edildi. PIV periferik kan hücrelerinden hesaplandı. Vasküler yük skoru; hipertansiyon, diabetes mellitus, hiperlipidemi, sigara, koroner arter hastalığı ve geçirilmiş serebrovasküler olaydan oluşan altı bileşenle belirlendi. Hastalar düşük (0–2) ve yüksek (3–5) yük gruplarına ayrıldı. İlişkiler korelasyon ve regresyon analizleriyle, ayırt edici performans ROC analiziyle değerlendirildi. Bulgular: PIV, yüksek vasküler yük grubunda daha yüksekti (428,9 [287,1–701,9] vs. 287,1 [202,1–452,5], p=0,001). PIV ile vasküler yük arasında pozitif korelasyon vardı (rho=0,317, p<0,001). Her 100 birimlik PIV artışı, yüksek vasküler yük ile bağımsız ilişkiliydi (OR=1,152; %95 GA: 1,058–1,255; p=0,001). Düzeltilmiş ordinal regresyonda PIV, daha yüksek vasküler yük ile ilişkiliydi (OR=1,116; %95 GA: 1,062–1,174; p<0,001). ROC analizinde AUC 0,651 (%95 GA: 0,577–0,725) bulundu. Sonuç: Yüksek PIV, KAS hastalarında daha yüksek vasküler komorbidite yükü ile bağımsız ilişkilidir. Ancak sınırlı ayırt edici performansı nedeniyle PIV tek başına risk sınıflandırma aracı olarak kullanılmamalıdır.

Background: Benidipine is a long-acting calcium channel blocker used for the treatment of hypertension and chronic coronary syndrome. Although it effectively lowers blood pressure (BP), the relationship between BP reduction and improvement in angina-related health status during benidipine therapy remains uncertain. This study evaluated changes in BP and patient-reported angina-related health status in a large real-world cohort. Methods: This prospective, multicenter, observational cohort study included 1659 patients with hypertension and/or chronic coronary syndrome who underwent baseline clinical assessment before initiation of benidipine therapy and were reassessed after 3 months. Changes in systolic and diastolic BP and Seattle Angina Questionnaire-7 (SAQ-7) scores were evaluated. Multivariable linear regression analyses were performed to identify predictors of BP reduction and symptomatic improvement. A propensity score-matched analysis according to coronary artery disease (CAD) status was conducted to further explore differences in treatment response. Results: The mean age was 62.2 ± 12.2 years, and 54.0% of participants were women. Systolic BP decreased by 13.8 mmHg and diastolic BP by 6.7 mmHg (both p < 0.001). Mean SAQ-7 score increased by 8.1 points (p < 0.001), exceeding the established threshold for clinically meaningful improvement. Baseline SAQ-7 score showed the strongest association with change in SAQ-7, whereas baseline systolic BP was the strongest predictor of BP reduction. The correlation between changes in systolic BP and SAQ-7 was weak (r = 0.058, p = 0.023). In the propensity score-matched cohort (n = 732), BP reduction was similar regardless of CAD status, whereas improvement in SAQ-7 was greater in patients without obstructive CAD. Conclusions: In this multicenter real-world cohort, benidipine therapy was associated with significant BP reduction and clinically meaningful improvement in angina-related health status over 3 months. Symptomatic improvement showed only a weak association with BP reduction. These findings should be interpreted within the limitations of an observational study and warrant confirmation in controlled comparative studies.