Objective:Atrial fibrillation (AF) is the most common arrhythmia following coronary artery by-pass graft surgery (CABG). The value of SYNTAX score to predict postoperative atrial fibrillation (PoAF) has not been clearly addressed. We aimed to evaluate this relationship in patients undergoing isolated CABG.Methods:This study was designed as a single-center, non-randomized, observational, prospective study. Ninety-four patients undergoing isolated on-pump CABG, who had sinus rhythm and were older than 18 years, were enrolled. Demographic characteristics of the patients were recorded; SYNTAX score was calculated preoperatively for each patient. The univariate and multivariate logistic regression analysis were used to determine for predictors of PoAF.Results:The median SYNTAX score of the enrolled patients was 21, (56–5). PoAF was observed in 31 (33.3%) patients. Univariate logistic regression showed that age, chronic obstructive pulmonary disease (COPD), red blood cell distribution width (RDW), urea, initial troponin I, peak postoperative troponin I, interventricular septum, left atrial diameter, and SYNTAX score were significantly associated with the frequency of PoAF following CABG. An independent association was identified with age [b 0.088, p:0.023, OR: 1.092, 95% CI (1.012–1.179)], COPD [(b: 2.222, p:0.003, OR: 9.228, 95% CI (2.150–39.602)], and SYNTAX score [(b: 0.130, p:0.002, OR: 1.139, 95% CI (1.050–1.235)].Conclusion:This study showed that a higher SYNTAX score was related to more frequent PoAF in patients undergoing isolated on-pump CABG.

The novel inflammatory marker NLR could be used to predict pericardial effusion and in-hospital mortality in patients with acute AD type A.

Percutaneous coronary intervention (PCI) for coronary bifurcation lesions (CBL) represents one of the most challenging procedures in interventional cardiology because of lower angiographic success rate and increased risk of procedural complications (1).Currently, the single stent strategy has been considered as the default approach for the treatment of CBL (2); however, the optimal therapy for Medina type 0,1,0 or 0,0,1 left main stem (LMS) bifurcation lesions remains unclear. For these lesions, precise ostial stent placement and crossover stenting technique have been proposed. Nevertheless, precise stent placement is known to be challenging, and there is no established technique for perfect ostial stent deployment despite the fact that different strategies and/or devices have been tested (3). Several studies have shown that the cross-over stenting approach is superior to the ostial stenting with a lower rate of major adverse cardiovascular event (MACE) rate during longterm clinical follow-up (4, 5). However, data indicates that this procedure may be complicated by a significant stenosis of the other major branch of the LMS even if ABSTRACT Objective: To investigate the safety and efficacy of a percutaneous revascularization strategy that is based on the use of drug-coated balloon (DCB) for the treatment of patients with acute coronary syndrome (ACS) and de novo Medina type 0,1,0 or 0,0,1 left main stem (LMS) bifurcation lesions. Methods:In this multicenter, prospective, proof-of-concept study, patients fulfilling the above criteria were enrolled and received treatment with DCB combined with provisional drug-eluting stent (DES) implantation in the proximal major branches of the LMS. Patients who declined this revascularization approach were treated with DES implantation 1-2 mm distally to the LAD or LCx ostium followed by DCB therapy for the ostial disease. The primary endpoint of the study was percent diameter stenosis (%DS) on quantitative coronary angiography post procedure as well as event rate at 8 months follow-up.Results: Thirty patients were enrolled in the study with mean age of 60.3±7.8 years, of whom 22 (73.3%) were male. Twenty-two patients were treated only with DCB and provisional DES implantation, and 8 had DES implantation followed by DCB therapy of the ostium of the LMS major branch. All the procedures were successful with no immediate complications. Lesion %DS decreased significantly post-procedure from 62.9±14.6 to 13.3±7.5, p<0.001. During the follow-up period, no major adverse cardiac events were reported. Conclusion:This proof-of-concept study indicates that ostial DCB therapy of the LMS major branches is safe and effective. Larger clinical data and longer follow-up is needed before advocating its regular use in clinical practice.

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BACKGROUND: The purpose of this study was to assess the relationship between the triglyceride/high density lipoprotein cholesterol ratio and the risk of acute myocardial infarction in young adults. PATIENTS AND METHODS: A total of 621 patients, who underwent coronary angiography (CAG) due to Myocardial Infarction (MI) at our hospital were included in this study. Demographic characteristics, risk factor profi le, laboratory test results, electrocardiographic and CAG fi ndings were assessed in the selected groups. RESULTS: Total cholesterol, triglyceride/high density lipoprotein cholesterol (Tg/HDL) ratio, Tg levels, were higher in younger patients with MI, while glucose and high-density lipoprotein levels were lower. Using propensity score matching in the matched population comparing young patients to the older ones, serum triglyceride levels [179 (145-231) vs 148 (101-197)] and triglyceride to high density lipoprotein cholesterol ratio [5.8 (4.1-9.1) vs 3.0 (1.8-4.6)] were signifi cantly higher, whereas high density lipoprotein levels were observed dramatically lower (32.6 ± 8.2 vs 41.7 ± 8.8). CONCLUSION: This study demonstrated that Tg/HDL ratio may be an important predictor for an acute coronary syndrome in the young adult population. Tg/HDL ratio can be used to prevent MI in young adults (Tab. 3, Fig. 1, Ref. 32.

Advances in stent technology and the design of endovascular devices with thinner struts, anti‐inflammatory and antithrombotic polymers, and better drug kinetics have enhanced the safety and efficacy of the second‐generation drug‐eluting stents and broadened their use in the therapy of high‐risk patients and complex anatomies. However, despite these developments, in‐stent restenosis and stent thrombosis remain the Achilles' heel of percutaneous coronary intervention, with their cumulative incidence reaching up to 10% at 5 years following percutaneous coronary intervention. The treatment of stent failure poses challenges and is associated with a worse prognosis than conventional percutaneous coronary intervention. Several studies have recently highlighted the value of intravascular imaging in identifying causes of stent failure, underscored its role in treatment planning, and registries have shown that its use may be associated with better clinical outcomes. The present review aims to summarize the evidence in the field; it discusses the value of intravascular imaging in identifying the mechanisms of in‐stent restenosis and stent thrombosis in assessing the morphological characteristics of neointima tissue that appears to determine long‐term outcomes in evaluating procedural results, and presents the findings of studies supporting its value in guiding therapy in stent failure.

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