Acute ST-elevation myocardial infarction (STEMI) is a critical condition where coronary collaterals can mitigate myocardial damage. The Coronavirus Disease 2019 (COVID-19) pandemic introduced unique challenges in STEMI management, potentially affecting outcomes. This study evaluates the efficacy of coronary collaterals during the pandemic compared to the post-pandemic period. A review of 1465 STEMI patients treated at a high-volume tertiary care center from April 2020 to December 2022 was conducted. Collaterals were assessed using the Rentrop classification. In-hospital mortality and 1-year major adverse cardiac events (MACE) were analyzed based on collateral status and timeframes. During the pandemic, there was a higher incidence of robust collaterals (28.2% vs 23.2%, = .04), but they were less protective, with similar in-hospital mortality (14.4% vs 8.1%, = .07) and 1-year MACE rates (21.9% vs 30.4%, = .09) across groups. Post-pandemic, robust collaterals showed significant protective effects with reduced in-hospital mortality (3.6% vs 7.4%, = .04) and 1-year MACE rates (17.1% vs 24.9%, = .03). These findings highlight a dynamic role of collaterals in STEMI management, with the pandemic impairing their functionality. This underscores the need for adaptive STEMI care strategies, especially during global health crises.

We investigated the effect of sex and age on the association between serum creatinine/cystatin C (CCR) ratio and carotid plaque in patients with type 2 diabetes mellitus (T2DM). The carotid plaque group and the non-plaque group were divided according to cervical vascular ultrasound; the general and biochemical data of the two groups were compared according to CCR, gender, and age. Binary logistic regression was used to analyze the factors influencing carotid plaque. A total of 1429 patients with T2DM were included in this study. On multivariate analysis, CCR was an independent predictor of carotid plaque with an adjusted odds ratio (OR) of 1.681 [1.250-2.260]. The risk of carotid plaque in men with T2DM increased significantly ( < .05) with decreasing levels of CCR. In addition, an association between CCR and carotid plaque was found in individuals with T2DM <65 years of age ( < .05). CCR is strongly associated with the risk of carotid plaques in persons with T2DM and are an independent risk factor for carotid plaques in men and people aged <65 years with T2DM.

Although there are many scoring systems for acute coronary syndromes, there is no suitable score for early risk stratification during initial medical contact with non-ST-elevation myocardial infarction (NSTEMI) patients. The present study compared the Rapid Emergency Medicine Score (REMS), an easy-to-use scoring system in emergency departments, with the Global Registry of Acute Coronary Events (GRACE) score used for in-hospital mortality risk stratification of NSTEMI patients. The results were: (i) the REMS score outperformed the GRACE score in predicting the in-hospital mortality; (ii) in estimating in-hospital mortality, the sensitivity of the GRACE score was 88%, the specificity was 65%, while the sensitivity of the REMS score was 100% and the specificity was 76%; (iii) the AUC (Area Under Curve) value of the REMS score (AUC 0.89) was superior to the GRACE score (AUC 0.79) in the data obtained from Receiver operating characteristic (ROC) descriptive analysis, but not statistically significant ( > .05). We suggest that the REMS score can be used to predict in-hospital mortality in patients with NSTEMI.

Abdominal aortic aneurysm (AAA) is a chronic vascular disease that commonly affects elderly individuals but has recently increased in younger populations. As the aneurysm grows, it can cause compression symptoms such as abdominal pain, rupture, and bleeding, which are absent in the early stages. Once an AAA ruptures and causes bleeding, the mortality rate is alarmingly high. Currently, the pathogenesis for AAA is unknown, and therapeutic options are limited, necessitating improvement in treatment efficacy. An essential research method for studying the processes and potential treatment of AAA is establishing animal models using mice. The present study provides a detailed overview of the widely used AAA mouse animal models and their construction strategies, advantages, disadvantages, scope of applications, and prospects.

The Naples prognostic score (NPS) is a novel multidimensional inflammatory and nutritional assessment system in cancer patients. However, its significance in patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI) remains unclear. The study has a single-center, retrospective design and included 631 patients with CKD who underwent index PCI between 2019 and 2022. All participants were divided into 2 groups according to the NPS (Low-risk group: = 209; High-risk group: = 422) and followed up until November 2022. The primary endpoint was Major Adverse Cardiac Events (MACE). NPS predicted MACE events better than other scores, besides, high-risk NPS with severe renal dysfunction (RD) group (MODEL 2) had superior MACE diagnostic efficiency than NPS high-risk group lonely. (NPS: AUC: 0.605, < .001; MODEL 2: AUC: 0.624, < .001, respectively). Kaplan-Meier survival analysis of two groups showed that high-risk group had higher incidence of MACE ( < .001). Meanwhile, high-risk group had higher MACE events [adjusted Hazard Ratio (aHR) 2.013, 95% CI 1.294, 3.132; = .002]. NPS is an independent prognostic factor for CKD patients undergoing index PCI before operation whose predictive value for survival prognosis is better than other nutritional and inflammatory indicators. Compared with low NPS, patients with high NPS have a relatively poor prognosis.

Systemic lupus erythematosus (SLE) patients are susceptible to marantic endocarditis (ME) due to a hypercoagulable state. The literature regarding the epidemiology and outcomes of ME in SLE patients is limited. All patients ≥18 years who had SLE with and without ME between 2007 and 2019 were identified from the National Inpatient Sample in the United States (US). Predictors of inpatient mortality for SLE patients with ME were analyzed. Between 2007 and 2019, there were 508,818 hospitalizations for SLE, of which 785 (0.2%) had ME. Of SLE patients with ME, 33 (4.2%) died while hospitalized over the study period. On multivariate analysis, female sex (adjusted odds ratio (aOR), 95% confidence intervals: 24.72 (3.21, 190.27)), age <34 years (aOR: 6.81 (1.80, 25.79)), anemia (aOR: 3.41 (1.12, 10.40)), antiphospholipid syndrome (aOR: 13.50 (3.83, 47.64)), stroke complicating ME (aOR: 9.64 (3.24, 28.71)), and acute kidney injury (aOR: 3.74 (1.06, 13.20)) were all associated with increased inpatient mortality among SLE patients with ME ( < .05 for all). Between 2007 to 2019, ME occurred in 0.2% of SLE hospitalizations, with a 4.2% average inpatient mortality over the study period. Female sex, antiphospholipid syndrome, and stroke were most strongly associated with increased inpatient mortality.

Patients with lower socioeconomic status (SES) have poorer outcomes following acute myocardial infarction (AMI) than patients with higher SES; however, how sex modifies socioeconomic differences is unclear. Using the United Kingdom (UK) Myocardial Ischaemia National Audit Project (MINAP) registry, alongside Office of National Statistics (ONS) mortality data, we analyzed 736,420 AMI patients between 2005 and 2018, stratified by Index of Multiple Deprivation (IMD) score Quintiles (most affluent [Q1] to most deprived [Q5]). There was no significant difference in probability of in-hospital mortality in our adjusted model according to sex. The probability of 30-day mortality in our adjusted model was similar between men and women throughout Quintiles, ((Q5; Men 7.6%; 95% CI 7.3-7.8% ( < .001), Women; 7.0%; 95% CI 6.8-7.3%, < .001)) ((Q1; Men 7.1%; 95% CI 6.8-7.4%, < .001, Women; 6.9%; 95% CI 6.6-7.1%, < .001)). The probability of one-year mortality in our adjusted model was higher in men throughout all Quintiles (Q1; Men 15.0%; 95% CI 14.8-15.6%), < .001, Women; 14.5%; 95% CI 14.2-14.9%, < .001) (Q5; Men 16.9%; 95% CI 16.5-17.3%, < .001, Women; 15.5%; 95% CI 15.1-15.9 by %, < .001). Overall, female sex did not significantly influence the effect of deprivation on AMI processes of care and outcomes.

Several scores can predict clinical outcomes of patients with Acute Coronary Syndromes (ACS). The validated PARIS (Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients) score is poorly used in clinical practice because it needs items that are not always easily available. The ACEF (Age, Creatinine, and Ejection Fraction) score is more attractive because it only includes three items. We compared these scores to risk-stratify ACS patients enrolled into the START (Survey on anticoagulated pAtients RegisTer)-ANTIPLATELET registry. ACS patients who completed 1-year follow-up ( = 1171) were grouped in tertiles (low, medium, and high-risk) according to their ACEF/PARIS scores. Primary endpoints were: one-year MACCE (major adverse cardiac and cerebrovascular events: death, non-fatal myocardial infarction, stroke or target vessel revascularization) and NACE (net adverse cardiac and cerebrovascular events): MACCE plus major bleeding). MACCE incidence was higher in the high-risk tertile (15%) VS low/medium (3/7 %) risk tertiles ( < .001). NACE incidence in the high-risk tertile was 24% VS low/medium (9/15 %) risk tertiles ( < .001), independently of the risk score used The ACEF score has similar accuracy as the validated PARIS score for the estimation of ischemic/bleeding risk. Thereby, we strongly suggest its use in clinical practice to risk-stratify ACS patients and select optimal therapeutic strategies.

The Atherogenic Index of Plasma (AIP) is associated with coronary artery disease (CAD) and acute coronary syndrome (ACS), but the relationship between AIP and ACS in elderly patients remains unclear. We investigated the prognostic capability of AIP for in-hospital and long-term mortality in elderly patients with ACS undergoing coronary angiography (CA). We analyzed 627 patients with ACS over 75 years of age who were admitted to our clinic between April 2015 and December 2022 and underwent CA. The primary clinical endpoints were in-hospital, 30-day, 1-year, and long-term mortality. The median follow-up time was 27 months. AIP was defined as log (triglyceride/high-density lipoprotein cholesterol). In-hospital mortality rates for patients with AIP ≤.1 and AIP >.1 were 4.7% and 17.6% ( < .001), 30-day mortality rates were 8.7% and 32.2% ( = .01), 1-year mortality rates were 12.1% and 45.1% ( < .001), and long-term mortality rates were 47.3% and 67.5% ( < .001), respectively. Multivariate Cox regression analysis revealed AIP, age, left ventricle ejection fraction (LVEF), admission creatinine, and Killip ≥2 as independent predictors for long-term mortality. AIP can predict in-hospital and long-time all-cause mortality in elderly patients with ACS undergoing CA. Age, LVEF, admission creatinine, and Killip ≥2 are additional factors that predict long-term all-cause mortality.