Association of Coronary Artery Severity and Late In-Stent Restenosis: An Angiographic Imaging Study.

Coronary in-stent restenosis (ISR) remains a challenge in interventional cardiology. We investigated the relationship between angiographic pre-interventional grade of lesion stenosis (LS) and the prognosis of late ISR. After exclusions, 110 patients with ISR and 109 patients without ISR were compared. In the ISR group, the grade of LS was greater (P < .001) and the length of the critical segment (LCS) was longer (P < .001). Stent length was longer in the ISR group (P = .008). Compared with the LCS, the grade of LS above 87.5% is 6.9 times more predictive of ISR than the LCS >10.5 mm. Kaplan-Meier curve analysis showed that the grade of initial LS >87.5% had a higher ISR rate than the grade of LS <87.5% (log-rank test P < .001) and critical lesion length over 10.5 mm had a higher ISR rate than critical lesion length under 10.5 mm (log-rank test P < .001). The present study found that the angiographic pre-interventional grades of LS and LCS were important predictors of ISR. Pre-interventional angiographic stenosis >87.5% was significantly predictive of late ISR.

The Clinical Outcomes of COVID-19 in Patients on Warfarin: A Propensity Score Matching Study.

BACKGROUND: COVID-19 is associated with vascular thrombosis in critical patients. However, warfarin has not been adequately studied in patients with COVID-19. This study aimed to evaluate whether the use of warfarin, a potent oral anticoagulant, was of clinical benefit in patients with COVID-19. METHODS: This was a retrospective cohort study of COVID-19 patients diagnosed at 3 different centers in Turkey between April 2020 and April 2021. Patients were grouped by whether they were taking warfarin or not. Propensity score matching analysis was used to compare the dif ferences between the groups in mortality, hospitalization, and admission to the intensive care unit. RESULTS: A propensity score analysis was performed on 128 patients in the warfarin group and 372 patients in the control group. After matching, 84 pairs of patients were compared. The patients in the control group were more likely to be admitted to the intensive care unit (33.3% vs. 14.3%, respectively; P=.007) and had longer hospital stays than the warfarin group (7.1 vs. 14.1 days; P=.005). The warfarin group had a lower death rate compared to the control group (7.1% vs. 27.4%, respectively; P=.001), and surviving patients were sig nificantly more likely to be in the warfarin group than the control group (56.1% vs. 20.7%, respectively; P=.001). In patients on warfarin, there was a lower incidence of in-hospital death (log-rank test P=.005). CONCLUSIONS: Warfarin therapy could provide clinical benefits in patients with COVID-19. The current data highlight the importance of potent anticoagulation in the treatment of COVID-19.

The association of galectin-3 level with ventricular arrhythmias and left ventricular strain in heart failure patients with implantable cardioverter defibrillator.

BACKGROUND: Ventricular arrhythmias are life-threatening complications of heart failure (HF). Galectin-3, an indicator of fibrosis, is associated with incident HF and was found to be related to poor prognosis in these patients. We aimed to investigate the association of galectin-3 level with left ventricular (LV) arrhythmias in HF. METHODS: A total of 92 non-ischaemic HF patients who had implantable cardioverter-defibrillator were included in this study. Patients were divided into two groups based on the galectin-3 level. Ventricular arrhythmic events and LV strain indices were compared between the two groups. Negative binomial regression was used to detect the independent predictors of total arrhythmic events in HF patients. RESULTS: The median age was 65 (54-71) in the high galectin-3 group (HGAL) and 62 (52-68) in the low galectin-3 group (LGAL). Ventricular arrhythmic events were more frequent in HGAL than in LGAL, including non-sustained ventricular tachycardia (VTnon), sustained-VT (VTs), and ventricular fibrillation (VF) (p < 0.0001, p = 0.002, and p = 0.026, respectively). There were no statistically significant differences between HGAL and LGAL in terms of LV strain measurements. Galectin-3 level was positively significantly correlated with total arrhythmic events (r = 0.58, p < 0.001), but no correlation was found between galectin-3 and LV global longitudinal strain (r = 0.15, p = 0.16). Galectin-3 was an independent predictor of total ventricular arrhythmic events in HF patients (p < 0.0001). CONCLUSION: VTnon, VTs, and VF events were higher in HGAL compared to LGAL. Galectin-3 was an independent predictor of total ventricular arrhythmic events in HF patients and might be used to detect high-risk HF patients for arrhythmic events.

Association of echocardiographic parameters with chest computed tomography score in patients with COVID-19 disease.

PURPOSE: Although coronavirus disease 2019 (COVID-19) primarily affects the pulmonary system, the involvement of the heart has become a well-known issue. Pulmonary CT plays an additive role in the diagnosis and prognosis of the disease. We aimed to investigate the association of echocardiographic indices with pulmonary CT scores and mortality in COVID-19 patients. MATERIALS AND METHODS: A total of 123 patients diagnosed with COVID-19 were included in this study. The British Society of Thoracic Imaging (BSTI) score and echocardiographic parameters were calculated, and echocardiographic indices were compared between BSTI score grades. RESULTS: During in-hospital follow-up, 36 of 123 patients (29.3%) had died. BSTI score, IVS, LVPWd, RV mid-diameter, RV basal diameter, RV longitudinal diameter, sPAP, and RVMPI were higher, and RVFAC, TAPSE, and RVS were lower in the non-survivor group than in the survivor group. There were statistically significant changes between BSTI scores in terms of LVPWd, RV mid diameter, RV basal diameter, RV longitudinal diameter, sPAP, RVFAC, RVMPI, and TAPSE. BSTI score was positively correlated with sPAP and RV basal diameter and negatively correlated with TAPSE and RVFAC. Multivariate logistic regression analysis demonstrated that sPAP (OR â€‹= â€‹1.071, p â€‹= â€‹0.002) and RV basal diameter (OR â€‹= â€‹1.184, p â€‹= â€‹0.005) were independent predictors of high BSTI scores (grade 4 and 5). Furthermore, age, sPAP, and a high BSTI score (grade 5) were independent predictors of in-hospital mortality in COVID-19 patients. CONCLUSION: Echocardiographic indices were correlated with BSTI scores, and patients with higher BSTI scores had more cardiac involvement in COVID-19.