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(1) Background: The clinical course of acute myocarditis in adolescents is heterogeneous, and reliable predictors of early functional changes remain limited, particularly in patients without severe systolic dysfunction. Routine hematologic parameters may reflect the early inflammatory response, but their prognostic relevance in pediatric non-fulminant myocarditis is poorly defined. This exploratory study aimed to assess whether admission inflammatory blood indices are associated with short-term changes in left ventricular systolic function in adolescents with acute myocarditis. (2) Methods: We retrospectively analyzed 44 adolescents (median age 16 years, 84% male) hospitalized with suspected acute non-fulminant myocarditis between 2020 and 2023. All patients had preserved or mildly reduced left ventricular ejection fraction (LVEF) at presentation. Clinical, laboratory, electrocardiographic, and echocardiographic data obtained at admission were analyzed. Changes in LVEF between the acute and post-acute phases during hospitalization were assessed using transthoracic echocardiography. Cardiac magnetic resonance imaging was performed in a subset of patients to support diagnosis but was not uniformly available for quantitative analysis. (3) Results: No in-hospital deaths occurred. A modest positive correlation was observed between neutrophil count at admission and improvement in LVEF during hospitalization (r = 0.348, p = 0.028). No significant associations were found between LVEF change and white blood cell count, lymphocyte count, monocyte count, neutrophil-to-lymphocyte ratio (NLR), troponin I, or NT-proBNP. (4) Conclusions: In adolescents with non-fulminant acute myocarditis and preserved or mildly reduced systolic function, admission neutrophil count was associated with short-term improvement in left ventricular ejection fraction. Given the retrospective design, limited sample size, and absence of mechanistic data, these findings should be interpreted as hypothesis-generating. Further prospective studies incorporating standardized cardiac magnetic resonance imaging and immunologic profiling are needed to clarify the clinical significance of this association.

Ambient air pollution is an established cardiovascular risk factor; however, its impact on long-term outcomes after coronary artery bypass grafting (CABG) remains insufficiently defined. We aimed to evaluate whether chronic exposure to air pollutants may influence long-term mortality following surgical revascularization. In this multicenter retrospective cohort study, 1033 consecutive patients undergoing CABG with BIMA (bilateral internal mammary arteries) grafting were analyzed with a median follow-up of 8.1 years. Individual exposure to nitrogen dioxide (NO ), particulate matter ≤10 μm (PM ), and ≤2.5 μm (PM ) was estimated based on residential data. Multivariable Cox proportional hazards models were used to assess associations with long-term mortality. Model performance was evaluated using receiver operating characteristic (ROC) analysis, while incremental prognostic value was quantified using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Kaplan-Meier analyses were performed using data-driven thresholds and model-based risk stratification. During follow-up, 220 deaths (21.1%) occurred. In multivariable analysis, both NO and PM were associated with increased mortality (NO : HR 2.70 per 10 μg/m , 95% CI 2.03-3.59; PM : HR 2.73 per 10 μg/m , 95% CI 1.94-3.83; both < 0.001), whereas PM was not significant. The clinical model demonstrated moderate discrimination (AUC 0.73), which improved significantly after inclusion of pollution variables (AUC 0.84; ΔAUC 0.11). Reclassification analysis showed substantial improvement (NRI 0.42, < 0.001; IDI 0.11, < 0.001). Kaplan-Meier analysis confirmed enhanced risk stratification, with a hazard ratio of 2.70 for the clinical model and 7.02 for the combined clinical and pollution model (both < 0.001). In this retrospective cohort of patients undergoing CABG with BIMA grafting, higher long-term residential exposure to NO and PM was associated with greater all-cause mortality after adjustment for measured clinical and procedural factors. These findings support further investigation of environmental exposure as a prognostic marker in surgically treated coronary disease, pending external validation and more granular control for contextual confounding. These findings suggest that environmental exposure may represent a relevant component of long-term risk stratification, although confirmation in large-volume cohorts is required.

Aortic stenosis (AS) is a leading cause of surgical intervention in adults with acquired heart disease, driven by an aging population and advancements in diagnostic and treatment approaches. This study aimed to investigate levels of macroelements (Ca, K, Na, Mg, and P) in aortic valve tissues, serum, and epicardial fat in patients undergoing aortic valve replacement due to degenerative disease. Elemental composition was determined using inductively coupled plasma mass spectrometry. Analyses revealed a distinct accumulation of Ca and P in aortic valve tissues, not correlated to and exceeding that in epicardial adipose tissue, suggesting localized mineralization. Significant relationships between serum and aortic valve element concentrations were found, with serum K and Mg levels inversely correlated with Ca and P deposition and Ca/P ratio in the valve, highlighting their potential role as calcification inhibitors. Moreover, serum and valvular Na/K ratios were positively correlated. Furthermore, patient age was associated with increased Ca, Mg, Na, P levels, and Ca/P ratio in valve tissues, reinforcing age as a risk factor for valvular calcification. Creatinine and lipoprotein (a) levels correlated positively with valvular K content and Ca/P ratio, respectively, while high-density lipoprotein cholesterol concentration was positively associated with Ca, Mg, and P content in epicardial fat. Patients with increased transvalvular systolic pressure gradient revealed higher valvular Na content. Future longitudinal research should address mineralization across earlier disease stages, exploring additional trace elements and molecular contributors to advance understanding of calcification mechanisms, ultimately aiding in developing biomarkers or therapeutic strategies for postponing or preventing AS onset.

Background: Several perioperative inflammatory markers are postulated to be significant factors for long-term survival after off-pump coronary artery bypass surgery (OPCAB). Hematological parameters, whether single or combined as indices, provide higher predictive values. Methods: The study group comprised 538 consecutive patients (125 (23%) females and 413 (77%) males) with a mean age of 65 ± 9 years, who underwent OPCAB with a mean follow-up time of 4.7 ± 1.7 years. This single-center retrospective analysis included perioperative inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and systemic inflammatory index (SII). Results: Multivariable analysis identified levels of neutrophils above 4.3 × 109/L (HR 13.44, 95% CI 1.05–3.68, p = 0.037), values of SIRI above 5.4 (HR 0.29, 95% CI 0.09–0.92, p = 0.036) and values of NLR above 3.5 (HR 2.21, 95% CI 1.48–3.32, p < 0.001) as being significant predictors of long-term mortality. The multifactorial models revealed the possibility of strong prediction by combining preoperative factors (COPD, stroke, PAD, and preoperative PLR) and postoperative neutrophil counts (p = 0.0136) or NLR (p = 0.0136) or SIRI (p = 0.0136). Conclusions: Among the postoperative inflammatory indices, the levels of neutrophils, NLR, and SIRI are the most prominent markers for long-term survival after off-pump coronary artery bypass surgery, when combined with preoperative characteristics.

Despite widespread implementation of intravascular techniques in cardiovascular medicine, combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) have still been standard of surgical treatment. A purpose of this multicenter retrospective cohort study was to assess an impact of female sex on early outcomes and late survival rate following simultaneous AVR + CABG. This study comprised 12,626 patients (30.1% females; 69.9% males) that underwent AVR + CABG in 2006 through 2020. Primary endpoint was late survival. Thirty-day mortality and morbidity rates were also evaluated. In order to reduce an impact of inherent confounders, a propensity score (PS) matching was applied. PS matching selected 3,443 pairs and both gender groups were well balanced for baseline and operative characteristics. Women had higher 30-day mortality (OR: 1.42 (1.17–1.73), p  < 0.001), more prevalent respiratory failure (OR: 1.28 (1.06–1.55), p  = 0.01) and increased risk of postoperative application of cardiac support devices (OR: 1.46 (1.09–1.94), p  = 0.01), but reduced incidence of re-thoracotomy due to bleeding compared to men (OR: 0.8 (0.67–0.95), p  = 0.01). A probability of survival of 4-year (76.2 vs. 76.1%) and 8-year (58.8 vs. 57.0%) follow-up was comparable between females and males, respectively. Women undergoing aortic valve replacement with concomitant artery bypass grafting presented worse early outcomes but comparable long-term survival to men.

Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59–64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17–17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001).

Currently, atherosclerotic cardiovascular disease is the major cause of mortality world-wide. Inflammatory processes are postulated to be a major driving force for coronary plaque initiation and progression and can be evaluated by simple inflammatory markers from whole blood count analysis. Among hematological indexes, systemic inflammatory response index (SIRI) is defined as a quotient of neutrophils and monocytes, divided by lymphocyte count. The aim of the present retrospective analysis was to present the predictive role of SIRI for coronary artery disease (CAD) occurrence. There were 256 patients (174 [68%] men and 82 [32%] women) in the median (Q1-Q3) age of 67 (58-72) years enrolled into retrospective analysis due to angina pectoris equivalent symptoms. A model for predicting CAD was created based on demographic data and blood cell parameters reflecting an inflammatory response. In patients with single/complex coronary disease the logistic regression multivariable analysis revealed predictive value of male gender (odds ratio [OR]: 3.98, 95% confidence interval [CI]: 1.38-11.42, p = 0.010), age (OR: 5.57, 95% CI: 0.83-0.98, p = 0.001), body mass index (OR: 0.89, 95% CI: 0.81-0.98, p = 0.012), and smoking (OR: 3.66, 95% CI: 1.71-18.22, p = 0.004). Among laboratory parameters, SIRI (OR: 5.52, 95% CI: 1.89-16.15, p = 0.029) and red blood cell distribution width (OR: 3.66, 95% CI: 1.67-8.04, p = 0.001) were found significant. Systemic inflammatory response index, a simple hematological index, may be helpful in patients with angina equivalent symptoms to diagnose CAD. Patients presenting with SIRI above 1.22 (area under the curve: 0.725, p < 0.001) have a higher probability of single and complex coronary disease.

The pro-coagulative characteristics of HF patients are postulated, though no specific therapeutic targets have been proposed. A total of 88 patients (17 female, 19%) with a median age of 68 years (range, 63 − 74) and a de novo congestive HF diagnosis were enrolled in the prospective study. Co-morbidities, laboratory tests, and imaging results (echocardiography, coronary angiography) were compared to the concentration of peripheral blood citrullinated histone 3 (CitH_3), a marker of neutrophil extracellular trap (NET) formation, on admission. The analyzed population was divided into two groups based on LVEF performance: HFmrEF (42 patients, 47%) and HFrEF (46 patients, 53%), with a median (Q1–Q3) age of 68 (62–74) vs. 69 (63–74) years ( p  = 0.789), respectively. The significant difference in CitH_3 serum concentration between the heart failure with preserved ejection fraction (HFrmEF) group (395 pg/ml [201–482]) and the heart failure with reduced ejection fraction (HFrEF) group (1941 pg/ml [405–3376]) was noted ( p  = 0.019). A negative correlation was noted between LVEF and citH_3 in the analyzed group ( r = -0.444, p  = 0.005), and with serum NT-pro-BNP ( r  =  -0.435, p  < 0.001). No correlation between citH_3 and NT-pro-BNP was found ( r  = 0.305, p  = 0.939). Patients with heart failure and a decreased left ventricular ejection fraction can be characterized by increased neutrophil extracellular trap formation. The negative correlation between left ventricular characteristics and CitH_3 concentration suggested an increased pro-thrombotic state in HF patients. NETs could be considered a potential therapeutic target in HF patients to improve clinical outcomes. Further studies are required to confirm these findings.

Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. Method and results: The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60–71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/− 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33–4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09–2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. Conclusion: Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis.

Platelet–leucocyte aggregates (PLA) are a formation of leucocytes and platelets bound by specific receptors. They arise in the condition of sheer stress, thrombosis, immune reaction, vessel injury, and the activation of leukocytes or platelets. PLA participate in cardiovascular diseases (CVD). Increased levels of PLA were revealed in acute and chronic coronary syndromes, carotid stenosis cardiovascular risk factors. Due to accessible, available, replicable, quick, and low-cost quantifying using flow cytometry, PLA constitute an ideal biomarker for clinical practice. PLA are promising in early diagnosing and estimating prognosis in patients with acute or chronic coronary syndromes treated by percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). PLA were also a reliable marker of platelet activity for monitoring antiplatelet therapy. PLA consist also targets potential therapies in CVD. All of the above potential clinical applications require further studies to validate methods of assay and proof clinical benefits.