Search Results (288)

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

Background and Objectives: Although survival after congenital cardiac malformations (CCM) has improved, little is known about Romanian children’s own perceptions of health-related quality of life (HRQoL) or their emotional burden. We compared HRQoL, depressive symptoms, and anxiety across lesion severity strata and explored clinical predictors of impaired HRQoL. Methods: In this cross-sectional study (1 May 2023–30 April 2025), 72 children (mean age 7.9 ± 3.0 years, 52.8% male) attending a tertiary cardiology clinic completed the Romanian-validated Pediatric Quality of Life Inventory (PedsQL), Children’s Depression Inventory (CDI) and the Screen for Child Anxiety-Related Emotional Disorders questionnaire (SCARED-C, child version). Lesions were classified as mild (n = 22), moderate (n = 34), or severe (n = 16). Left-ventricular ejection fraction (LVEF) and unplanned cardiac hospitalisations over the preceding 12 months were extracted from electronic records. Results: Mean PedsQL total scores declined stepwise by severity (mild 80.9 ± 7.3; moderate 71.2 ± 8.4; severe 63.1 ± 5.4; p < 0.001). CDI and SCARED-C scores rose correspondingly (CDI: 9.5 ± 3.0, 13.6 ± 4.0, 18.0 ± 2.7; anxiety: 15.2 ± 3.3, 17.2 ± 3.8, 24.0 ± 3.4; both p < 0.001). PedsQL correlated positively with LVEF (r = 0.51, p < 0.001) and negatively with hospitalisations (r = −0.39, p = 0.001), depression (r = −0.44, p < 0.001), and anxiety (r = −0.47, p < 0.001). In multivariable analysis, anatomical severity remained the sole independent predictor of lower HRQoL (β = −8.4 points per severity tier, p < 0.001; model R² = 0.45). Children with ≥ 1 hospitalisation (n = 42) reported poorer HRQoL (69.6 ± 8.0 vs. 76.1 ± 11.1; p = 0.005) and higher depressive scores (p < 0.001). Conclusions: HRQoL and internalising symptoms in Romanian children with CCM worsen with increasing anatomical complexity and recent hospital utilisation. The severity tier outweighed functional markers as the main determinant of HRQoL, suggesting that psychosocial screening and support should be scaled to lesion complexity. Integrating the routine use of the Romanian-validated PedsQL, CDI, and SCARED-C questionnaire into cardiology follow-up may help identify vulnerable patients early and guide targeted interventions. Full article

Introduction: Congestive heart failure (CHF), a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments, is a growing public health concern, with profound implications for patients’ physical and emotional well-being. In India, the burden of CHF is rising due to aging demographics and increasing prevalence of lifestyle-related risk factors. Among the subtypes of CHF, heart failure with preserved ejection fraction (HFpEF), i.e., heart failure with left ventricular ejection fraction of ≥50% with evidence of spontaneous or provokable increased left ventricular filling pressure, and heart failure with reduced ejection fraction (HFrEF), i.e., heart failure with left ventricular ejection fraction of 40% or less and is accompanied by progressive left ventricular dilatation and adverse cardiac remodeling, may present differing impacts on health-related quality of life (HRQoL), i.e., an individual’s or a group’s perceived physical and mental health over time, yet comparative data remains limited. This study assesses HRQoL among CHF patients using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), one of the most widely used health-related quality of life questionnaires for patients with heart failure based on physical and emotional dimensions and identifies sociodemographic and clinical variables influencing these outcomes. Methods: A cross-sectional analytical study was conducted among 233 CHF patients receiving inpatient and outpatient care at the Department of Cardiology at a quaternary care teaching hospital in coastal Karnataka in India. Participants were enrolled using convenience sampling. HRQoL was evaluated through the MLHFQ, while sociodemographic and clinical characteristics were recorded via a structured proforma. Statistical analyses included descriptive measures, independent t-test, Spearman’s correlation and stepwise multivariable linear regression to identify associations and predictors. Results: The mean HRQoL score was 56.5 ± 6.05, reflecting a moderate to high symptom burden. Patients with HFpEF reported significantly worse HRQoL (mean score: 61.4 ± 3.94) than those with HFrEF (52.9 ± 4.64; p < 0.001, Cohen’s d = 1.95). A significant positive correlation was observed between HRQoL scores and age (r = 0.428; p < 0.001), indicating that older individuals experienced a higher burden of symptoms. HRQoL also varied significantly across NYHA functional classes (χ² = 69.9, p < 0.001, ε² = 0.301) and employment groups (χ² = 17.0, p < 0.001), with further differences noted by education level, gender and marital status (p < 0.05). Multivariable linear regression identified age (B = 0.311, p < 0.001) and gender (B = –4.591, p < 0.001) as significant predictors of poorer HRQoL. Discussion: The findings indicate that patients with HFpEF experience significantly poorer HRQoL than those with HFrEF. Older adults and female patients reported greater symptom burden, underscoring the importance of demographic-sensitive care approaches. These results highlight the need for routine integration of HRQoL assessment into clinical practice and the development of comprehensive, personalized interventions addressing both physical and emotional health dimensions, especially for vulnerable subgroups. Conclusions: CHF patients, especially those with HFpEF, face reduced HRQoL. Key factors include age, gender, education, employment, marital status, and NYHA class, underscoring the need for patient-centered care. Full article

Heart rate (HR) is strongly affected by the autonomic nervous system (ANS), while its spontaneous fluctuations, called heart rate variability (HRV), report about the dynamics of the complex, vegetative regulation of the heart rhythm. Hence, HRV is widely considered an important marker of the ANS effects on the cardiac system, and as such, a crucial diagnostic tool in cardiology. In order to obtain nontrivial results from HRV analysis, it would be desirable to establish exact, universal interrelations between the typical HRV parameters and HR itself. That, however, has not yet been fully accomplished. Hence, our aim was to perform a comparative statistical analysis of ECG recordings from a public database, with a focus on the HR dependence of typical HRV parameters. We revealed their fundamental connections, which were substantiated by basic mathematical considerations, and were experimentally demonstrated via the analysis of 24 h of ECG recordings of more than 200 healthy individuals. The large database allowed us to perform unique age-cohort analyses. We confirmed the HR dependence of typical time-domain parameters, such as RMSSD and SDNN, frequency-domain parameters such as the VLF, LF, and HF components, and nonlinear indices such as sample entropy and DFA exponents. In addition to shedding light on their relationship, we are the first, to our knowledge, to identify a new, diffuse structure in the VHF regime as an important indicator of SNS activity. In addition, the demonstrated age dependence of the HRV parameters gives important new insight into the long-term changes in the ANS regulation of the cardiac system. As a possible molecular physiological mechanism underlying our new findings, we suggest that they are associated with Piezo2 channel function and its age-related degradation. We expect our results to be utilized in HRV analysis related to both medical research and practice. Full article

Background: Large Language Models (LLMs) such as ChatGPT, Claude, and Gemini are being increasingly adopted in medicine; however, their reliability in cardiology remains underexplored. Purpose of the study: To compare the performance of three general-purpose LLMs in response to cardiology-related clinical queries. Study design: Seventy clinical prompts stratified by diagnostic phase (pre or post) and user profile (patient or physician) were submitted to ChatGPT, Claude, and Gemini. Three expert cardiologists, who were blinded to the model’s identity, rated each response on scientific accuracy, completeness, clarity, and coherence using a 5-point Likert scale. Statistical analysis included Kruskal–Wallis tests, Dunn’s post hoc comparisons, Kendall’s W, weighted kappa, and sensitivity analyses. Results: ChatGPT outperformed both Claude and Gemini across all criteria (mean scores: 3.7–4.2 vs. 3.4–4.0 and 2.9–3.7, respectively; p < 0.001). The inter-rater agreement was substantial (Kendall’s W: 0.61–0.71). Pre-diagnostic and patient-framed prompts received higher scores than post-diagnostic and physician-framed ones. Results remained robust across sensitivity analyses. Conclusions: Among the evaluated LLMs, ChatGPT demonstrated superior performance in generating clinically relevant cardiology responses. However, none of the models achieved maximal ratings, and the performance varied by context. These findings highlight the need for domain-specific fine-tuning and human oversight to ensure a safe clinical deployment. Full article

Thyroid nodules are a common clinical finding, with their prevalence influenced by multiple environmental and occupational factors, including exposure to ionizing radiation. Healthcare workers, particularly those operating in radiology, nuclear medicine, interventional cardiology, and radiation oncology, are potentially at increased risk due to chronic low-dose radiation exposure. This review aims to evaluate the current evidence regarding the association between occupational radiation exposure and the development of thyroid nodules among healthcare professionals. The findings suggest a higher prevalence of thyroid nodules in radiation-exposed workers compared to the general population, although data heterogeneity and methodological limitations exist. Factors such as the duration of exposure, radiation protection practices, and frequency of monitoring play critical roles in modulating the individual risk. While some studies report no significant difference in malignancy rates, the increased detection of nodules underlines the need for regular thyroid surveillance in at-risk populations. Further longitudinal and multicentric studies are warranted to clarify the causality and guide preventive strategies. This review highlights the importance of occupational health protocols, including radiation shielding and periodic thyroid evaluation, in safeguarding the long-term endocrine health of healthcare workers. Full article

Background and Objectives: International guidelines differ on short-term (4-week) oral anticoagulation (OAC) indication after acute cardioversion for recent-onset atrial fibrillation (AF < 12–48 h) in low-risk patients (CHA₂DS₂-VA = 0). While Canadian and Chinese guidelines recommend OAC for all, European, Australian and New Zealand, and American guidelines state that such treatment is optional due to the absence of high-quality evidence supporting its indication in this specific scenario. This study aimed to assess physicians’ management of a simple clinical case at an international level, focusing on how they balance ischemic and bleeding risks in a setting lacking any strong evidence-based recommendations. Materials and Methods: Six different AF guidelines were evaluated regarding the recommendation for and scientific evidence justifying short-term OAC in this specific setting. Following review, an international questionnaire was developed with Google Forms 2024 (Mountain View, CA, USA) and circulated among physicians working in the fields of cardiology, internal medicine, intensive care unit, geriatrics, and emergency medicine at 17 centres in Italy, France, and Canada. Results: A total of 78 responses were obtained. Younger physicians and cardiologists appeared to administer OAC more frequently compared to older physicians or those working in other specialties (95% CI Fisher’s Exact Test p = 0.049 and 0.029, respectively). Significant differences were observed in the use of periprocedural imaging, with transoesophageal echocardiogram (TOE) prior to cardioversion being performed more often in Europe vs. Canada (p = 0.006) and in long-term rhythm control, with first-line pulmonary vein isolation (PVI) being offered more frequently by European cardiologists (p = 0.013). No statistically significant association was found regarding guideline adherence for OAC administration (p = 0.120). Conclusions: The real-world antithrombotic management of low-risk (CHA₂DS₂-VA = 0), acutely cardioverted AF patients varies significantly among different healthcare systems. Particularly in cardiology departments, reducing the time limit for safely not prescribing OAC to < 12 h, ensuring local access to direct oral anticoagulants (DOACs) and considering regional stroke risk profiles, as well as actively preventing haemorrhage in patients receiving short-term OAC could all limit cardioversion-related complications in this low-risk population. Full article

Contextualization: Lifestyle changes, such as smoking cessation, physical activity, and healthy eating, are essential for the treatment and prevention of cardiovascular diseases. The 2021 update of the European Society of Cardiology (ESC) guidelines highlights the need to investigate the adherence to the Mediterranean diet in patients who have suffered acute myocardial infarction (AMI). Objective: The aim of this study was to investigate the adherence to the Mediterranean diet and dietary 2021 ESC guidelines of individuals who have suffered AMI and to evaluate the sociodemographic and lifestyle factors associated with the adherence. Methods: A cross-sectional study was conducted using baseline data from participants prior to enrollment in the DICA-NUTS multicenter clinical trial. The dietary intake was assessed using a food frequency questionnaire and 24 h dietary recall. The nutrient intake was compared with the nutritional recommendations of the 2021 ESC guidelines, and the adherence to the Mediterranean diet was analyzed using a Mediterranean diet score. Furthermore, the analyses of the factors associated with the Mediterranean diet score and 2021 ESC were performed. Analyses were conducted using Stata Data Analysis and Statistical Software version 15.0. Values were considered statistically significant when the p-value < 0.05. Results: Among 488 participants aged ≥ 40 years, moderate adherence to the Mediterranean diet was observed obtaining an average of nine points, with a low intake of vegetables, fish, and cereals. The protein intake was adequate with 18% (interquartile range [IQR] 15.0–23.1) of the total energy value, and the saturated fat intake was high with 9.7% (IQR 7.3–12.7) of the total energy value, while the carbohydrate and total fat intake was adequate. According to the 2021 ESC guidelines, the fiber intake was low with more than 79% of the sample consuming less than 30 g per day. The multivariate analysis using the 2021 ESC dietary recommendations showed that older age (≥60 years) [odds ratio (OR) = 1.63; 95% confidential interval (CI) = 1.44–1.91], never smoking (OR = 1.34; 95% CI = 1.17–1.65), and higher education (OR = 1.37; 95% CI = 1.17–1.77) were correlated with an increased fruit and vegetable intake. Non-white, never-smokers, and former smokers were more likely to consume fish. The alcohol scores were higher in older age participants and women. The dairy scores increased with older age, while the cereal scores decreased. No significant association was found for legumes. Conclusions: According to the scores used, the diet of these individuals moderately reflects the Mediterranean characteristics. Analyzing the 2021 ESC dietary recommendations, the studied population was inadequate. This study found different factors associated with an adequate food intake in post-AMI patients. The highlight of this study was that older age is more likely to increase fruit, vegetable, and dairy intake. Full article

Background/Objectives: Major adverse cardiovascular events (MACE)—including heart attacks and strokes—are the leading cause of death in patients with peripheral artery disease (PAD), yet biomarker research for MACE prediction in PAD patients remains limited. Inflammatory proteins play a key role in the progression of atherosclerosis and may serve as useful prognostic indicators for systemic cardiovascular risk in PAD. The objective of this study was to evaluate a broad panel of circulating inflammatory proteins to identify those independently associated with 2-year MACE in patients with PAD. Methods: We conducted a prospective cohort study involving 465 patients with PAD. Plasma concentrations of 15 inflammatory proteins were measured at baseline using validated immunoassays. Patients were followed over a two-year period for the development of MACE, defined as a composite endpoint of myocardial infarction, stroke, or mortality. Protein levels were compared between patients with and without MACE using the Mann–Whitney U test. Cox proportional hazards regression was used to determine the independent association of each protein with MACE after adjusting for baseline demographic and clinical variables, including existing coronary and cerebrovascular disease. To validate the findings, a random forest machine learning model was developed to assess the relative importance of each protein for predicting 2-year MACE. Results: The mean age of the cohort was 71 years (SD 10), and 145 participants (31.1%) were female. Over the two-year follow-up, 84 patients (18.1%) experienced MACE. Six proteins were significantly elevated in PAD patients who developed MACE: interferon gamma (IFN-γ; 42.55 [SD 15.11] vs. 33.85 [SD 12.46] pg/mL, p < 0.001), tumor necrosis factor alpha (TNF-α; 9.00 [SD 5.00] vs. 4.65 [SD 4.29] pg/mL, p < 0.001), chemokine (C-X-C motif) ligand 9 (CXCL9; 75.99 [SD 65.14] vs. 5.38 [SD 64.18] pg/mL, p = 0.002), macrophage inflammatory protein-1 beta (MIP-1β; 20.88 [SD 18.10] vs. 15.67 [SD 16.93] pg/mL, p = 0.009), MIP-1δ (25.29 [SD 4.22] vs. 17.98 [SD 4.01] pg/mL, p = 0.026), and interleukin-6 (IL-6; 12.50 [SD 40.00] vs. 6.72 [SD 38.98] pg/mL, p = 0.035). After adjusting for all baseline covariates, only two proteins—TNF-α (adjusted HR 1.66, 95% CI 1.28–2.33, p = 0.001) and IFN-γ (adjusted HR 1.25, 95% CI 1.12–2.29, p = 0.033)—remained significantly and independently associated with 2-year MACE. These findings were corroborated by the random forest model, where TNF-α and IFN-γ received the highest importance scores for predicting 2-year MACE: (TNF-α: 0.15 [95% CI 0.13–0.18], p = 0.002; IFN-γ: 0.19 [95% CI 0.17–0.21], p = 0.001). Conclusions: From a panel of 15 proteins, TNF-α and IFN-γ emerged as inflammatory biomarkers associated with 2-year MACE in PAD patients. Their measurement may aid in cardiovascular risk stratification, helping to identify high-risk individuals who could benefit from early multidisciplinary referrals to cardiology, neurology, and/or vascular medicine specialists to provide intensified medical therapy. Incorporating these biomarkers into PAD management may improve systemic cardiovascular outcomes through more personalized and targeted treatment approaches. Full article

Background/Objectives: The aim of this study was to determine the prevalence of functional cardiovascular anomalies detected on fetal echocardiography in third-trimester large-for-gestational-age (LGA) fetuses, who were subsequently born as macrosomic newborns with a birth weight exceeding 4000 g. Methods: A retrospective study was conducted on 1002 fetuses examined during the third trimester at our fetal cardiology center between 2018 and 2024. All fetuses were classified as having “normal heart anatomy” (NHA). Statistical analysis was performed using Microsoft Excel 2024, Statistica 13.1, and EasyMedStat (version 3.37.1). A p-value of <0.05 was considered statistically significant. Results: The 1002 fetuses were divided into two groups. The study group (NHA-LGA) consisted of 167 fetuses born with a weight of >4000 g and the control group (NHA-AGA) was made up of 835 fetuses with a birth weight between 2500 and 4000 g. In the NHA-LGA group, 24 fetuses (14.4%) experienced ductal constriction (DC), while in the NHA-AGA group, it was 11 (1.3%) fetuses (p < 0.00001). Myocardial hypertrophy was observed in 30 fetuses (18.0%) in the NHA-LGA group versus 72 (8.6%) in the NHA-AGA group (p < 0.0003). Additionally, cardiomegaly was noted in 95 fetuses (11.4%) in the NHA-LGA group, compared to 37 (4.4%) in the NHA-AGA group (p < 0.0004). Conclusions: LGA fetuses with normal heart anatomy may present with functional cardiovascular anomalies, including ductal constriction, myocardial hypertrophy, and cardiomegaly. In our cohort, such anomalies were identified in up to 51% of cases. These findings suggest that targeted fetal echocardiographic screening in macrosomic fetuses could be clinically valuable, even in the absence of structural heart defects, and may aid in the early identification of functional cardiac alterations that could impact perinatal management. Full article

Improved medical treatments have extended survival and life expectancy in adults with congenital heart defects (ACHD), placing greater emphasis on psychosocial health. Up to one-third of ACHD experience anxiety or depression, and half develop a mental illness during their lifetime. While there is solid evidence on the prevalence of mental health, many do not receive psychological, psychotherapeutic, or psychiatric treatment (PST) and the psychological care situation remains understudied. In a nationwide, online cross-sectional survey conducted in Q1 2024, 1486 ACHD aged 18 to 85 (M_age = 36.84 years; 60.8% female) registered in the German National Register for Congenital Heart Defects (NRCHD) completed self-report questionnaires on sociodemographics, illness identity (Illness Identity Questionnaire), mental well-being, and utilisation of PST. CHD diagnoses were determined in conformity with the International Pediatric and Congenital Cardiac Code (IPCCC) and CHD was classified according to Warnes et al. (simple/moderate/complex). Analyses included chi-square tests, t-tests, and binary logistic regression. Overall, 32.8% of participants reported current and/or previous PST (women 37.5%, men 25.3%). PST utilisation was significantly higher in those with complex (40.2%) compared to moderate (29.6%) and simple CHD (25.3%) (ps < 0.01). Primary treatment reasons were mental illness (41.7%) and CHD-related concerns (37.2%). Nearly half of treatments were self-initiated (45.8%) and about one-third were physician-recommended (30.8%). Logistic regression revealed CHD severity as a significant predictor of PST use (ps < 0.05), with lower odds for simple (OR = 0.48) and moderate (OR = 0.66) compared to complex CHD when controlling for sex (p < 0.001, OR = 1.87), age (p = 0.022, OR = 1.011), education level (ps between 0.060 and 0.780), and net income (ps < 0.05). Those receiving PST showed significantly higher maladaptive illness-identity scores (engulfment, rejection) and lower acceptance. Approximately one in three ACHD requires mental health support, particularly those with complex CHD. The CHD itself acts as a key stressor and treatment motivator. Findings underscore the need for integrated care linking cardiological and psychosocial services. Routine screening for psychological distress and low-threshold access to PST—also for patients with simple and moderate CHD—are essential to identify and address mental health needs early. Full article

Ischemia–reperfusion (I/R) damage remains a major problem in surgery, primarily based on high oxidative stress generated during the reperfusion process. Mitochondria are significantly affected, their metabolic and energetic processes are impaired, and the redox system is out of balance. Regulation and restoration of the redox balance by oxidative preconditioning with ozone is being investigated worldwide in cell and animal models. Selected preclinical trials and their results, with a focus on cardiological and neuronal I/R damage, are presented and discussed. We regularly find an upregulation of antioxidants, demonstrated in SOD (superoxide dismutase) and GSH (glutathione, reduced form, and a decrease in oxidative stress as a result, shown here using the typical stress parameters, MDA (malondialdehyde) and TBARS (thiobarbituric acid reactive substances). Mitochondrial biogenesis, comparable to moderate physical activity, is induced by ozone oxidative preconditioning in an I/R model in rats and reviewed in this paper. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease associated with an increased prevalence of cardiac and cerebrovascular events. Despite advancements in management, no validated tools exist that can predict the risk of ischemic stroke in SLE patients. However, several studies have demonstrated an association between a higher CHA₂DS₂-VASc score and an enhanced risk of ischemic stroke in autoimmune diseases without atrial fibrillation (AF) or atrial flutter (AFL). Recently, the European Society of Cardiology suggested the use of a revised score of CHA₂DS₂-VASc without taking sex into account (CHA₂DS₂-VA). Therefore, we sought to check if the new CHA₂DS₂-VA score might predict stroke or other cardiovascular events in SLE patients without AF/AFL. Patients and Methods: We retrospectively analyzed the records of patients with SLE treated at the University Hospital in Kraków, Poland, from 2012 to 2022. Patients with a history of AF/AFL were excluded. Results: This study enrolled 787 SLE patients without AF/AFL (aged 49 (38–60) years) with a predominance of women (n = 705, 89.58%). Common comorbidities included arterial hypertension (n = 376, 47.78%) and hypercholesterolemia (n = 345, 43.84%). Most non-AF/AFL SLE patients had 0–1 points in the CHA₂DS₂-VA score (n = 514, 65.31%). Overall, ischemic stroke occurred in 47 cases during a median follow-up of 8 (4–17) years regarding time from the SLE diagnosis to the stroke, with the incidence rising from 0% (n = 0/297) to 28% (n = 14/50) as the CHA₂DS₂-VA score increased from 0 to ≥5 points. No ischemic strokes or other thromboembolic events occurred among the 575 (73.06%) patients with a CHA₂DS₂-VA score of 0–2 points. In the whole cohort, patients with ≥3 points in the CHA₂DS₂-VA score (n = 212, 26.94%) were older at the last visit, had longer disease duration, were more commonly of the male sex, and were diagnosed more frequently with ischemic stroke or other thromboembolic events in their medical history (p < 0.05, for all) compared to those with 0–2 points (n = 575, 73.06%). However, in multivariable logistic regression, among the CHA₂DS₂-VA components, only older age (≥50 years) was related to the increased risk of thromboembolic complications (OR = 2.09, 95% CI: 1.36–3.22). Other determining factors included the presence of lupus anticoagulant (OR = 3.39, 95% CI: 2.20–5.27) and neurological SLE symptoms (OR = 2.19, 95% CI: 1.19–4.02). Interestingly, male sex (OR = 0.34, 95% CI: 0.22–0.52) and general SLE symptoms (OR = 0.43, 95% CI: 0.28–0.67) were associated with a decreased risk of thromboembolic events in this model (p = 0.034, for the model). Conclusions: SLE-related factors seem important for the onset of thromboembolic episodes. However, a higher CHA₂DS₂-VA score may also help to identify SLE patients with an increased risk of cardiovascular events, including stroke. Prospective studies with a long-term analysis need to be validated using the CHA₂DS₂-VA score to predict stroke risk in SLE patients. Full article

Background/Objectives: Hypercholesterolemia, accompanied by vascular inflammation, leads to the premature initiation and progression of atherosclerosis, and both are considered nowadays as well-established cardiovascular (CV) risk factors. For several years, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is), drugs that reduce the degradation of the receptors for low-density lipoprotein cholesterol (LDLRs), have appeared to be a very efficient lipid-lowering therapy among patients with complications resulting from atherosclerotic cardiovascular disease (ASCVD). Previous studies showed that drugs used to fight hypercholesterolemia (predominantly statins) have significant pleiotropic effects, including anti-inflammatory effects. To date, data on the potential impact of PCSK9 inhibitors, especially inclisiran, on the course of inflammation is still lacking. Therefore, we conceived a study to evaluate the effects of inclisiran on the markers of subclinical inflammation (e.g., pentraxin 3 (PTX3), interleukin-18 (IL-18), and soluble cluster of differentiation 40 ligand (CD40L)) and compared their magnitude in patients at high CV risk, with and without established heterozygous familial hypercholesterolemia (HeFH). Methods: A total of 24 patients at high cardiovascular risk, according to European Society of Cardiology (ESC) guidelines, with or without concomitant HeFH diagnosed using Dutch Lipid Clinic Network (DLCN) criteria, were enrolled in this study. Lipid concentrations and levels of subclinical inflammatory markers of atherosclerosis were measured at the beginning and after 3 months of therapy. Results: After three months of therapy with inclisiran, a statistically significant reduction included total cholesterol (TC): study group 1: from 287.6 ± 94.15 to 215.2 ± 89.08 [mg/dL], p = 0.022 and study group 2: from 211.71 ± 52.72 to 147.64 ± 55.44 [mg/dL], p < 0.001, and low-density lipoprotein cholesterol (LDL-c): study group 1: from 180.79 ± 73.33 to 114.65 ± 71.54 [mg/dL], p = 0.031 and study group 2: from 129.62 ± 46.75 to 63.39 ± 43.6 [mg/dL], p < 0.001. Moreover significant drops were observed in concentrations of PTX3: study group 1: from 1336.33 ± 395.15 to 1121.75 ± 351.17 [pg/mL], p = 0.013 and study group 2: from 1610.76 ± 537.78 to 1376.92 ± 529.19 [pg/mL], p = 0.017), and IL-18: study group 1: from 11.89 (9.72–13.98) to 9.15 (8.62–10.06) [pg/mL], p = 0.005 and study group 2: from 11.58 (10.87–16.97) to 9.65 (8.43–10.95) [pg/mL], p = 0.003). There were no significant changes in the levels of sCD40L. Conclusions: This study confirmed the ability of inclisiran to reduce LDL-c levels in patients at high cardiovascular risk just after one dose of the drug. Furthermore, it appeared that beyond its lipid-lowering effect, the drug may also affect some inflammatory processes involved in the initiation and progression of atherosclerosis. Full article

Background: The SARS-CoV-2 virus, identified in December 2019, led to a global pandemic resulting in over 6 million deaths. While most COVID-19 cases present mild symptoms, severe complications can develop in immunocompromised patients, including impacts on the heart. This study aimed to compare angiographic findings and hospitalization outcomes in acute coronary syndrome (ACS) patients with and without COVID-19. Methods: This retrospective study analyzed 174 ACS patients (105 men, 69 women) hospitalized in the Department of Cardiology and Internal Medicine of the Nicolaus Copernicus University in Bydgoszcz and Regional Hospital in Grudziądz (2019–2021). Forty-eight of them had COVID-19. The analyzed parameters included, inter alia, the coronary artery disease severity, the presence of thrombosis, survival rates, risk factors, and prior endovascular procedures. Results: COVID-19 patients with ACS showed a higher rate of thrombus in non-culprit vessels (6.25% vs. 0.0%, p = 0.0293), and overall survival was significantly lower (68.75% vs. 93.65%, p < 0.0001), while prior PCI rates were higher in non-COVID patients (34.13% vs. 6.25%, p = 0.0002). Procedure times were shorter for non-COVID patients, reducing catheterization lab exposure. Other procedural factors showed no significant differences. Conclusions: This study highlights significant differences in coronary angiography and hospitalization outcomes between ACS patients with and without COVID-19. The extended stay of COVID-19 patients in the catheterization lab poses an increased risk to medical staff, and the presence of thrombi underscores the need for effective antithrombotic strategies. The significant association of COVID-19 with hypercoagulability and its role in precipitating acute coronary syndromes necessitates the development of specific clinical guidelines to manage these patients effectively. Full article