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The study aimed to evaluate the impact of antecedent aspirin use on infarct size, bleeding and composite endpoint in patients with de novo acute myocardial infarction. A total of 562 consecutive patients with de novo acute myocardial infarction were included in this prospective cohort study. Patients were assigned into two groups based on presence (n=212) and absence (n=350) of prior aspirin use. Primary endpoint was myocardial infarct size, as estimated by troponin I peak. In-hospital mortality, bleeding and composite clinical endpoint including cardiogenic shock, stroke, in-hospital mortality and major bleeding were also evaluated. Although GRACE and CRUSADE scores were higher, troponin I peak was lower in prior aspirin users. This result was maintained after adjustment for baseline ischemic risk profile and other major confounders including MI type and location. Despite high CRUSADE score, there was no increase in major and minor bleeding. Minimal bleeding was higher in antecedent aspirin users. When it was adjusted for the CRUSADE score, a similar risk was reported. Patients with de novo acute myocardial infarction using aspirin for primary prevention have an unexpectedly smaller infarct size and similar bleeding rates.

Background: Infective endocarditis (IE) remains associated with high morbidity and mortality despite advances in diagnostic and therapeutic strategies. Markers reflecting both inflammatory burden and nutritional status may improve early risk stratification. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is a composite index integrating hematologic and nutritional parameters; however, its prognostic value in IE has not been well established. Methods: This two-center retrospective cohort study included 218 adult patients hospitalized with IE between January 2016 and January 2025. HALP score was calculated from admission laboratory values. The primary outcome was in-hospital mortality, and 1-year mortality was evaluated as a secondary outcome. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value. Patients were categorized into low- and high-HALP groups, and survival was assessed using Kaplan–Meier analysis. Cox regression analyses were performed to identify independent predictors of in-hospital mortality. Results: A total of 218 patients were analyzed. In-hospital mortality occurred in 38.5% of patients. HALP score was significantly lower in non-survivors and was independently associated with in-hospital mortality. ROC analysis demonstrated good discriminatory performance (AUC 0.784), with an optimal cut-off value of 15.1 (sensitivity 73.9%, specificity 73.8%). Low HALP scores were associated with more advanced functional status, more frequent intracardiac complications, and higher rates of acute heart failure, renal failure, and septic shock. One-year mortality was also higher in the low-HALP group (42.9% vs. 18.2%, p = 0.005). Conclusions: HALP score is independently associated with in-hospital mortality in patients with IE and identifies a subgroup with more severe disease and worse outcomes. As an easily calculated parameter, it may serve as a complementary tool for risk stratification and clinical decision-making.

Objective: Carotid plaques are divided into calcified, mixed and fatty types according to the morphological ultrastructure. Increased risk of rupture, thromboembolism and stroke are more pronounced in mixed and fatty carotid plaques due to composition and instability. The present study aimed to assess the role of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) to predict mixed and fatty plaques in patients with intermediate carotid artery stenosis. Method: A total of 223 asymptomatic patients who had 50-70% stenosis in the carotid artery were included in this retrospective cohort study. Patients were assigned into three groups based on plaque morphology: 94 with calcified, 71 with mixed and 58 with fatty plaques. Groups were compared in terms of MHR. Predictive role of MHR for mixed and fatty plaque was investigated. Results: MHR was significantly higher in the mixed and fatty plaque groups (16.951±5.935 vs 20.181±9.405 vs 11.200±4.126, p<0.001). It, with a cut off of 13.61, had 71.8% sensitivity and 56.6% specificity for the prediction of mixed plaque [area under the curve (AUC): 0.645, 95% confidence interval (CI): 0.571-0.718, p=0.001]. Moreover, MHR, with a cut off of 14.40, had 77.6% sensitivity and 62.4% specificity for the prediction of fatty plaque (AUC: 0.746, 95% CI: 0.675-0.818, p<0.001). Multivariate regression analysis showed MHR was a significant independent predictor of mixed [odds ratio (OR): 1.230, p<0.001] and fatty (OR: 1.364, p<0.001) plaques in intermediate carotid artery stenosis, after adjusting for other risk factors. Conclusion: MHR plays a favorable role for the prediction of mixed and fatty plaques in asymptomatic intermediate carotid artery stenosis.

Objective: The relationship between the interatrial block (IAB) and atrial fibrillation (AF) has been demonstrated in previous studies. The aim of this study is to investigate the relationship of the IAB with the psoriasis area severity index (PASI) score in psoriasis. Method: Patients with psoriasis who were examined at the cardiology outpatient clinic between January 2017 and May 2019 were retrospectively screened. Two hundred and thirty-eight patients whose electrocardiogram (ECG) and PASI scores were available were included in the study. IAB was defined as if P wave duration was equal to or longer than 120 msec with (advanced IAB) or without (partial IAB) biphasic P morphology in the inferior electrocardiographic leads. The prevalence of IAB in patients with psoriasis and its relationship with the severity of psoriasis were evaluated in the present study. Results: The mean age was 35 (18-62) years, 53% of the study population were male. The median PASI score was 6. IAB was observed in 9.9% of patients. Partial IAB was observed in 6% of patients whereas the prevalence of advanced IAB was 3.0%. No statistically significant difference was observed between the PASI score in patients with and without IAB [6.0 (3.0-13.5) vs. 7.0 (2.5-22.5), respectively, p=0.35]. The mean P wave duration (PWD) was 101 (90-111) ms. No statistically significant correlation was observed between PWD and the PASI score (p=0.35, r=0.06). Conclusion: No significant correlation was identified between IAB and the PASI score, which is used for assessing the severity of psoriasis.

Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women. In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups. Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001), lumbar vertebral z-scores (r=-0.290; P=0.001), and proximal femoral T-scores (r=-0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.318; P=0.001), lumbar vertebral z-scores (r=-0.340; P=0.001), and proximal femoral T-scores (r=-0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46-3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254-3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007-1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters. The present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both hypertension and diabetes were demonstrated as significant independent predictors of osteopenia in postmenopausal Turkish women. Clinicians should be aware of the high risk of developing osteopenia in diabetic hypertensive postmenopausal women.

The present study aimed to assess the role of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) to predict mixed and fatty plaques in patients with intermediate carotid artery stenosis.

Background We investigated the role of ventricular repolarization parameters to predict complete atrioventricular block in patients undergoing transcatheter aortic valve implantation (TAVI). Methods A total of 150 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned in two groups based on the presence (n: 49) or absence (n: 101) of complete atrioventricular block after TAVI. Ventricular repolarization intervals (QT, QTc, JT, JTc, TP‐E), indices (QT dispersion), and ratios (TP‐E/QT, TP‐E/QTc, TP‐E/JTc) were measured. Results Electrocardiographic repolarization parameters such as Tp‐e interval: 74.2 ± 5.1 versus 59.2 ± 6.1 ms, p < .001; QTc interval: 397.6 ± 3.4 versus 368.1 ± 7.8 ms, p < .001; JTc interval: 317.4 ± 11.3 versus 291.1 ± 6.7 ms, p < .001; Tp‐e/QT ratio: 0.28 ± 0.04 versus 0.20 ± 0.04, p < .001; Tp‐e/QTc ratio: 0.29 ± 0.04 versus 0.19 ± 0.03, p < .001; Tp‐e/JT ratio: 0.32 ± 0.03 versus 0.23 ± 0.03, p < .001; Tp‐e/JTc ratio: 0.30 ± 0.02 versus 0.2 ± 0.03, p < .001; and QT dispersion: 34.4 ± 3.0 versus 17.8 ± 3.6 ms, p < .01 were significantly higher in post‐TAVI permanent pacemaker group. In a univariate regression analysis, pulmonary artery pressure, heart rate, coronary artery disease, Tp‐e/QTc, Tp‐e/JTc, and PR interval were significantly associated with complete heart block. Tp‐e/JTc (OR 0.373, p = .067) and PR interval (OR 0.898, p = .079) were found to be independent predictors of these type of arrhythmias in a multivariate analysis. But it is not statistically significant. Conclusion Our results suggest that repolarization parameters may play a role in predicting complete atrioventricular block. Tp‐e/JTc was found to be potential independent risk marker for this setting.

Objective: The relationship between the interatrial block (IAB) and atrial fibrillation (AF) has been demonstrated in previous studies. The aim of this study is to investigate the relationship of the IAB with the psoriasis area severity index (PASI) score in psoriasis. Method: Patients with psoriasis who were examined at the cardiology outpatient clinic between January 2017 and May 2019 were retrospectively screened. Two hundred and thirty-eight patients whose electrocardiogram (ECG) and PASI scores were available were included in the study. IAB was defined as if P wave duration was equal to or longer than 120 msec with (advanced IAB) or without (partial IAB) biphasic P morphology in the inferior electrocardiographic leads. The prevalence of IAB in patients with psoriasis and its relationship with the severity of psoriasis were evaluated in the present study. Results: The mean age was 35 (18-62) years, 53% of the study population were male. The median PASI score was 6. IAB was observed in 9.9% of patients. Partial IAB was observed in 6% of patients whereas the prevalence of advanced IAB was 3.0%. No statistically significant difference was observed between the PASI score in patients with and without IAB [6.0 (3.0-13.5) vs. 70 (2.5-22.5), respectively, p=0.35]. The mean P wave duration (PWD) was 101 (90-111) ms. No statistically significant correlation was observed between PWD and the PASI score (p=0.35, r=0.06). Conclusion: No significant correlation was identified between IAB and the PASI score, which is used for assessing the severity of psoriasis. Keywords: Atrial fibrillation, electrocardiography, interatrial block, psoriasis, psoriasis area severity index, stroke Amac: interatriyal blok ve atriyal fibrillasyon arasindaki iliski daha onceki yayinlarda gosterilmistir. Bu calismanin amaci interatriyal blok (IAB) ve psoriazis alan ciddiyeti indeksi (PACI) arasindaki iliskinin arastirilmasidir. Yontem: Ocak 2017-Mayis 2019 arasinda kardiyoloji polikliniginde muayene olan psoriasis hastalari retrospektif olarak taranmistir. Elektrokardiyografilerine ve PACI skorlarina ulasilan 238 hasta calismaya alindi. IAB P dalga suresi 120 msn uzerinde ve bifazik morfoloji eslik ediyorsa ileri (aIAB), etmiyorsa parsiyal IAB (pIAB) olarak tanimlandi. IAB'nin psoriasis hastalarinda yayginligi ve psoriazisin siddetiyle iliskisi degerlendirildi. Bulgular: Hastalarin ortalama yasi 35 (18-62) yildi, %53'u erkekti. Ortalama PACI degeri 3,29[+ or -]3,81 idi. IAB hastalarin %9,9'unda goruldu. Bu hastalarin %6'sinda pIAB, %3'unde aIAB izlendi. Total IAB izlenen hastalarin PACI degerleri ile IAB olmayan hastalarin PACI degerleri arasinda anlamli istatistiksel fark saptanmadi [6,0 (3,0-13,5) vs. 7,0 (2,522,5), p=0,35]. Ortalama P dalga suresi (PDS) 101 (90-111) msn idi. PDS ile PACI skoru arasinda istatiksel acidan anlamli olmayan korelasyon izlendi (p=0,35, r=0,06). Sonuc: Psoriazisin siddetini gosteren PACI skoru ile IAB blok arasinda anlamli iliski bulunmadi. Anahtar kelimeler: Atriyal fibrillasyon, elektrokardiyografi, inme, interatriyal blok, psoriazis, psoriazis alan ciddiyet indeksi

Objectives: Increased homocysteine (HCY) levels are associated with an increased risk of cardiovascular disease. Plasma HCY is increased in chronic heart failure (CHF) patients, and previous studies suggest that hyperhomocysteinemia causes adverse cardiac remodeling and affects pump function. We aimed to evaluate the HCY levels in patients with diastolic heart failure with preserved left ventricular ejection fraction (LVEF). Methods: We prospectively studied 68 patients (39 females and 29 males) who were hospitalized for symptomatic heart failure, as well as 40 age- and sex-matched healthy subjects who comprised the control group. CHF was diagnosed in all cases based on Framingham diagnostic criteria. CHF with preserved LVEF was defined as cases with CHF with an LVEF of 50% or more. Patients with regional left ventricular wall motion abnormalities, atrial fibrillation, and renal failure were excluded. Results: The mean age was 65.5 ± 9.6 years in the heart failure group and 65.2 ± 9.7 years in the control group. The mean LVEF was 59.8 ± 5.3 in the heart failure group and 61.4 ± 5.2 in the control group. The mean total fasting HCY concentrations were significantly higher in patients with heart failure (16.9 ± 5.27 µmol/l vs. 10.15 ± 3.49 µmol/l, respectively; p < 0.001). Multiple regression analysis indicated that NT-proBNP, hs-CRP, E/A ratio, and HbA1C were independently associated with hyperhomocysteinemia. Conclusions: Our results suggest that hyperhomocysteinemia is prevalent in heart failure with preserved ejection fraction. Larger scale studies are needed to clarify its pathogenic mechanisms and effects on the natural history of heart failure.

Introduction. Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine. There is growing evidence that SCH is associated with increased cardiovascular risk. We tried to investigate prevalence of SCH in acute myocardial infarction patients. Methods and Results. We evaluate free T3, free T4, and TSH levels of 604 patients (age 58.4) retrospectively, who have been admitted to the coronary intensive care unit between years 2004–2009 with the diagnosis of ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI). Mild subclinical hypothyroidism (TSH 4.5 to 9.9 mU/l) was present in 54 (8.94%) participants and severe subclinical hypothyroidism (TSH 10.0 to 19.9 mU/l) in 11 (1.82%). So 65 patients (10.76%) had TSH levels between 4.5 and 20. Conclusions. In conclusion, 65 patients (10.76%) had TSH levels between 4.5 and 20 in our study, and it is a considerable amount. Large-scale studies are needed to clarify the effects of SCH on myocardial infarction both on etiologic and prognostic grounds.