Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.
There is a lack of evidence regarding the short-term predictive value of serum albumin to creatinine ratio (sACR) in patients with ST-segment elevation myocardial infarction (STEMI). This study aims to investigate the relationship between sACR and short-term outcomes in these patients. We retrospectively enrolled 3057 patients with STEMI who underwent primary percutaneous coronary interventions (PCI) (median age was 58 years, and 74.3% were male). In-hospital mortality occurred in 114 (3.7%) patients. Contrast-induced nephropathy (CIN) was reported in 381 (12.4%) patients. During a 30-day follow-up, stent thrombosis (ST) occurred in 28 (.9%) patients and 30-day death in 147 (4.8%) patients. Multivariable logistic regression analysis reported that sACR was inversely associated with 30-day mortality (adjusted odds ratio (aOR): .51, 95% confidence interval (CI) .31–.82, P < .001). The sACR was also inversely associated with in-hospital mortality (aOR: .71, 95% CI .56–.90, P = .009), CIN (aOR: .60, 95% CI .52–.68, P < .001), congestive heart failure (CHF) (aOR: .64, 95% CI .47–.87, P = .007), and ST (aOR .61, 95% CI .41–.92, P = .001) at 30 days. Our findings suggest that sACR is inversely associated with short-term clinical outcomes in patients with STEMI after PCI.
The Naples score is a new prognostic score developed according to inflammatory and nutritional status and frequently evaluated in cancer patients. The present study aimed to evaluate using the Naples prognostic score (NPS) to predict the development of decreased left ventricular ejection fraction (LVEF) after acute ST-segment elevation myocardial infarction (STEMI). The study has a multicenter and retrospective design and included 2280 patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) between 2017 and 2022. All participants were divided into 2 groups according to their NPS. The relationship between these 2 groups and LVEF was evaluated. The low-Naples risk group (Group-1) included 799 patients, and the high-Naples risk group (Group-2) had 1481 patients. Hospital mortality, shock, and no-reflow rates were found to be higher in Group 2 compared with Group 1 ( P < .001, P = .032, P = .004). The NPS was significantly inversely associated with discharge LVEF (B coefficient: −1.51, 95% CI-2.26; −.76, P = .001). NPS, a simple and easily calculated risk score, may help identify high-risk STEMI patients. To the best of our knowledge, the present study is the first to demonstrate the relationship between low LVEF and NPS in patients with STEMI.
IntroductionCoronary fractional flow reserve (FFR) is recommended as the gold standard method in evaluating intermediate coronary stenoses. However, there are significant debates concerning the agents and the timing of the measurement.AimTo compare the contrast medium induced Pd/Pa ratio (CMR) with the FFR.Material and methodsWe enrolled 28 consecutive patients with 34 intermediate lesions who underwent coronary FFR measurement by intracoronary (i.c.) adenosine. After baseline Pd/Pa was calculated, a single contrast medium (Iomeron) injection of 6 ml (3 ml/s) was performed manually. Within 10 s after the contrast medium injection, the CMR was calculated. Bolus injection of i.c. adenosine was performed to induce maximal hyperemia (from 60 µg to 600 µg), and when it was ≤ 0.80, the intermediate lesion was considered as significant.ResultsAfter bolus i.c. adenosine, 12 lesions of 34 (35.3%) were identified as significant. The CMR value was 0.86 ±0.06 (range: 0.71–0.97). There were no significant differences between FFR and CMR values (p = 0.108). A substantial positive correlation between adenosine and contrast values was detected (0.886 and p < 0.001). Good agreement in Bland-Altman analysis was revealed (mean bias was 0.027, 95% confidence interval 0.038–0.092). Receiver operating characteristics curve analysis showed 90.9% sensitivity and 91.7% specificity for a cut-off value of 0.85 for the CMR compared to FFR (≤ 0.80).ConclusionsOur study showed that measuring the CMR is a feasible method compared to FFR. The CMR may be used in situations where adenosine cannot be administered.
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