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: Hypertension (HT) is one of the most common causes of myocardial dysfunction. Although early detection of myocardial impairment remains challenging, left ventricular global longitudinal strain (LV-GLS) is a sensitive echocardiographic parameter that can identify subclinical myocardial damage. However, its application is limited in routine clinical settings. R-wave peak time (RWPT) is a simple and widely available electrocardiographic parameter that may reflect intramyocardial conduction delay and early structural remodeling. This study aimed to investigate the association between RWPT and LV-GLS in patients with HT. METHODS: This prospective study included 403 patients with a confirmed diagnosis of HT. All participants underwent transthoracic echocardiography and 12-lead surface ECG. LV-GLS was assessed using speckle-tracking echocardiography. ECG images were digitized and analyzed using ImageJ software, and RWPT was defined as the interval from the onset of the QRS complex to the peak of the R-wave. RESULTS: Patients were divided into two groups according to their LV-GLS value of −15.9%, which is defined as the cutoff value of myocardial impairment. Patients with a lower LV-GLS had significantly longer RWPT and QRS durations. In multivariate analysis, RWPT was found to be an independent predictor of impaired LV-GLS (OR: 1.085; 95% CI: 1.056–1.114; P < 0.001). ROC analysis demonstrated an AUC of 0.715 (95% CI: 0.665–0.765; P < 0.001) with a sensitivity of 64.9% and a specificity of 67.7% at a cutoff value of 45.5 ms. CONCLUSIONS: RWPT may serve as a practical, accessible, and sensitive electrocardiographic marker for detecting subclinical myocardial dysfunction in patients with HT.

Background: Thiazide‐induced hyponatremia (TIH) is a well‐recognized adverse effect of thiazide diuretics, typically occurring in elderly individuals. Severe acute hyponatremia presenting with seizures in middle‐aged adults is uncommon. Combination therapy with spironolactone and hydrochlorothiazide (Aldactazide) may increase susceptibility to rapid electrolyte shifts. We report a case of early‐onset, symptomatic hyponatremia leading to generalized seizure shortly after initiation of Aldactazide. Case Presentation: A 52‐year‐old woman with hypertension presented after experiencing a generalized tonic–clonic seizure at home. She had started Aldactazide (spironolactone + hydrochlorothiazide 25 mg daily) 3 days earlier, in addition to perindopril/amlodipine and captopril. Two weeks before symptom onset, her serum sodium level was 131 mmol/L. On admission to the intensive care unit, she was alert and hemodynamically stable, with a Glasgow Coma Scale score of 15. Laboratory evaluation revealed severe hyponatremia (115 mmol/L), hypokalemia (3.3 mmol/L; ionized 2.7 mmol/L), and hypochloremia (76 mmol/L). Lactate was transiently elevated at 8.3 mmol/L, consistent with postictal physiology. Renal, thyroid, and adrenal functions were normal. Brain CT and MRI showed no acute abnormalities. Controlled correction with 3% hypertonic saline resulted in progressive normalization of serum sodium (115 ⟶ 121 ⟶ 125 ⟶ 131 mmol/L) without overcorrection. The patient experienced complete neurological recovery and was transferred to the nephrology ward for continued monitoring. Aldactazide was discontinued. Conclusion: This case demonstrates that TIH can develop rapidly in middle‐aged individuals and may lead to life‐threatening neurological complications, including seizures. Clinicians should closely monitor serum sodium during the early phase of thiazide‐containing diuretic therapy, particularly when combination regimens such as Aldactazide are prescribed.

Behçet Hastalığı, kronik inflamatuar sistemik bir vaskülit hastalığı olarak tanımlanmaktadır. Kardiyak tutulum, özellikle akut koroner sendrom, Behçet hastalığı’nda sık karşılaşılan bir durum değildir. Bu olguda Behçet hastalığı tanısı olan ve ST segment yükselmeli miyokart enfarktüsü (STYME) tablosu ile başvuran 40 yaşında kadın hasta sunulacaktır.

Tüm yazarlarımızla birlikte “Klinikten pratiğe kardiyoloji” kitabının ilk baskısını okuyucuları ile buluşturmanın heyecanını taşıyoruz. ‘Klinikten pratiğe kardiyoloji’ kitabında hem kardiyoloji hem de kardiyovasküler cerrahi alanlarındaki güncel bilgileri ve yenilikleri okurlarına iletmek amaçlanmıştır. Bu kitapta kardiyolojik ve cerrahi bakış açıları bir araya getirilmiştir. Aynı zamanda pratik hayatta hastaların yandaş sorunlarına yaklaşım açısından da ilgili uzmanlık alanlarından, yazdıkları bölümlerle katkılar alınmıştır. Sağlık kuşkusuz ki bütüncül yaklaşımlarla geliştirilebilir. Ancak artan bilgi birikimi ve gelişen yeni teknikler alt konu başlıklarında uzmanlaşmayı da zorunlu kılmıştır. Günümüzde sağlıkta bütüncül yaklaşım, farklı konularda uzmanlaşmış kişilerin birikimlerini ortak platformlarda paylaşmaları ile sağlanabilir. Bu kitapta kardiyoloji ve kardiyovasküler cerrahi konusundaki bilgi ve tekniklerin bütüncül olarak bir araya getirilmesi hedeflenmiştir. Tüm yazarlarımızca ortak düşümüz kitabın tekrar eden baskılarında bu yaklaşımı güncel bilgilerle daha da geliştirmektir.