The European Society of Cardiology has recently defined heart failure (HF) patient group with a left ventricular ejection fraction (LVEF) of 41–49% as a different category with the term heart failu...

Backround: We aimed to evaluate the utility of the preprocedural platelet–lymphocyte ratio (PLR) for predicting the no‐reflow phenomenon after thrombus aspiration during percutaneous coronary intervention (PCI) in patients with ST‐segment elevation myocardial infarction (STEMI).Method: We retrospectively analyzed postprocedural thrombolysis in myocardial infarction (TIMI) flow grades and myocardial blush grades (MBG) of 247 patients who underwent a PCI procedure with thrombus aspiration.We divided these patients into two groups according to whether they had no‐reflow (TIMI < 3, MBG < 2) or not (TIMI 3, MBG ≥ 2).Results: No‐reflow developed in 43 (17%) patients.Preprocedural PLR was significantly higher in the no‐reflow group (183.76 ± 56.65 vs 118.32 ± 50.42 p < 0.001).Independent predictors of no‐reflow were as follows: higher preprocedural platelet‐lymphocyte ratio (PLR) (OR = 1.018; 95% CI = 1.004, 1.033; p = 0.013),mean corpuscular volume (MCV) (OR = 1.118; 95% CI = 1.024, 1.220; p = 0.012) and SYNTAX Score‐2 (OR = 1.073; 95% CI = 1.005, 1.146; p = 0.036). PLR of 144 had 79% sensitivity and 75% specificity for the prediction of no‐reflow.Conclusion: PLR is a reliable predictor for no‐reflow in STEMI patients undergoing thrombus aspiration.

Background: Although the incidence of myocardial bridge (MB) has been defined in different femoral access conventional coronary angiography (FACCA) studies, the frequency of MB on radial access coronary angiography (RACA) is unknown. The aim of this study was to determine the difference in the incidence of MB between patients undergoing RACA and FACCA. Method: A total of 2500 consecutive patients who underwent RACA and a total of 1455 consecutive patients who underwent FACCA were retrospectively investigated to detect the presence of MB. The incidences of the groups were calculated separately and compared. The clinical and angiographic features of the patients with MB were analyzed. Results: MB was detected at an incidence of 10.2%, in 255/2500 patients who underwent RACA, and 1.8% in 27/1455 patients who underwent FACCA (p < 0.001). In both RACA and FACCA patients, the most involved coronary artery was the left anterior descending artery (LAD) (86.9% and 93.1%) and the mid-segment (84.9% and 88.9%) was the most affected section. Co-involvement of multiple coronary arteries by MB was 7.8% in patients who underwent RACA and 7.4% in patients who underwent FACCA. Coronary artery disease (CAD) was determined in 111 (35.7%) of the coronary arteries with MB, of which 81.9% were proximal to the MB. No significant CAD was detected in any of the vessels of 69.8% (178/255) of the patients who underwent RACA for different clinical indications. Conclusion: These data demonstrated that the incidence of myocardial bridge able to be detected on RACA was much higher than FACCA.

Pneumopericardium is a rare complication of pericardiocentesis and defined as the presence of air in the pericardial space. Pneumopericardium usually occurs after trauma. However, pneumopericardium due to iatrogenic procedures, such as pericardiocentesis, is extremely rare. It can be caused by either direct pleuropericardial connection development or reverse air leakage in the drainage system. Herein, we report the case of a 39-year-old female with cardiac tamponade who developed pneumopericardium after pericardiocentesis.

Bruton's tyrosine kinase (BTK) inhibition in cardiac tissue causes inhibition of the PI3K-AKT signaling pathway, which is responsible for protecting cardiac tissue during stress. Therefore, there is an increase in the risk of arrhythmia. This risk can be predicted with the Age-Creatinine-Ejection Fraction (ACEF) score, which is a simple scoring system that can be calculated from age, creatinine and ejection fraction components. Patients diagnosed with Chronic Lymphocytic Leukemia (CLL) and receiving Ibrutinib treatment for at least 1 year were evaluated with echocardiography and holter electrocardiography, and the results were compared with the control group of CLL patients who did not receive treatment. When arrhythmia development of the patients was evaluated, no statistically significant difference was found between the control and Ibrutinib groups in terms of other types of arrhythmias exact Paroxismal Atrial Fibrillation (PAF). PAF was found to be 8% versus 22% (p-value: 0.042) in the Ibrutinib non-users and users groups. In patients receiving ibrutinib, ACEF score of >1.21 predicted the development of PAF with 77% sensitivity and 75% specificity (Receiver Operating Characteristic [ROC] area under curve: 0.830, 95% CI: 0.698-0.962, P<0.001). The ACEF risk score can be used as a risk score that predicts the development of PAF in patients diagnosed with CLL and planned to start ibrutinib.