Selim Aydemir

Background/Objectives: This study aimed to evaluate the discriminative performance of routine systemic inflammation- and nutrition-based indices for distinguishing histopathologically confirmed gastric malignancy from non-malignant endoscopic findings. Methods: This retrospective case–control study included 211 patients who underwent upper gastrointestinal endoscopy with histopathological evaluation: 139 non-malignant endoscopic controls (129 benign/non-neoplastic and 10 premalignant findings) and 72 gastric malignancy cases. Premalignant lesions were not considered malignant outcomes. Discrimination was evaluated using univariable ROC analyses and multivariable logistic models. The fixed predictor set was assessed using 10-fold out-of-fold validation and 500-resample bootstrap optimism correction; a separate fully nested selection-inclusive audit was used to quantify uncertainty arising from variable selection. Results: NLR (AUC = 0.792), INR (AUC = 0.791), and SIRI (AUC = 0.783) showed the highest univariable discrimination. Among the variables retained in Model 1, higher ESR and RDW, lower MPV and HDL, higher INR values, and male sex showed statistically significant multivariable associations. Model 1 had an apparent AUC of 0.928 (95% CI, 0.890–0.959), a fixed-set 10-fold out-of-fold AUC of 0.890, and a bootstrap optimism-corrected AUC of 0.901. A fully nested selection-inclusive audit yielded an out-of-fold AUC of 0.873 and a bootstrap-corrected AUC of 0.869. Conclusions: Routine inflammation- and nutrition-related laboratory measures discriminated gastric malignancy from non-malignant endoscopic findings in this endoscopy-selected cohort. The model remains exploratory and requires prospective external validation. These data do not establish screening performance or diagnostic accuracy for early or asymptomatic gastric cancer.

Background: Heart failure (HF) is a global health problem with high mortality rates. Systemic inflammation and neurohumoral dysfunction play an important role in its pathophysiology. Unlike other subtypes, HF with preserved ejection fraction (HFpEF) represents a highly heterogeneous group of patients. Therefore, the phenotyping must be conducted with great care. Objective: In our study, we aimed to evaluate the relationship between the C-reactive protein-albumin-lymphocyte (CALLY)-index, a composite biomarker reflecting the nutritional, inflammation and immune status of the patient, and long-term mortality due to all causes in HF. Subjects and Methods: Our retrospective, single-centre study included patients diagnosed with HF and followed up at our clinic between 2018– 2025. The CALLY-index was calculated using the patients’ blood tests at the time of hospital admission. In this study, where the primary endpoint was all-cause mortality, patients were divided into two groups according to their survival status. Variables independently associated with mortality were identified using Cox-regression analysis. To assess the predictive power of the CALLY-index for mortality, a Receiver Operating Characteristic (ROC) analysis was performed and the area under the curve (AUC) was calculated. Results: Our study included 1541 patients, with a mean age of 69.39± 12.82, 758 (49.2%) males, and a mean follow-up period of 5.51± 2.37 years. The all-cause mortality rate in the sample was 9.6% (148 patients). Consequently, the CALLY-index showed an independent association with mortality in HF (P=0.002) and predicted mortality with a cut-off value of 0.43, a sensitivity of 66.2% and a specificity of 66.2% (AUC:0.715, P=0.001). When regression analyses were repeated by subgroup, an independent association between the CALLY-index and mortality was identified only in the HFpEF group, unlike in the others. In HFpEF, the CALLY-index predicted mortality with a sensitivity of 68.8% and a specificity of 68.7% at a cut-off value of 0.40 (AUC:0.744, P< 0.001). Conclusion: This study has shown that the CALLY index may have prognostic value in HF, particularly in HFpEF. We believe that this could be important in identifying high-risk patients in HF.

Objective: Contrast-induced nephropathy (CIN) remains a common complication after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The BUN-to-albumin ratio (BAR) has recently emerged as a composite biomarker reflecting inflammation, renal function, and nutritional status. To evaluate the predictive value of BAR for CIN in NSTEMI patients undergoing PCI.Material and Methods: This retrospective study included 1,540 NSTEMI patients treated with PCI between 2020 and 2024. Patients were divided into CIN (+) and CIN (-) groups. Clinical, laboratory, and procedural variables were analyzed. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors and assess discriminative performance.Results: CIN developed in 204 patients (13.2%). BAR was significantly higher in the CIN group (5.2±1.5 vs. 4.0±1.2, p<0.001). In multivariate analysis, BAR emerged as an independent predictor of CIN (OR: 1.943, 95% CI: 1.703-2.217, p<0.001). ROC analysis showed that BAR had the highest discriminative ability (AUC: 0.726), outperforming NLR (AUC: 0.654) and the Mehran score (AUC: 0.599). A cut-off value of 4.5 yielded 69.1% sensitivity and 63.8% specificity.Conclusion: BAR is a simple, inexpensive, and effective predictor of CIN in NSTEMI patients undergoing PCI and may serve as a practical tool for risk stratification in clinical practice.

One of the most common complications observed after transradial coronary angiography is radial artery occlusion (RAO). Endothelial damage plays an importan

1. Chronic coronary syndrome (CCS) represents the stable clinical manifestation of coronary artery disease, yet it continues to be associated with a considerable risk of long-term major adverse car...

Coronary no-reflow phenomenon (NRP) is a complex condition that can be observed frequently after percutaneous coronary intervention (PCI) in patients with

Objective: Aortic stenosis (AS) is one of the most common valvular heart diseases, and transcatheter aortic valve implantation (TAVI) has become an established treatment option for patients at high surgical risk. As TAVI is increasingly performed, there is a growing need for reliable risk stratification tools to predict peri- and post-procedural outcomes. This study compared the predictive value of the Syntax Score II (SS II), commonly used in coronary artery disease, with conventional surgical risk scores – EuroSCORE and the Society of Thoracic Surgeons (STS) score; in estimating in-hospital mortality after TAVI. Methods: Seventy patients who underwent TAVI for severe AS between 2011 and 2018 at our center were included. Patients were classified according to in-hospital survival, and associations between risk scores and mortality were assessed. Results: The mean age was 77.4±10.1 years, and 58.6% of the patients were male. Univariate analysis showed that STS, EuroSCORE, SS II, left ventricular systolic diameter, and mean aortic gradient were higher in the mortality group. Post-procedural complications did not differ significantly between survivors and non-survivors (stroke, p=0.22; acute renal failure, p=0.50; pacemaker implantation, p=0.49). Multivariable regression analysis identified EuroSCORE as an independent predictor of in-hospital mortality (p=0.05), whereas STS and SS II were not statistically significant. Conclusion: Among the scores evaluated, EuroSCORE demonstrated superior predictive ability for in-hospital mortality following TAVI. Nonetheless, the findings highlight the need for novel, procedure-specific risk models tailored to TAVI populations.

Background and Objectives: Patients with a prior history of coronary artery bypass grafting (CABG) who present with non-ST-segment elevation myocardial infarction (NSTEMI) represent a complex, high-risk subgroup due to advanced comorbidity burden and challenging coronary anatomy. Whether an invasive strategy offers meaningful benefit over conservative management in this population remains unclear. Therefore, this study aimed to compare long-term outcomes of percutaneous coronary intervention (PCI) versus medical therapy in NSTEMI patients with previous CABG and to identify independent predictors of major adverse cardiovascular events (MACE) and all-cause mortality. Materials and Methods: This retrospective cohort study included 286 NSTEMI patients with prior CABG (PCI: 112; medical therapy: 174). Baseline demographic, clinical, laboratory, and angiographic characteristics were assessed. The primary endpoint was MACE, while the secondary endpoint was all-cause mortality. Kaplan–Meier analysis evaluated survival differences, and multivariable Cox regression identified independent predictors. Results: During follow-up, MACE rates were comparable between PCI and medical therapy (14.3% vs. 18.9%; p = 0.305). All-cause mortality was likewise similar (9.8% vs. 10.3%; p = 0.541). Kaplan–Meier analysis showed no survival benefit with PCI (log-rank p = 0.334). Hypoalbuminemia independently predicted both MACE and mortality, while CKD and HF were major determinants of long-term mortality. Conclusions: In NSTEMI patients with prior CABG, no long-term superiority of PCI over medical therapy was observed with respect to MACE or mortality. Prognosis appears more closely linked to hypoalbuminemia, CKD, and HF than to the chosen management strategy. These findings underscore the importance of individualized and risk-adapted clinical decision-making in this complex population.

Heart failure (HF) is a chronic progressive clinical condition characterized by structural or functional impairment of the ventricles. The prevalence of HF is increasing, and it continues to be a significant cause of morbidity and mortality. Liver involvement during fibrosis in HF patients is associated with adverse clinical outcomes. Our study aimed to evaluate the relationship between noninvasive liver fibrosis indices and HF mortality. Our study was a retrospective analysis of patients with HF admitted to our hospital between 2017 and 2023. Patients were followed up until 2024 and divided into 2 groups according to mortality. The patients’ liver fibrosis indices were calculated, and Cox regression analysis was performed to identify the independent predictors of mortality. Their ability to predict mortality was assessed using receiver operating characteristic Curve analysis, and the areas under the curve were compared. Our study included 2029 patients with HF. The mean follow-up period was 1655 days. The mortality rate was 9.5% (N = 193). The aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio was not a predictor of HF mortality, whereas APRI and FIB-4 index were independent predictors of HF mortality. According to receiver operating characteristic curve analysis, the FIB-4 score was superior to the APRI in predicting mortality. The APRI had a specificity of 93.4% at a cutoff value of 1.0. The FIB-4 Score had a sensitivity of 89.6% at a cutoff value of 1.0. Our study found that AST/ALT ratio did not predict HF mortality. However, our study found that the FIB-4 score was associated with mortality in all types of HF, and the APRI was associated with mortality in HFrEF and HFmrEF. These parameters can be calculated easily and practically from routine examinations and can be used in HF follow-up and prognosis estimation.