Comparison of HEAR and HEART Scores for Major Adverse Cardiovascular Events.

BACKGROUND: Early identification of patients with low and high risk for acute coronary syndrome in the emergency department (ED) is important for process management and proper resource use. The aim of this study was to compare the HEAR and HEART scores to determine the risk for major adverse cardiovascular events (MACE) over 30 days. METHODS: Demographic data and clinical evaluations of the patients who presented to the ED with chest pain were recorded. ECGs were evaluated without knowing the clinical status of the patients. The HEART (including history, ECG, age, coronary risk factors, and troponin level) and HEAR (including four items with no troponin) risk scores were calculated. MACE was defined as all MI, all coronary revascularization procedures (PCI and CABG), all-cause death, cardiac arrest, cardiogenic shock, or life-threatening cardiac arrhythmias within 30 days. Patients with MACE were evaluated as Group 1, and patients without MACE were considered as Group 2, and the data from the two groups were compared. RESULTS: A total of 230 patients were included in the study. There were 56 (24.3%) patients with MACEs. According to the ROC analysis, the threshold value was determined as ≤3 for both scoring systems. According to this threshold value, sensitivity and specificity were found to be 0.77 and 0.78 for the HEAR score and 0.82 and 0.77 for the HEART score. CONCLUSIONS: Although the HEAR and HEART scoring systems are useful for the management of patients with chest pain in the ED, the HEART score was evaluated to be more effective.

Role of simple inflammatory parameters in predicting the severity of coronary artery disease.

OBJECTIVE: In our study, we aimed to find simple, useful biomarkers in patients with non-ST elevation myocardial infarction to predict coronary artery severity. METHODS: Between May 2022 and December 2022, patients diagnosed with non-ST elevation myocardial infarction according to the European cardiology guidelines were included in our study. The Synergy between PCI with Taxus and Cardiac Surgery score was calculated to determine the severity of coronary artery disease. These patients were classified into two groups according to Synergy between PCI with Taxus and Cardiac Surgery≥23 and Synergy between PCI with Taxus and Cardiac Surgery<23 scores. Biochemical markers such as platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were studied in blood tests taken before coronary angiography in patients diagnosed with non-ST elevation myocardial infarction according to current guidelines. These two groups were compared in terms of the data obtained. RESULTS: There were 281 patients in group 1 and 67 patients in group 2. There was no significant difference between the two groups in terms of demographic data such as age and gender. Platelet-to-lymphocyte ratio [group 1=125 (26-134) and group 2=156 (73-293); p=0.001] and neutrophil-to-lymphocyte ratio [group 1=2.71 (1.3-30.2) and group 2=3.2 (2.1-32.1); p=0.002] were higher in the group of patients with a Synergy between PCI with Taxus and Cardiac Surgery score of <23, while lymphocyte-to-monocyte ratio [group 1=3.6 (0.56-11) and group 2=3.4 (0.64-5.75); p=0.017] was lower in group 2. CONCLUSION: We observed that elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios showed coronary artery severity. Multivessel disease and chronic total occlusion rates were observed to be higher in patients with high platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios.

Role of simple inflammatory parameters in predicting the severity of coronary artery disease

SUMMARY OBJECTIVE: In our study, we aimed to find simple, useful biomarkers in patients with non-ST elevation myocardial infarction to predict coronary artery severity. METHODS: Between May 2022 and December 2022, patients diagnosed with non-ST elevation myocardial infarction according to the European cardiology guidelines were included in our study. The Synergy between PCI with Taxus and Cardiac Surgery score was calculated to determine the severity of coronary artery disease. These patients were classified into two groups according to Synergy between PCI with Taxus and Cardiac Surgery≥23 and Synergy between PCI with Taxus and Cardiac Surgery<23 scores. Biochemical markers such as platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were studied in blood tests taken before coronary angiography in patients diagnosed with non-ST elevation myocardial infarction according to current guidelines. These two groups were compared in terms of the data obtained. RESULTS: There were 281 patients in group 1 and 67 patients in group 2. There was no significant difference between the two groups in terms of demographic data such as age and gender. Platelet-to-lymphocyte ratio [group 1=125 (26-134) and group 2=156 (73-293); p=0.001] and neutrophil-to-lymphocyte ratio [group 1=2.71 (1.3-30.2) and group 2=3.2 (2.1-32.1); p=0.002] were higher in the group of patients with a Synergy between PCI with Taxus and Cardiac Surgery score of <23, while lymphocyte-to-monocyte ratio [group 1=3.6 (0.56-11) and group 2=3.4 (0.64-5.75); p=0.017] was lower in group 2. CONCLUSION: We observed that elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios showed coronary artery severity. Multivessel disease and chronic total occlusion rates were observed to be higher in patients with high platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios.

The influence of environmental instability on the reproductive strategy of the critically endangered Acigöl killifish (Aphanius transgrediens).

To investigate the variability in the reproductive tactics of Acigöl killifish (Aphanius transgrediens), one of the most seriously threatened freshwater teleost species, this study compared its reproductive ecology in two contrasting habitats that differ substantially in terms of stability of environmental parameters, particularly salinity regime (stable vs. unstable). Fish were sampled monthly from October 2013 to September 2014 with the aim of testing whether the reproductive life-history response of fish to stable and unstable conditions differed. The reproductive effort (gonad weight) of both sexes did not differ significantly between the two habitats, but females in the unstable habitat had significantly lower fecundity and larger eggs. The relationship between fecundity and fish size was stronger in the stable habitat, whereas the relationship was quite variable and uncertain in the unstable habitat. Fish born in the unstable habitat reached their first maturity at a smaller size than those in the stable habitat. The gonado-somatic index and the duration of hydrated eggs showed that reproduction continued from February to May in both habitats; nonetheless, a second spawning event occurred during July and August in the unstable habitat, which included the reproductive contributions of YOY individuals and older generations. This study's results suggest that A. transgrediens employs varying reproductive strategies against environmental instability in its restricted unique range. This may have further implications for the ways in which habitat-specific conservation methods are used.

Risk screening of the potential invasiveness of non-native marine fishes for South Korean coastal waters.

Risk screening tools are being increasingly used to identify the potential invasiveness and associated risks of non-native species. In this study, the Aquatic Species Invasiveness Screening Kit was used to evaluate the invasiveness risks of extant and horizon non-native marine fish species for the coastal waters of South Korea. In total, 57 marine fish species were screened and the threshold scores for the Basic Risk Assessment (BRA) and the BRA + Climate Change Assessment (BRA+CCA) (5.5 and 1.5, respectively) reliably distinguished those species carrying a high risk of invasiveness from those carrying a low to medium risk. For both the BRA and BRA+CCA, common lionfish Pterois miles was the highest-scoring species, followed by white perch Morone americana, red drum Sciaenops ocellatus, marbled spinefoot Siganus rivulatus and redcoat Sargocentron rubrum. The outcomes of this study will contribute to the management of non-native marine fish species for the conservation of the native ecosystems in the coastal waters of South Korea.

The effects of eosinophil on the left atrial thrombus in patients with atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac rhythm disorder. Atrial fibrillation causes a 5-fold increased risk for thromboembolic stroke. It is known that eosinophils play an important role in thrombosis. We aimed to compare the number of eosinophil counts of the patients with and without thrombi in the left atrium (LA) or in the left atrial appendage (LAA) and to ascertain the association of eosinophil counts with the presence of thrombi. METHOD: The study included 89 patients diagnosed with persistent AF who underwent transesophageal echocardiography and designated to undergo cardioversion. The patients were divided into 2 groups: group 1 consisted of 40 patients (18 male; average age 63.27 ± 1.4) who had thrombus formation in the LA or LAA, and group 2 consisted of 49 patients (23 male; average age 66.53 ± 1.56) who did not have any thrombus in the LA or LAA. These patients underwent concurrent routine biochemical tests and eosinophil count on whole blood count was also performed. RESULTS: Baseline characteristics of the study groups were comparable. Group 1 patients had higher eosinophil and mean platelet volume values than group 2 (233.0 ± 30.7 vs 118.9 ± 11.8 and 9.77 ± 0.20 vs 8.27 ± 0.12 fL, P < .001, respectively). In group 1, the patients' LA diameter is higher than that in group II. CONCLUSION: As a result, our study revealed a relationship between eosinophil count and LA thrombus in patients with nonvalvular AF.

The effects of vitamin D deficiency on atrial fibrillation.

BACKGROUND: Vitamin D deficiency is associated with cardiovascular disease such as coronary artery disease, heart failure, and hypertension. Vitamin D deficiency activates the renin-angiotensin-aldosterone system, which affects the cardiovascular system. For this reason, it could be suggested that there is a relationship between vitamin D deficiency and atrial fibrillation (AF). In our study, we compared 25-hydroxyvitamin D (25-OHD) levels between nonvalvular AF, valvular AF, and control groups in sinus rhythm. METHOD: A total of 102 patients with nonvalvular chronic AF without any other cardiovascular disease (mean age 62.51 ± 5.88; group I) and 96 patients with AF, which is associated with mitral valve disease (mean age 61.51 ± 5; group II) were included in our study. Of all, 100 age-matched healthy people with sinus rhythm were accepted as control groups (mean age 61.35 ± 5.44). Routine biochemical parameters, 25-OHD and parathormone levels were performed. RESULTS: Baseline characteristics of the study groups were comparable. Group I patients had a lower vitamin D level than group II and the control group (6.51 ± 4.89, 9.24 ± 7.39, and 11.18 ± 6.98 ng/mL, P < .001, respectively). In groups I and II, the patients' left atrium diameter and systolic pulmonary artery pressure are higher than the control group. CONCLUSION: As a result, our study revealed a relationship between vitamin D deficiency and nonvalvular AF.

Evaluation of Tp-e interval and Tp-e/QT ratio in patients with non-dipper hypertension.

AIMS: Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with non-dipper hypertension. MATERIALS AND METHOD: This study included 80 hypertensive patients. Hypertensive patients were divided into two groups: 50 dipper patients (29 male, mean age 51.5 ± 8 years) and 30 non-dipper patients (17 male, mean age 50.6 ± 5.4 years). Tp-e interval and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups. RESULTS: No statistically significant difference was found between two groups in terms of basic characteristics. In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in non-dipper patients compared to the dippers (39.4 ± 11.5 versus 27.3 ± 7.5 ms and 37.5 ± 9.5 versus 29.2 ± 6.5 ms, p = 0.001 and p = 0.01, respectively). Tp-e interval and Tp-e/QT ratio were also significantly higher in non-dipper patients (97.5 ± 11.2 versus 84.2 ± 8.3 ms and 0.23 ± 0.02 versus 0.17 ± 0.02, all p value <0.001). CONCLUSION: Our study revealed that QTd, Tp-e interval and Tp-e/QT ratio are prolonged in patients with non-dipper hypertension.

The Relationship Between Serum Bilirubin Concentration and Atrial Fibrillation.

BACKGROUND: Several studies have demonstrated that higher serum bilirubin inhibits the inflammation and proliferation of vascular smooth muscle cells; also there is a relationship between serum bilirubin and cardiovascular disease. However, the relationship between bilirubin and atrial fibrillation (AF) is still unknown. In our study, we compared serum bilirubin, between nonvalvular AF patients and controls. MATERIALS AND METHOD: One hundred and two patients with nonvalvular chronic AF without any other cardiovascular disease (mean age 62.51 ± 5.88) were included in our study. One hundred age-matched healthy people with sinus rhythm were accepted as control groups (mean age 61.35 ± 5.44). Routine biochemical parameters and serum bilirubin levels were performed. RESULTS: No statistically significant difference was found between two groups in terms of basic characteristics. Total, direct and indirect serum bilirubin levels were significantly lower among persons with AF compared to controls (0.82 ± 0.8 vs. 0.48 ± 0.5, 0.30 ± 0.2 vs. 0.19 ± 0.1 and 0.52 ± 0.5 vs. 0.29 ± 0.3 mg/dL; all P < 0.001, respectively). CONCLUSION: As a result, our study revealed a relationship between serum bilirubin and nonvalvular AF.