Background and objectives: Despite being within the normal reference range, changes in thyroid stimulating hormone (TSH) levels have negative effects on the cardiovascular system. The majority of patients admitted to hospital with acute coronary syndrome (ACS) are euthyroid. The aim of this study was to investigate the effect of TSH level on the prognosis of in-hospital and follow-up periods of euthyroid ACS patients. Materials and Methods: A total of 629 patients with acute coronary syndrome without thyroid dysfunction were included in the study. TSH levels of patients were 0.3–5.33 uIU/mL. Patients were divided into three TSH tertiles: TSH level between (1) 0.3 uIU/mL and <0.90 uIU/mL (n = 209), (2) 0.90 uIU/mL and <1.60 uIU/mL (n = 210), and (3) 1.60 uIU/mL and 5.33 uIU/mL (n = 210). Demographic, clinical laboratory, and angiographic characteristics were compared between groups in terms of in-hospital and follow-up prognosis. Results: Mean age was 63.42 ± 12.5, and 73.9% were male. There was significant difference between tertiles in terms of TSH level at admission (p < 0.001), the severity of coronary artery disease (p = 0.024), in-hospital mortality (p < 0.001), in-hospital major hemorrhage (p = 0.005), total adverse clinical event (p = 0.03), follow-up mortality (p = 0.022), and total mortality (p < 0.001). In multivariate logistic regression analysis, the high–normal TSH tertile was found to be cumulative mortality increasing factor (OR = 6.307, 95%; CI: 1.769–22.480; p = 0.005) during the 6-month follow-up period after hospitalization and discharge. Conclusions: High–normal TSH tertile during hospital admission in euthyroid ACS patients is an independent predictor of total mortality during the 6-month follow-up period after hospitalization and discharge.

In the current literature, there are few studies investigating the relationship between premature coronary atherosclerosis and nonalcoholic fatty liver disease. We aimed to evaluate the relationship between nonalcoholic fatty liver disease and premature coronary atherosclerosis. In this cross-sectional study, female patients aged <55 years and male patients aged <50 years were enrolled. Both male and female patients underwent coronary angiography and abdomen ultrasonography between 2014 and 2019. A stepwise binary logistic regression analysis was carried out to evaluate the independent variables related to premature coronary atherosclerosis and nonalcoholic fatty liver disease. A p-value<0.05 was considered statistically significant. nonalcoholic fatty liver disease was present in 44% of patients (n=377). Notably, 62% of the patients were female and the mean age was 44.5 (39–49) years. In a multivariate analysis, nonalcoholic fatty liver disease was shown to be an independent risk factor of premature coronary atherosclerosis (OR 1.438; 95%CI, 1.050–1.969; p=0.024). The presence of nonalcoholic fatty liver disease is an important independent risk factor for the development of premature coronary atherosclerosis.

Background and objectives: Cranial magnetic resonance imaging findings of patients considered to be cryptogenic stroke may be useful in determining the clinical and prognostic significance of arrhythmias, such as atrial premature beats and atrial run attacks, that are frequently encountered in rhythm Holter analysis. This study was conducted to investigate the relationship between short atrial runs and frequent premature atrial contractions detected in Holter monitors and infarct distributions in cranial magnetic resonance imaging of patients diagnosed with cryptogenic stroke. Materials and Methods: We enrolled the patients with acute ischemic stroke whose etiology were undetermined. We divided the patients in two groups according to diffusion-weighted magnetic resonance imaging as single or multiple vascular territory acute infarcts. The demographic, clinical, laboratory, echocardiographic, and rhythm Holter analyses were compared. Results: The study investigated 106 patients diagnosed with cryptogenic stroke. Acute cerebral infarctions were detected in 31% of the investigated patients in multiple territories and in 69% in a single territory. In multivariate logistic regression analysis, the total premature atrial contraction count (OR = 1.002, 95% CI: 1.001–1.004, p = 0.001) and short atrial run count (OR = 1.086, 95% CI: 1.021–1.155, p = 0.008) were found as independent variables that could distinguish between infarctions in a single or in multiple vascular territories. Conclusions: Rhythm Holter monitoring of patients with infarcts detected in multiple vascular territories showed significantly higher premature atrial contractions and short atrial run attacks. More effort should be devoted to the identification of cardioembolic etiology in cryptogenic stroke patients with concurrent acute infarcts in the multiple vascular territories of the brain.

The aging population is rapidly growing, increasing the need for practical and accessible risk prediction tools, particularly in elderly patients with ST-elevation myocardial infarction. Traditional risk stratification models often fail to capture the full complexity of cardiovascular risk in this population. The triglyceride (TyG)-glucose index and body roundness index (BRI) have been individually associated with metabolic and cardiovascular risk. This research aimed to assess the prognostic value of the combined TyG-BRI index in predicting in-hospital mortality in octogenarian STEMI patients. This retrospective observational study included 203 octogenarian STEMI patients (age ≥80 years) admitted to the coronary intensive care unit. The TyG index, BRI, TyG-BRI index, and PNI were calculated using standard formulas. Multivariate logistic regression analysis was performed to detect independent predictors of in-hospital mortality, and ROC curve analysis assessed the discriminative ability of the TyG-BRI index. Among the 203 patients, 56 (27.6%) died during hospitalization. The TyG-BRI index was significantly higher in non-survivors (33.7 vs. 27.17, p < 0.001) and independently predicted in-hospital mortality (OR = 1.32, 95% CI:1.02-1.71, p = 0.031). The optimal TyG-BRI threshold for mortality prediction was >30.7, with a sensitivity of 83% and specificity of 67%. Additionally, low prognostic nutritional index (OR = 0.49, 95% CI:0.30-0.81, p = 0.005) and low glomerular filtration rate (OR = 0.92, 95% CI:0.86-0.99, p = 0.043) were independent predictors of mortality. The TyG-BRI index is a simple, cost-effective, and independent predictor of in-hospital mortality in octogenarian STEMI patients, offering additional prognostic value beyond traditional risk factors. Its ease of calculation using routine laboratory and anthropometric data makes it a practical tool for risk stratification, even in resource-limited settings. Further prospective studies are needed to validate its long-term prognostic value and potential role in personalized treatment strategies for elderly STEMI patients.