ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 28 (6)
Volume: 28  Issue: 6 - June 2024
1.Angiojet Rheolytic Thrombectomy, AIZANOI study and COVID-19
Çetin Erol
PMID: 38829260  doi: 10.14744/AnatolJCardiol.2024.6  Page 263
Abstract |Full Text PDF

2.Is it Time to Reappraise for Black-Box Warning on AngioJet Rheolytic Thrombectomy in Patients with Pulmonary Embolism: A Systematic Review and Meta-analysis
Cihangir Kaymaz, Barkın Kültürsay, Hacer Ceren Tokgöz, Aykun Hakgör, Berhan Keskin, Özgür Yaşar  Akbal, Ayhan Tosun, Seda Tanyeri, Ahmet Sekban, Çağdaş Buluş, Şeyhmus Külahçıoğlu, Ali Karagöz, İbrahim Halil  Tanboğa, Nihal Özdemir
PMID: 38530216  doi: 10.14744/AnatolJCardiol.2024.4081  Pages 264 - 272
Background: AngioJet rheolytic thrombectomy (ART) system has been widely used as a catheter-directed treatment (CDT) method in acute pulmonary embolism (PE), however, there has been a controversy regarding the safety of its use. In this systematic review and meta-analysis, we evaluated the efficacy and safety outcomes of ART in patients with PE.

Methods: Our meta-analysis have been based on search in the MEDLINE, EMBASE, and Cochrane Library for studies published up to August 2022. The primary outcomes were overall pooled rates of major bleeding (MB) and minor bleeding (mB), worsening renal function (WRF), bradycardia/conduction disturbance (BCD), and PE-related and all-cause mortality in patients who underwent ART.

Results: Among the 233 studies documented at initial search, 24 studies were eligible for meta-analysis, and a total of 427 PE patients who underwent ART were evaluated. Overall pooled rates of MB and mB were 9.6% (95% CI 5.9%-15.2%) and 9.2% (95% CI 6.1%-13.6%), transient BCD and WRF were 18.2% (95% CI 12.4%-26%) and 15% (95% CI 10%-21.8%), and PE-related death and all-cause death were 12.7% (95% CI 9.1%-17.3%) and 15% (95% CI 11%-20%), respectively. However, significant heterogeneity and some evidence of funnel plot asymmetry and publication bias were noted for MB, BCD and WRF, but not for PE-related death and all-cause death.

Conclusion: Overall pooled rates of bleeding events, BCD and WRF episodes, PE-related death and all-cause death may be considered as encouraging results for efficacy and safety issues of ART utilization in specific scenarios of acute PE, and a reappraisal for black-box warning on ART seems to be necessary.

3.Adherence to Current Dyslipidemia Guideline in Patients Utilizing Statins According to Risk Groups and Gender Differences: The AIZANOI Study
Taner Şen, Lale Dinç asarcıklı, Saadet Güven, Umut Kocabaş, Mehmet Özgeyik, Mevlüt Demir, Tülay Oskay, Halil İbrahim  Durmuş, Belma Kalaycı, Muhammet Cihat  Çelik, Fatih Kahraman, Ökkeş Utku, Mehmet Ali  Astarcıoğlu, Sabiye Yılmaz, Abdullah Tunçez
PMID: 38829258  doi: 10.14744/AnatolJCardiol.2024.4218  Pages 273 - 282
Background: The aim of this study was to assess the adherence to the current European Society of Cardiology dyslipidemia guidelines, the ratio of reaching target values according to risk groups, and the reasons for not reaching LDL-cholesterol (LDL-C) goals in patients on already statin therapy in a cardiology outpatient population.

Methods: The AIZANOI study is a multi-center, cross-sectional observational study including conducted in 9 cardiology centers between August 1, 2021, and November 1, 2021.

Results: A total of 1225 patients (mean age 62 ± 11 years, 366 female) who were already on statin therapy for at least 3 months were included. More than half (58.2%) of the patients were using high-intensity statin regimens. Only 26.2% of patients had target LDL-C level according to their risk score. Despite 58.4% of very high-risk patients and 44.4% of high-risk patients have been using a high-intensity statin regimen, only 24.5% of very-high-risk patients and only 34.9% of high-risk patients have reached guideline-recommended LDL-C levels. Most prevalent reason for not using target dose statin was physician preference (physician inertia) (40.3%).

Conclusion: The AIZANOI study showed that we achieved a target LDL-C level in only 26.2% of patients using statin therapy. Although 58.4% of patients with a very high SCORE risk and 44.4% of patients with a high SCORE risk were using a target dose statin regimen, we were only able to achieve guideline-recommended LDL-C levels in 24.5% and 34.9% of them, respectively, in cardiology outpatients clinics. Physician inertia is one of the major factors in non-adherence to guidelines. These findings highlight that combination therapy is needed in most of the patients.

4.Bridging the Gap: Insights from the AIZANOI Study on Low-Density Lipoprotein-Cholesterol Management in Türkiye
Meral Kayıkçıoğlu
PMID: 38829259  doi: 10.14744/AnatolJCardiol.2024.4607  Pages 283 - 285
Abstract |Full Text PDF

5.Fragmentation of the QRS Complex Is Associated with Right Ventricular Dilatation and Mortality in Critically Unwell Coronavirus Disease 2019 Patients
Randeep S. Heer, Faye  L. Selby, Amit J. K. Mandal, Vadir Baktash, Piotr Szawarski, Sirtaaj Mattoo, Hasan Mohiaddin, Kanchani K. Makuloluwa, Hussein Chreif, Fouad R. Amin, Constantinos G. Missouris
PMID: 38530215  doi: 10.14744/AnatolJCardiol.2024.3494  Pages 286 - 293
Background: QRS fragmentation (fQRS) is a depolarization disorder that can be detected on routine electrocardiography (ECG). Current evidence suggests that fQRS is a prognosticator of adverse cardiovascular events. This study aimed to assess the relationship between fQRS and all-cause mortality in critically unwell coronavirus disease 2019 (COVID-19) patients and to investigate the significance of associated abnormalities on echocardiography.

Methods: A retrospective cohort study of COVID-19 patients in a critical care setting was performed. Electrocardiography was performed on presentation to hospital, admission to the critical care unit, and at subsequent points according to clinical need. Transthoracic echocardiography was performed at clinical discretion to assess for structural and functional cardiac abnormalities. Primary outcome was in-hospital mortality and secondary outcome was the need for mechanical invasive ventilation.

Results: Totally, 212 consecutive patients were included of which 120 (57%) exhibited fQRS and inferior leads were involved in 88% of the patients. Overall, fQRS was a significant predictor of mortality [65% vs. 44% P =.003; multivariate odds ratio = 2.96, 95% confidence interval (CI): 1.42-6.40, P =.005] and inferior fQRS itself was a significant predictor of mortality (P =.03). There was no significant association between fQRS and the need for invasive mechanical ventilation. A total of 112 patients underwent echocardiography. There was a greater incidence of right ventricular (RV) dilatation in the fQRS group (16% vs. 2% respectively, P =.02) and pulmonary hypertension (33% vs. 14% respectively, P =.03) based on echocardiographic criteria.

Conclusion: Our study demonstrates that fQRS is significantly associated with RV dilation, pulmonary hypertension, and mortality in critically unwell COVID-19 patients.

6.Comparison of the Effects of Recent Coronavirus 2019 Infection and Vaccination on the Prognosis of Acute Coronary Syndrome: A Retrospective Study Conducted in a Single Center in Türkiye
Özlem Özbek, Mehmet Mustafa Can
PMID: 38770698  doi: 10.14744/AnatolJCardiol.2024.4372  Pages 294 - 304
Background: We aimed to examine the effects of COVID-19 infection versus vaccination within the month prior to acute coronary syndrome (ACS) diagnosis with respect to their impact on the development of mortality or major adverse cardiovascular events (MACE).

Methods: This retrospective cohort study included patients hospitalized with a diagnosis of ACS between June 2020 and December 2022. Patients diagnosed with ACS were grouped according to the presence of COVID-19 infection (post-COVID), vaccination (post-vaccine), or non-exposure during the month prior to ACS diagnosis. Patients with and without MACE were also compared separately.

Results: We analyzed 1890 ACS patients (mean age 57.43 ± 11.53 years, 79.15% males). Of these, 319 (16.88%) were in the post-vaccine group, and 334 (17.67%) were in the post-COVID group. Major adverse cardiovascular events occurred in 569 (30.11%) patients. Mortality was recorded in 271 (14.34%) patients. In the post-COVID group, the frequencies of MACE and mortality and length of stay in hospital were significantly higher (vs. post-vaccine and vs. non-exposure groups; both P <.001). High age, ST-elevation myocardial infarction, having suffered from Post-COVID ACS, and high glucose were independently associated with increased MACE risk; whereas, hyperlipidemia, 3 or more COVID vaccinations, receipt of the Biontech vaccine, and high estimated glomerular filtration rate were independently associated with decreased MACE risk.

Conclusion: Acute coronary syndrome patients who have recently had COVID-19 infection may have a worse prognostic course compared to those with recent vaccination, necessitating continuing care for pandemic-related risk factors as well as previously known factors impacting MACE and prognosis.

7.The Prognostic Accuracy of Get With The Guidelines-Heart Failure Score Alone and with Lactate Among Acute Symptomatic Heart Failure Patients: A Retrospective Cohort Study
Buğra İlhan, Göksu Bozdereli Berikol, Halil Doğan, Attila Beştemir, Adnan Kaya
PMID: 38629352  doi: 10.14744/AnatolJCardiol.2024.4116  Pages 305 - 311
Background: To evaluate the prognostic accuracy of the Get With The Guidelines-Heart Failure (GWTG-HF) score, Shock Index (SI), Modified Shock Index (MSI), and Age Shock Index (Age-SI) alone and with lactate in patients with acute symptomatic heart failure (HF).

Methods: A retrospective cohort study was conducted in the emergency department of a tertiary hospital between January 1, 2019, and December 31, 2019. Patients aged >18 years and diagnosed with acute symptomatic HF were consecutively included in the study. Patients referred from another center and missing medical records were excluded. Arrival type, vital parameters, demographic characteristics, comorbid diseases, consciousness status, laboratory results, and outcomes of the patients were recorded. The primary endpoint of the study was in-hospital mortality.

Results: A total of 368 patients were included in the final analysis. The in-hospital mortality rate of the patients was 7.6%. The GWTG-HF score outperformed other scores in predicting in-hospital, 24-hour, and 30-day mortality (area under the curve (AUC) = 0.807, 0.844, and 0.765, P <.001, respectively). The overall performance of the GWTG-HF score with lactate (GWTG-HF+L) was better in predicting in-hospital, 24-hour, and 30-day mortality than the original GWTG-HF score (AUC = 0.872, 0.936, and 0.801, P <.001, respectively). Adding lactate values to the SI, MSI, and Age-SI improved their overall performance for all 3 outcomes.

Conclusion: Both the GWTG-HF and GWTG-HF+L scores have acceptable discriminatory power in patients with acute symptomatic HF. The GWTG-HF score, SI, MSI, and Age-SI can be used together with lactate to predict mortality in patients with acute HF.

8.Cardiovascular Events After Coronavirus Disease 2019 Vaccinations: Hypersensitivity Myocarditis After Coronavirus Disease 2019 Vaccines, Diagnostic and Long-term Considerations
Nicholas G. Kounis
PMID: 38686593  doi: 10.14744/AnatolJCardiol.2024.4400  Pages 312 - 313
Abstract |Full Text PDF

9.Reply to Letter to the Editor: “Cardiovascular Events After Coronavirus Disease 2019 Vaccinations: Hypersensitivity Myocarditis After Coronavirus Disease 2019 Vaccines, Diagnostic and Long-term Considerations”
Hans-Bernd Bludau, Sergei V. Jargin
PMID: 38655863  doi: 10.14744/AnatolJCardiol.2024.4417  Pages 314 - 315
Abstract |Full Text PDF

10.Revisiting and Refining the Body Mass Index-Based Thromboembolic Risk Score in Atrial Fibrillation: A Constructive Review
Yunus Emre Yavuz, Fatih Kahraman
PMID: 38655864  doi: 10.14744/AnatolJCardiol.2024.4329  Page 316
Abstract |Full Text PDF

11.Asymptomatic Right Atrial Appendage Aneurysm Associated with Tricuspid Regurgitation in a 7-year-old Boy
Ruofan Zhou, Xi Li, Jun Gu, Shuhua Luo
PMID: 38785121  doi: 10.14744/AnatolJCardiol.2024.4320  Pages E22 - E23
Abstract |Full Text PDF | Video

12.Huge Pseudoaneursym Presenting with Silent Myocardial Infarction and Stroke
Muhammed İkbal Şaşmaz, Bülent Demir, Mustafa Uçar, Akkan Avci
PMID: 38770697  doi: 10.14744/AnatolJCardiol.2024.4431  Pages E24 - E25
Abstract |Full Text PDF | Video

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