Ali Çoner

Primary cardiac leiomyosarcoma is an extremely rare malignancy often misdiagnosed as benign atrial myxoma. A 55-year-old male presented with syncope from a recurrent left atrial mass, eight months after initial resection for a presumed myxoma at another center. Redo median sternotomy and…

Aim: Although SGLT2 inhibitors offer cardiovascular benefits in type 2 diabetes, their impact on antianginal therapy needs after CABG remains unclear. This study investigates the potential association between SGLT2i use and alterations in the frequency and intensity of antianginal regimens in these patients.Methods: This retrospective study included 125 diabetic patients ≥1 year post-CABG, divided into SGLT2i users (n=70) and non-users (n=55). Demographic characteristics, laboratory findings, comorbidities, and antianginal medication profiles were retrospectively analyzed. The primary outcomes were changes in the number and intensity of antianginal medications during follow-up. One-way analysis of covariance (ANCOVA) was performed to assess the independent effect of SGLT2i use after adjustment for potential confounders.Results: Baseline antianginal medication burden and treatment intensity were similar between groups (p>0.05). During follow-up, SGLT2i users demonstrated significantly greater reductions in ivabradine and ranolazine use compared with controls (p=0.035 and p=0.001, respectively). Patients receiving SGLT2i experienced a significantly greater reduction in both the total number of antianginal medications (–0.371 ± 0.66 vs. –0.036 ± 0.57; p=0.001) and overall treatment intensity (–0.52 ± 0.89 vs. –0.07 ± 0.79; p=0.001). After adjustment for age, sex, glomerular filtration rate, neutrophil count, and baseline medication burden, SGLT2i use remained independently associated with reduced antianginal medication number (F=7.175; p=0.009) and treatment intensity (F=8.106; p=0.005).Conclusion: SGLT2 inhibitor therapy was independently associated with a reduced antianginal treatment burden in diabetic CABG patients. These findings indicate a potential association between SGLT2i use and additional anti-ischemic benefits beyond glycemic control in chronic coronary syndrome management.

Letter to Editor: Role of intracoronary imaging in STEMI patients undergoing primary PCI

Background: Postoperative atrial fibrillation (POAF) remains a common complication after cardiac surgery. The ability to accurately identify patients at risk through previous risk scores is limited. This study aimed to evaluate the new HARMS2-AF risk score to predict POAF after coronary artery bypass grafting (CABG) surgery. Methods: In this retrospective cohort study, we included 265 patients undergoing CABG surgery from 2022-2023. Data were obtained from the medical files of the patients and hospital records. Each patient was assigned a HARMS2-AF risk score. A univariate and multivariate regression analyses were done to analyze independent predictors of POAF. Results: Of 265 patients, 49 had postoperative atrial fibrillation. HARMS2-AF score was significantly higher in patients with POAF. Age, sleep apnea,a left atrial diameter (LAd), and HARMS2-AF score were independently associated with POAF. A HARMS2-AF score ≥ 4.5 predicted POAF with 91% sensitivity and 64% specificity (AUC = 0.787, 95% CI = 0.731-0.842, P < .001). Conclusion: The HARMS2-AF score is a strong predictor of atrial fibrillation (AF) development after isolated CABG surgery. It can be used as a novel stratification tool to estimate AF after cardiac surgery.