Mustafa Özkoç

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.

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

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.

Malnutrition is associated with adverse outcomes in certain cardiovascular diseases. This study investigates the prognostic value of nutritional status in

Our study compared the effect of P2Y12 receptor inhibitors in combination with abciximab on clinical outcomes in patients with acute coronary syndrome (ACS). Our study is retrospective, consisting of 852 consecutive ACS patients who presented to our clinic between 2015 and 2021, underwent primary percutaneous coronary intervention (PCI), and received abciximab in addition to dual antiplatelet therapy. The P2Y12 receptor inhibitors were compared in terms of in-hospital and 1-year major adverse cardiac events (MACE), and clinically significant in-hospital and 1-year bleeding complications. The patients' mean age was 60.4 ± 11 years, and 702 (82.4%) were male. In-hospital MACE, in-hospital mortality, 1-year MACE, and 1-year mortality were significantly higher in the clopidogrel group compared to the ticagrelor group. There was no significant difference in the development of in-hospital and 1-year bleeding between clopidogrel and the more potent P2Y12 receptor inhibitors. According to the BARC score, there was no difference in major bleeding between ticagrelor and clopidogrel (p = 0.641), but minor bleeding was significantly lower in the ticagrelor group (p < 0.001). In logistic regression analysis, the 1-year MACE rate was lower in the potent P2Y12 receptor inhibitors group compared to clopidogrel. At the same time, no association was found with short- and long-term mortality, bleeding, or in-hospital MACE. In our study, potent P2Y12 receptor inhibitors combined with abciximab decreased 1-year MACE without significantly increasing bleeding in ACS patients undergoing PCI compared to clopidogrel. This study suggests that potent P2Y12 receptor inhibitors can be safely used with abciximab, considering the bleeding risk.

Coronary artery ectasia (CAE) is localized or generalized dilatation of the coronary artery lumen. CAE is difficult to diagnose, treat, and manage and is associated with the risk of adverse cardiovascular events. In our study, we aimed to evaluate and compare these predictive parameters of CAE. We conducted a study that involved analyzing patients who had underwent angiography for acute coronary syndrome. The patients were categorized into two groups based on the presence or absence of CAE. The Cox regression analysis considered significant predictors for CAE while assessing independent variables. ROC Curve analysis was used to evaluate the predictive capability of these variables for CAE, and area under the curve (AUC) values were compared. 2279 patients included in the study were followed for an average of 498 days. Coronary ectasia was present in 5.35% of the patients. LDL/HDL ratio and lymphocyte count independently predicted CAE. In our study, low density lipoprotein/high density lipoprotein (LDL/HDL) ratio and lymphopenia were observed to independently predict CAE. LDL/HDL ratio obtained from standard blood tests can be used as a cost-effective and simple method to predict CAE, making a significant contribution to treatment planning, prognosis and patient follow-up.

Tüm yazarlarımızla birlikte “Klinikten pratiğe kardiyoloji” kitabının ilk baskısını okuyucuları ile buluşturmanın heyecanını taşıyoruz. ‘Klinikten pratiğe kardiyoloji’ kitabında hem kardiyoloji hem de kardiyovasküler cerrahi alanlarındaki güncel bilgileri ve yenilikleri okurlarına iletmek amaçlanmıştır. Bu kitapta kardiyolojik ve cerrahi bakış açıları bir araya getirilmiştir. Aynı zamanda pratik hayatta hastaların yandaş sorunlarına yaklaşım açısından da ilgili uzmanlık alanlarından, yazdıkları bölümlerle katkılar alınmıştır. Sağlık kuşkusuz ki bütüncül yaklaşımlarla geliştirilebilir. Ancak artan bilgi birikimi ve gelişen yeni teknikler alt konu başlıklarında uzmanlaşmayı da zorunlu kılmıştır. Günümüzde sağlıkta bütüncül yaklaşım, farklı konularda uzmanlaşmış kişilerin birikimlerini ortak platformlarda paylaşmaları ile sağlanabilir. Bu kitapta kardiyoloji ve kardiyovasküler cerrahi konusundaki bilgi ve tekniklerin bütüncül olarak bir araya getirilmesi hedeflenmiştir. Tüm yazarlarımızca ortak düşümüz kitabın tekrar eden baskılarında bu yaklaşımı güncel bilgilerle daha da geliştirmektir.