Infective Endocarditis (IE) is a severe and potentially life-threatening infection of the heart valves, necessitating a comprehensive understanding of factors influencing patient outcomes. The study aims to investigate the relationship between NPS and in-hospital mortality in patients diagnosed with Infective Endocarditis (IE). A total of 153 IE patients were included in the study, with 32 (20,9%) experiencing in-hospital mortality. Patients were categorised into survivors and non-survivors, and detailed clinical and demographic characteristics were recorded. The final endpoint of the study was determined as in-hospital mortality. Regression analyses were conducted to identify the independent variables, and Kaplan-Meier estimates were created to determine survival outcomes, using a significance level of p < 0.05 for all statistical analyses. The non-survivor group exhibited a significantly higher NPS compared to the survivor group (28 (87.5) vs. 56 (46.3); p < 0.001). ROC curve analysis, utilising NPS, the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), albumin, and total cholesterol values, identified NPS as the most robust parameter, with an area under the curve of 0.704 (95% CI: 0.612-0.797; p < 0.001). Multivariate regression analysis revealed Septic shock (p = 0.001), NPS (p = 0.004), and Age (p = 0.012) as independent determinants of in-hospital mortality in IE patients. This study demonstrated a strong correlation between NPS and mortality in IE. This novel score, as it reflects both the level of inflammation and nutrition, can be used to predict the prognosis in IE.
Introduction: The most basic and well-known cause of peripheral arterial disease (PAD) is atherosclerosis. One of the main factors causing atherosclerosis is dyslipidemia. We will evaluate whether specific ratios of dyslipidemia, such as the atherogenic plasma index (AIP) and LDL/HDL ratio, which have recently been used in practice, can help us to predict the complexity of PAD in the clinic. Methods: A total of 305 patients with PAD admitted to our clinic were retrospectively included in this study. After evaluation according to angiography images using TASC-II classification, patients were divided into TASC A-B and TASC C-D. AIP was evaluated with the following formula: Log (TG/HDL). Cut-off values for AIP and LDL/HDL were determined on the ROC (receiver operating characteristic) curve. Logistic regression analysis were conducted to predict peripheral arterial disease complexity. Results: The mean ages of Group 1 ( n :180, 68.3% male) and Group 2 ( n :125, 77.6% male) patients were 64.10 ± 12.39 and 64.94 ± 11.12 years, respectively. The prevalence of diabetes mellitus (DM, p < 0.016) and coronary artery disease (CAD, p < 0.001) was higher in group 2. Group 2 had higher TG ( p = 0.045), LDL-C ( p = 0.004), AIP ( p = 0.010), LDL/HDL ( p < 0.001), and lower HDL-C ( p = 0.015). In multivariate logistic regression analysis evaluating parameters in predicting PAD complexity, DM (OR: 1.66 Cl 95%: 1.01–2.73 p = 0.045), CAD (OR: 2.86 Cl 95%: 1.75–4.69 p < 0.001) and LDL/HDL (OR: 1.47 Cl 95%: 1.10–1.96 p = 0.008) were independent variables. Conclusion: In our study, we compared LDL/HDL ratio and AIP in PAD for the first time in the literature and showed that LDL/HDL ratio is a more valuable ratio and an independent predictor of PAD complexity.
Introduction: Subclinical hypothyroidism (SCH) is a biochemical condition that is diagnosed when peripheral free thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone (TSH) levels are mildly elevated. The aim of this study was to investigate the relationship between SCH and arterial stiffness using two different non-invasive methods, including echocardiography and oscillometric arteriography. Material and Methods: The study included 33 newly diagnosed SCH patients and 34 age- and gender-matched healthy controls. Systolic and diastolic diameters and elastic parameters of the aorta were calculated by 2D Transthoracic echocardiography (TTE). Central blood pressure and aortic stiffness values of patient groups were measured noninvasively from the brachial artery using Mobil-O-Graph arteriography. Pulse wave velocity (PWV) and augmentation index (AIx) were used as arterial stiffness indicators. Results: There was no significant difference between SCH and control groups with regard to age, gender, and body mass index (BMI). Aortic strain and aortic distensibility, were significantly lower in the SCH group than in the control group (p < 0.001). PWV and AIx which measured by Mobil-O-Graph arteriography were found to be significantly higher in the subclinical hypothyroid group compared to the control group (p < 0.05). Conclusion: Aortic stiffness assessed by TTE and Mobil-O-Graph arteriography deteriorated in patients with SCH after excluding other cardiovascular risk factors. The assessment of aortic stiffness by the oscillometric method was easy and useful for widespread clinical use.
Introduction: Peripheral artery disease (PAD) poses a growing clinical challenge due to an aging population, despite advances in treatment methods. Various scoring systems have emerged to predict high-risk patients, including the HALP (hemoglobin, albumin, lymphocyte, and platelet) score, known for predicting prognosis in cancers and stroke. This study assesses the HALP score’s relation to lesion severity and long-term mortality in PAD patients. Methods: We retrospectively analyzed 305 symptomatic PAD patients undergoing endovascular intervention. The following formula was used to calculate the HALP score: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L) / platelet count (/L). Lesion severity was classified by TASC-II: TASC AB and TASC CD. Mortality data were obtained from hospital and social security records. Results: The study involved 305 patients (mean age 64.4 ± 11.8 years; 72.1% male), divided into survivors (208) and non-survivors (97). ROC analysis identified HALP score as the strongest predictor of long-term mortality (AUC: 0.736; 95% CI: 0.679–0.793; p < .001). HALP score (HR, 0.087; 95% CI, 0.025–1.300; p < .001), age ( p < .001), DM ( p = .007), and CRP ( p = .013) independently predicted mortality. Kaplan–Meier analysis showed higher HALP scores linked to lower long-term mortality (Log-rank: 20.102, p < .001), with an average follow-up of 48 ± 18 months. Conclusion: The HALP score emerged as a robust predictor of PAD prognosis, surpassing individual components and other parameters. Lower HALP scores correlated with more severe lesions and reduced life expectancy.
Objective: The frontal QRS-T angle (fQRS-T) is linked to myocardial ischemia and ventricular arrhythmias. On the other hand, non-dipper hypertension is a risk factor for cardiac adverse events. The objective of this research was to determine whether the fQRS-T, a marker of ventricular heterogeneity, could be used to predict non-dipper hypertensive individuals in the lack of left ventricular hypertrophy. Methods: The observational study was carried out retrospectively. Patients diagnosed with hypertension were included in this study. Blood tests were routinely conducted for all patients. Electrocardiography (ECG) was conducted for each patient and echocardiography was performed. Blood pressure (BP) values were collected from the ambulatory Holter records. According to ambulatory Holter monitoring, the individuals were separated into two groups. The association between fQRS-T and hypertension was investigated. Results: The research involved 123 patients, with an average age of 51.85±8.22 years, comprising 76 women (61.8%) and 47 males (38.2%). According to ambulatory Holter monitoring, patients were separated into dippers (n=65) and non-dippers (n=58). There were no statistically significant in the laboratory and echocardiographic variables (p>0.05). QT dispersion (QTd) and fQRS-T were substantially greater in the non-dipper group than in the dipper group (p=0.043 and p<0.001, respectively). Independent determinants of non-dipper status were determined by univariate and multivariate logistic regression analyses. fQRS-T was found to be the only independent indicator of non-dipper status (OR: 1.03, 95%CI: 1.02-1.06, p<0.001). Conclusion: The fQRS-T may be a useful marker for estimating non-dipper hypertensive individuals in the lack of left ventricular hypertrophy.