Mesut Karataş

Objective: Identifying patients at high risk for contrast-induced nephropathy (CIN) is essential for implementing effective preventive strategies. This study aimed to evaluate the predictive value of the total bilirubin-phosphorus ratio (TBPR) for CIN development. Methods: This retrospective, observational study included 2217 patients who underwent coronary angiography between June 2020 and January 2022. Patients were categorized into two groups based on CIN occurrence: those who developed CIN (Group 1) and those who did not (Group 2). Baseline characteristics, CIN status, and TBPR were compared between the groups. Results: CIN incidence was highest among patients with ST-elevation myocardial infarction (STEMI) (39.4%), followed by those with Non-STEMI (27.2%) and stable/unstable angina pectoris (12.1%) (pConclusion: This study highlights TBPR as a potential independent predictor of CIN development.

Coronary slow flow (CSF) is claimed to be a systemic microvascular pathology rather than an isolated cardiac vascular pathology. We aimed to investigate the relation of CSF with retinal vascular calibers. This cross-sectional study enrolled 122 consecutive patients with CSF and 109 age- and sex-matched controls. Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery-vein ratio were measured using Interactive Vessel Analyzer, a semi-automated retinal vascular analyzer. There were significant differences in CRAE, CRVE, and artery-vein ratio between the CSF and control groups ( P < .001, .009, and <.001, respectively). Correlation analysis revealed statistically significant negative correlations between CRAE and left anterior descending artery-corrected TIMI frame count, circumflex-TIMI frame count, mean TIMI frame count, systolic blood pressure, diastolic blood pressure, and high-density lipoprotein cholesterol levels ( r = −0.373, −0.390, −0.459, −0.416, −0.471, and −0.350, respectively, P < .001 for all), significant positive correlations of CRVE with left anterior descending artery-corrected TIMI frame count, mean TIMI frame count, smoking, and triglyceride levels ( r = 0.341, 0.315, 0.404, and 0.447, respectively, P < .001 for all), and significant negative correlations of CRVE with systolic blood pressure and high-density lipoprotein cholesterol levels ( r = −0.254 and −0.359, respectively, P < .001 for all). The CSF is closely associated with retinal vascular caliber, suggesting that, it is a systemic generalized microvascular phenomenon. The utility of retinal imaging for CSF screening is worth further investigation.

Objective: To evaluate clinical outcomes and identify predictors of mortality and endoleak after endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) procedures. Methods: A retrospective cohort study of 164 EVAR and TEVAR patients (January 2000–December 2022) was conducted. Data on demographics, comorbidities, aneurysm size, and clinical outcomes were extracted. Statistical analysis included Pearson’s chi-square test, Student’s t -test, Mann–Whitney U test, and multivariate logistic regression. Model performance was assessed by receiver operating characteristic and Hosmer–Lemeshow tests. Results: Overall mortality was 7%, and endoleak incidence was 20.75%. Diabetes mellitus was an independent predictor of mortality [adjusted odds ratio (AOR) = 3.93; 95% CI: 1.51–10.24, P = 0.005], and aneurysm size (>7 cm) independently predicted endoleaks (AOR = 3.21; 95% CI: 1.28–8.06, P = 0.013). Physician specialty and procedure type did not significantly predict outcomes. Model discrimination (area under the curve = 0.96) and calibration (Hosmer–Lemeshow P = 0.400) were strong. Conclusion: Diabetes mellitus and aneurysm size (>7 cm) significantly influence clinical outcomes following EVAR and TEVAR, guiding risk stratification and patient management.

Aims: Conduction abnormalities are well-recognized complications following aortic valve replacement, particularly after transcatheter aortic valve implantation (TAVI). The incidence of permanent pacemaker implantation (PPI) post-TAVI remains variable, influenced by patient and procedural factors. To evaluate the incidence, clinical predictors, and outcomes associated with PPI following TAVI, with specific attention to left ventricular ejection fraction (LVEF). Methods: We conducted a retrospective analysis of 60 patients who underwent transfemoral TAVI between 2008 and 2011. Baseline demographic, clinical, procedural, and echocardiographic parameters were compared between patients who required PPI and those who did not. Univariate and bivariate analyses were used to identify potential predictors. Results: PPI was required in 29 of 60 patients (48.3%), with the majority of devices implanted within 72 hours post-procedure. Dual-chamber pacemakers were most commonly utilized, predominantly for complete atrioventricular block or symptomatic bradycardia associated with new-onset left bundle branch block. No statistically significant associations with PPI were found for variables such as age, sex, atrial fibrillation, ischemic heart disease, or baseline LVEF (all p > 0.05). Trends suggesting possible associations with atrial fibrillation and mitral regurgitation did not reach statistical significance. Conclusion: PPI remains a frequent yet unpredictable outcome after TAVI, particularly in the era of early-generation valve systems. Our findings underscore the absence of reliable clinical predictors and emphasize the need for prospective studies incorporating procedural, anatomical, and electrophysiologic markers to refine risk stratification and minimize unnecessary device implantation.

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease associated with significant morbidity, including cardiovascular complications. This study investigates the relationship between NAFLD and electrocardiographic parameters indicative of ventricular arrhythmia risk. Materials and Methods: We conducted a cross-sectional study enrolling 136 patients with NAFLD and 136 healthy controls. Electrocardiographic parameters—Tp-e interval, QT and corrected QT (QTc) intervals, and Tp-e/QTc ratio—were measured and compared between groups. Results: Patients with NAFLD exhibited significantly higher Tp-e, QTc, Tp-e/QT ratio, and Tp-e/QTc ratio (p < 0.001, for all) than controls. Subgroup analysis showed progressive increases in Tp-e and Tp-e/QT ratio correlating with NAFLD severity (p < 0.001 and p = 0.001, respectively, for grade 1 vs. grade 2; p < 0.001 and p = 0.001, respectively, for grade 1 vs. grade 3). ROC analysis indicated that the Tp-e interval was a strong predictor for identifying grade 2 or more NAFLD (AUC 0.887, p < 0.001). Conclusions: Our findings highlight the association of NAFLD with prolonged electrocardiographic intervals that may predispose patients to ventricular arrhythmias. These parameters can serve as valuable markers for cardiac risk stratification in patients with NAFLD, suggesting the need for vigilant cardiac follow-up in this population.

Aims: Inflammation plays a very important role in the pathogenesis of coronary artery disease (CAD) and its prognosis. Especially; C-reactive protein (CRP) is associated with poor prognosis in patients with CAD. In this study, the relationship between CRP levels and BMI was investigated in patients who underwent primary coronary intervention (PCI) due to ST-segment elevation myocardial infarction (STEMI). Methods: Between January 2015 and February 2016, 132 patients who underwent primary coronary intervention due to acute STEMI were included in the retrospective study. Patients were classified into two groups: (Group 1:BMI35 kg/m2 n:9, total:36 patients; Group2: BMI>25 and BMI30 and BMI25 and BMI25 and BMI<35. Conclusion: In this study, the relationship between CRP levels and BMI was investigated in patients who underwent primary coronary intervention (PCI) due to ST elevation myocardial infarction (STEMI). The reasons for the better prognosis of mildly overweight and class 1 obese patients with STEMI diagnosis may be the low values of CRP which has many effects on atherosclerotic plaque formation.

Aims: Hypertension (HT) is a leading global cause of morbidity and mortality, contributing significantly to the burden of cardiovascular diseases. Despite its widespread prevalence, HT is often underdiagnosed and poorly managed, particularly among younger populations. This study investigates HT awareness among university students, focusing on the impact of education, gender, and lifestyle practices. Methods: A cross-sectional online survey was conducted among 546 students from various academic disciplines using an online questionnaire that assessed demographics, HT awareness, lifestyle factors, and blood pressure monitoring habits. Statistical comparisons were performed using independent t-tests, Mann-Whitney U tests, and correlation analyses. Results: Study results revealed notable disparities in HT awareness and behaviors. Medical students demonstrated higher awareness of risk factors, diagnostic thresholds, and BP monitoring practices compared to non-medical students. Females consistently exhibited healthier lifestyle behaviors, including lower smoking prevalence, greater physical activity, and proactive BP monitoring. Awareness of dietary factors contributing to HT was moderate (62.8%), but knowledge of diagnostic BP thresholds was alarmingly low (22.9%), even among medical students. Family history of cardiovascular diseases positively influenced HT awareness, while beliefs about COVID-19’s impact on BP regulation highlighted gaps in health literacy. Conclusion: The findings underscore the critical role of formal education and targeted interventions in enhancing HT awareness. Integrating basic health education into non-medical curricula, addressing gender-specific disparities through tailored campaigns, and promoting familial health education are vital strategies for mitigating the long-term cardiovascular risks associated with undiagnosed and uncontrolled hypertension among young adults.

Background and Objectives: The prognostic value of Left Ventricular Global Function Index (LVGFI) in chronic cardiovascular diseases is well-documented; however, limited evidence exists for its utility in non-ST elevation myocardial infarction (NSTEMI). This study aims to evaluate LVGFI as a predictor of three-year mortality and major adverse cardiovascular events (MACE) in NSTEMI patients. Materials and Methods: This retrospective cohort study included 432 NSTEMI patients divided into tertiles based on LVGFI values: T1 (low), T2 (intermediate), and T3 (high). LVGFI values were derived from echocardiographic imaging. Kaplan–Meier survival analysis was used to assess outcomes, and the Cox proportional hazards models, adjusted for demographics and clinical covariates, determined the association between LVGFI tertiles and three-year outcomes. Results: The average age and sex distribution were similar across tertiles with no significant differences in cardiovascular risk factors or most laboratory parameters. However, significant differences were noted in body surface area (higher in T3), platelet counts (higher in T1), and triglyceride levels (lower in T3). The ROC analysis identified an optimal LVGFI cut-off of 23.22 for predicting three-year mortality, with a sensitivity of 72% and specificity of 75% (AUC: 0.81; 95% CI: 0.74–0.87, p < 0.001). Patients in the T1 exhibited a three-year mortality rate of 25%, compared to 2.1% in the T3. After adjustment, the hazard ratio (HR) for mortality was significantly higher in T1 (HR 11.86; 95% CI: 3.60–39.10) compared to T3. Similarly, MACE rates were highest in T1 (27.1%) and lowest in T3 (7.6%). Conclusions: LVGFI is a significant independent predictor of three-year mortality and MACE in NSTEMI patients.

Background: Studies analyzing factors associated with mortality after intracranial stenting are limited. We aimed to investigate potential factors associated with 1-year mortality after urgent or elective intracranial stenting in those patients with intracranial atherosclerotic stenosis. Methods: Patients, who underwent urgent intracranial stenting of the target lesion either due to acute stroke unresponsive to mechanical thrombectomy, or who underwent elective stenting for symptomatic intracranial atherosclerotic stenosis were included in the study. The Modified Rankin Scale (mRS) score was evaluated on admission and grouped accordingly: ≤2 vs. >2. Restenosis and mortality rates in the 1-year follow-up were also analyzed. Results: A total of 60 patients were included in the study; the mean age was 60.2 (±10.8). The ratio of urgent/elective intracranial stenting was 7/53. Complete revascularization was achieved in all patients, but no periprocedural complications occurred. The rate of in-hospital mortality was 1/60, 1-year mortality due to any cause 4/60, and restenosis in a 1-year follow-up was 4/60. The age over 65 years, previous history of stroke, atrial fibrillation (AF), and rheumatic mitral valve disease were associated with mortality (p < 0.001, p = 0.002, p = 0.017, and p = 0.003, respectively). The median mRS score on admission was lower in the surviving patients at 1 year (p = 0.001). Conclusions: Intracranial stenting may provide long-term survival with low adverse event rates in elective and selected emergency cases. Advanced age, poor functional status, previous stroke, AF, and rheumatic mitral valve disease are associated with 1-year mortality.