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.

Background: The coronary slow flow phenomenon (CSFP) is delayed contrast progression through the epicardial coronary arteries in the absence of significant stenosis. The stress hyperglycemia ratio (SHR) normalizes admission glucose to the estimated average glucose derived from HbA1c, separating acute glycemic excursion from chronic hyperglycemia. Whether the SHR is independently associated with CSFP in patients with type 2 diabetes mellitus (T2DM) is not known. Methods: This retrospective case-control study enrolled 235 consecutive patients with T2DM who underwent coronary angiography between January 2022 and January 2025. Patients with epicardial stenosis exceeding 40% in any vessel, prior revascularization, or acute coronary syndrome within 30 days were excluded. Among the remaining patients, those with a corrected TIMI frame count (CTFC) above 27 in any epicardial vessel were classified as CSFP (n=112) and the rest as normal coronary flow (NCF) (n=123). The SHR was calculated as admission blood glucose (mmol/L) divided by (1.59 × HbA1c% − 2.59). Results: The SHR was higher in the CSFP group than in the NCF group (1.42 ± 0.31 vs. 1.08 ± 0.24, p<0.001). After multivariate adjustment, it remained independently associated with CSFP (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.92–4.21, p<0.001). On receiver operating characteristic analysis the area under the curve (AUC) was 0.819 (95% CI 0.760–0.876); a cutoff of 1.21 gave 78.6% sensitivity and 74.0% specificity. The SHR correlated with mean CTFC (r=0.621, p<0.001) and outperformed admission glucose alone (AUC 0.724, p=0.003). Conclusion: In this cohort, the SHR was independently associated with CSFP and discriminated it better than admission glucose alone. Because it is calculated from two values routinely available at catheterization, admission glucose and HbA1c, the SHR is a practical candidate marker that warrants prospective validation for risk stratification in patients with T2DM undergoing coronary evaluation.

Background: P-wave duration and P-wave dispersion (PWD) are electrocardiographic (ECG) markers of atrial conduction. This study aimed to compare these parameters in ischemic and hemorrhagic stroke patients versus controls and to examine the effects of stroke subtypes on atrial electrophysio-logy. Materials and Methods: This cross-sectional study included , 34 patients with ischemic stroke, 33 patients with hemorrhagic stroke, and 45 healthy subjects as control group. The 12-lead ECGs of all individuals taken at the time of admission to the hospital were analyzed. Maximum P wave duration (Pmax) and PWD were manually measured. All patients underwent brain CT and/or MRI within the first 24-48 hours of presentation, while echocardiography was performed within the first 48-72 hours of hospitalization. Results: Both stroke groups had significantly increased Pmax (ischemic: 130.3±11.9 ms, hemorrhagic: 118.8±14.7 ms, control: 91.8±11.5 ms; p<0.001) and PWD (ischemic: 40.9±13.3 ms, hemorrhagic: 43.6±13.1 ms, control: 23.8±9.1 ms; p<0.001) values compared to controls. No significant differ-ences were found between the ischemic and hemorrhagic groups. Conclusions: Ischemic and hemorrhagic stroke patients had prolonged P wave duration and increa-sed PWD during the acute phase of stroke compared to the control group. These findings suggest altered atrial conduction in stroke patients, regardless of stroke subtype, and may indicate an incre-ased risk of atrial fibrillation (AF) in this population.

Early identification of anatomically significant coronary artery disease (CAD) remains a major clinical challenge despite advances in cardiovascular diagnostics. Novel circulating biomarkers may improve risk stratification and diagnostic discrimination beyond conventional parameters. We investigated the diagnostic utility of four emerging biomarkers—Phoenixin-14, Syntenin-1, Alamandine, and Cerebellin-1—for the assessment of CAD severity. In this prospective observational study, 90 participants undergoing coronary angiography were categorized into three groups: severe CAD (≥70% stenosis; n = 30), non-obstructive/non-critical CAD (<70% stenosis; n = 30), and angiographically normal controls (n = 30). Patients with acute coronary syndrome, diabetes mellitus, prior coronary revascularization, cardiomyopathy, or significant systemic disease were excluded. Circulating biomarker concentrations were quantified using the enzyme-linked immunosorbent assay. Comparative analyses, correlation testing, and receiver operating characteristic (ROC) analyses were performed to evaluate discriminatory performance. Circulating Phoenixin-14 concentrations progressively declined across the control, non-critical CAD, and severe CAD groups [40.1 (29.0–49.7) vs. 24.4 (18.5–30.1) vs. 16.7 (13.4–19.0) pg/mL, respectively; p < 0.001]. Phoenixin-14 demonstrated outstanding discrimination for severe CAD, achieving an area under the ROC curve (AUC) of 0.969 (95% CI, 0.888–0.997), with 86.7% sensitivity and 96.7% specificity at a threshold of ≤20.2 pg/mL. Diagnostic performance was substantially lower for Syntenin-1 (AUC, 0.795), Alamandine (AUC, 0.661), and Cerebellin-1 (AUC, 0.597). Phoenixin-14 also showed robust discrimination for non-critical CAD (AUC, 0.832). Biomarker concentrations exhibited correlations with metabolic indices while remaining largely independent of traditional cardiovascular risk factors. Among the evaluated novel circulating biomarkers, Phoenixin-14 demonstrated superior diagnostic performance for both obstructive and non-obstructive CAD, markedly outperforming Syntenin-1, Alamandine, and Cerebellin-1. These findings identify Phoenixin-14 as a promising candidate biomarker for CAD severity assessment and clinical risk stratification. Larger multicenter studies are warranted to validate these exploratory findings and determine their incremental value in contemporary cardiovascular practice.

Background and Objectives: Inflammation and nutritional status are closely associated with prognosis in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). This study compared the prognostic performance of the conventional Naples score and CRP-modified Naples score for predicting in-hospital mortality. Materials and Methods: This retrospective, single-center study included 921 patients with NSTE-ACS undergoing percutaneous coronary intervention. Multivariable logistic regression, ROC analysis, reclassification indices, restricted cubic spline analysis, and decision curve analysis were performed. Results: In-hospital mortality occurred in 79 patients (8.6%). Patients who died had higher Naples score and modified Naples score values than survivors. In multivariable models adjusted for baseline clinical variables and GRACE score, both the modified Naples score and conventional Naples score remained independently associated with in-hospital mortality. The modified Naples score showed an adjusted-OR of 3.85 (95% CI: 2.71–5.48; p < 0.001), whereas the conventional Naples score showed an adjusted-OR of 4.52 (95% CI: 3.05–6.70; p < 0.001). The addition of the modified Naples score improved model performance, with a C-index of 0.819, NRI of 0.741, and IDI of 0.127. Similarly, the conventional Naples score model showed a C-index of 0.827, NRI of 0.843, and IDI of 0.125. In ROC analysis, the AUC was 0.701 for the modified Naples score and 0.683 for the conventional Naples score, without a statistically significant difference between them (ΔAUC = 0.017; p = 0.300). Decision curve analysis showed positive net clinical benefit for both scores, with no consistent superiority of either score. Conclusions: Both Naples-based scores were independently associated with in-hospital mortality and provided comparable prognostic performance in patients with NSTE-ACS undergoing PCI.