Anatolian Journal of Cardiology最新文献

Background: Hypothyroidism is a known risk factor for cardiovascular diseases, affecting metabolic pathways such as dyslipidemia, insulin resistance, and visceral fat accumulation. This study aimed to investigate the value of the Body Roundness Index (BRI) and the newly defined BRI/TSH (thyroid-stimulating hormone) ratio (BRITSH) in predicting coronary artery disease (CAD) in patients with hypothyroidism.

Methods: This cross-sectional study included 152 hypothyroid patients, of whom 55 had CAD and 97 served as controls. Data collected included age, sex, body mass index (BMI), waist circumference, BRI, lipid profiles, and TSH levels. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis and logistic regression. A new ratio, BRITSH, was also evaluated.

Results: Patients with CAD had significantly higher BRI values (P < .001). The BRI/TSH ratio was significantly lower in the CAD group (P = .005). Non-high-density lipoprotein (non-HDL) cholesterol levels were also elevated in the CAD group (P < .001). Receiver operating characteristic analysis showed a strong predictive value for BRI (area under the curve [AUC] = 0.86). BRITSH ratio demonstrated a moderate predictive capacity (AUC = 0.67). In multiple logistic regression analysis, BRITSH, age, diabetes mellitus, high-sensitivity C-reactive protein, and non-HDL cholesterol remained independent predictors of CAD, whereas male sex, BMI, and smoking were not.

Conclusion: The new BRITSH ratio, combining body fat and thyroid function, was an independent predictor of CAD. The BRI also showed good ability to identify CAD risk in patients with hypothyroidism. These simple measures may help improve heart risk assessment and could be incorporated into routine care for patients with hypothyroidism.

Background: Transcatheter aortic valve replacement (TAVR) is the standard therapy for severe aortic stenosis, particularly in elderly patients with comorbidities. Simple biomarkers to predict mid-term mortality are still needed. This study evaluated the prognostic value of the preprocedural neutrophil percentage-to-albumin ratio (NPAR) for 2-year all-cause mortality after TAVR.

Methods: A total of 618 patients undergoing TAVR between 2013 and 2023 were retrospectively analyzed. NPAR was calculated as neutrophil percentage × 100 / albumin (g/dL), and patients were classified into tertiles. The prognostic role of NPAR was assessed using Cox regression, Kaplan-Meier survival analysis, and receiver operating characteristic curves.

Results: Baseline characteristics were similar across tertiles, but higher NPAR was associated with elevated inflammation and lower albumin levels. In multivariable Cox analysis, high NPAR independently predicted 2-year mortality (T3 vs. T1: hazard ratio [HR] 2.75, 95% CI 1.77-4.28; P < .001). In a model including both categorical NPAR and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), tertile 3 of NPAR (HR 2.49, 95% CI 1.61-3.85; P < .001) and STS-PROM (HR 1.31, 95% CI 1.12-1.53; P = .001) remained independent predictors, indicating incremental prognostic value of NPAR beyond established surgical risk scores. Kaplan-Meier curves showed the lowest survival in the highest tertile (35.9% mortality at 2 years). Receiver operating characteristic analysis confirmed NPAR had the best discriminatory ability (area under the curve = 0.703).

Conclusion: Preprocedural NPAR is an independent, low-cost, and readily available biomarker for predicting mid-term mortality after TAVR. Its integration into risk models may improve prediction accuracy and help guide patient management.

Background: Erectile dysfunction (ED) and coronary artery disease (CAD) frequently coexist, sharing common risk factors and pathophysiological mechanisms. The frontal QRS-T angle (fQRSTa), a novel electrocardiographic marker reflecting ventricular depolarization-repolarization heterogeneity, has been linked to adverse cardiac outcomes. However, the combined prognostic value of ED and fQRSTa in predicting CAD severity remains unexplored. The aim was to investigate whether the coexistence of ED and widened fQRSTa is associated with increased CAD severity, and to evaluate their individual and combined utility in identifying patients with advanced CAD.

Methods: This prospective observational study included 236 male patients undergoing first-time coronary angiography for suspected CAD. Patients were stratified into 4 groups based on ED status (International Index of Erectile Function-5 [IIEF-5] ≤21) and fQRSTa (cutoff: 52.5°). Coronary artery disease severity was assessed using the Gensini and SYNTAX scores. Hierarchical regression and correlation analyses were performed to evaluate associations.

Results: Erectile dysfunction prevalence was 62.7%, and patients with both ED and high fQRSTa exhibited significantly reduced ejection fraction and the highest Gensini and SYNTAX scores (all P < .001). Regression analyses demonstrated that ED (β = 11.927, P = .009, 95% CI: 2.014-21.839), high fQRSTa (β = 9.906, P = .012, 95% CI: 2.710-22.523), and their interaction (β = 17.233, P = .028, 95% CI: 1.906-32.560) were independent predictors of higher Gensini scores after full adjustment. Similar results were observed for SYNTAX scores. A moderate inverse correlation was found between IIEF-5 and fQRSTa (r = -0.436, P < .001).

Conclusion: Erectile dysfunction and widened fQRSTa are independently and synergistically associated with more severe CAD. Their coexistence identifies a high-risk subgroup with pronounced angiographic abnormalities.