The Relationship of Coronary Thrombus Burden and Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Score in Patients With ST-Segment Elevation Myocardial Infarction.

BACKGROUND: The anticoagulation and risk factors in atrial fibrillation (ATRIA) score is associated with adverse cardiovascular events. However, its relationship with coronary thrombus burden is unclear. Therefore, we aimed to investigate the relationship between the ATRIA score and thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). MATERIALS AND METHODS: The study was designed as a prospective cross-sectional observational study. Our study included 319 patients who were prospectively admitted with STEMI between January 2021 and April 2022. Patients were divided into 2 groups with low thrombus burden (LTB) (grade <3) and high thrombus burden (HTB) (grade ≥3). ATRIA score was calculated and recorded for all patients. ATRIA scores of both groups were compared. RESULTS: In our study, 58.9% (n = 188) of patients in the LTB group and 41% (n = 131) of patients in the HTB group. The ATRIA risk score (p < .001) was significantly higher in the HTB group. In multivariate logistic regression analysis, ATRIA score, glomerular filtration rate, hypertension, abciximab usage, and no-reflow were found to be independent predictors of HTB in STEMI patients undergoing primary PCI. In receiver operating characteristic analysis, ATRIA score >4 had a sensitivity of 66.2% and specificity of 95.2%, and ATRIA score >8 sensitivity of 98% and specificity of 100% predicted HTB. CONCLUSION: In this study, we found that thrombus burden may be associated with ATRIA risk score in patients presenting with STEMI.

Clinical results of high probability ventilation/perfusion scintigraphy in the diagnosis of pulmonary embolism.

Purpose: While computed tomography pulmonary angiography plays an effective role in the diagnosis and prognosis of pulmonary embolism (PE), there are not enough studies regarding ventilation/perfusion (V/Q) scintigraphy. We aimed to evaluate the clinical outcomes of PE patients whose V/Q scintigraphy was reported as high probability for PE. Method: Demographic data, Simplified Pulmonary Embolism Severity Index (SPESI), radiological findings, V/Q scintigraphy and echocardiographic (ECHO) findings, laboratory data, treatment information and comorbidities of 43 patients whose V/Q scintigraphy was reported as high probability for PE between January 2020 and January 2023 was recorded. Perfusion scintigraphy defects were classified as subsegmental, multiple subsegmental, segmental, and multiple segmental. Those with subsegmental, multiple subsegmental, and segmental perfusion defects were classified as Group 1, and those with multiple segmental defects as Group 2. Results: The mean age of the patients was 74 years (31-94), being 27 women (62.8 %) and 16 men (37.2 %), and there was no significant difference between the two groups. Multisegmental perfusion defect was detected in 23 (53.5 %) patients. 25 % of patients reported as high-probability PE had a SPESI score of ≥2. There was no significant difference between Groups 1 and 2 in terms of SPESI scoring. Perfusion defect had no significant correlation with SPESI score, D-Dimer, Troponin, pulmonary artery systolic pressure, right ventricular dilatation, and length of hospital stay. The presence of comorbidity was significantly positively correlated only with the SPESI score. There was no difference between the two groups regarding laboratory, radiological, echocardiographic findings, presence of comorbidity, unit of treatment, and duration of hospitalization. Conclusion: Parameters predicting clinical severity and providing treatment benefits are required in PE patients diagnosed with V/Q scintigraphy.

Evaluation of gastric emptying rate in patients with fibromyalgia: a case control study.

Fibromyalgia (FM) is a chronic pain illness with unknown etiology, and it generally affects women. These patients also have gastrointestinal symptoms and signs. In this study, we aimed to evaluate the gastric emptying rate in patients with newly diagnosed FM by using the radionuclide method. Investigation of the differences in gastric emptying rate, the number of pain points, and Fibromyalgia Impact Questionnaire (FIQ) scores between premenopausal and postmenopausal FM patients was planned as secondary goal of this study. Fifteen female patients (ages 17-68 years) with FM and 15 age-matched healthy women (ages 20-65 years) as a control group participated in the study. Exponential gastric emptying rate at 30, 60, 90 min and duration of the lag phase were calculated. There was no statistically significant difference in the mean age or in the gastric emptying rates at 30, 60, and 90 min between these two groups (p > 0.05). Mean time of the lag phase of the FM group was significantly longer than that of the control group (p < 0.05). Average age at menopause in the FM group was also significantly lower than that of patients in the control group (p < 0.05). When FM patients were divided into the two subgroups of menopausal and premenopausal patients, there was no significant difference in gastric emptying rate, duration of the lag phase, the number of pain points, and FIQ scores between these two groups (p > 0.05). Although gastric emptying rate was not affected in patients with FM, grinding was prolonged. This result can be explained as one of the causes of gastrointestinal complaints of FM patients. In addition there was no determined influence of menopause on prolonged grinding. However, further studies are needed to elucidate the relationship between clinical findings and gastrointestinal functions and complaints of FM patients.