Objective: MicroRNAs have been explored as potential biomarkers for many pathological pro-cesses including coronary artery disease. In this study, we aimed to compare the circulating levels of selected atherosclerosis-associated miRNAs in patients with a history of early-onset coronary artery disease with that of age- and sex-matched healthy controls and older patients with late-onset coronary artery disease.

Methods: Study population consisted of 30 patients with early onset coronary artery disease, 31 age- and sex-matched healthy controls, and 30 patients with late-onset coronary artery disease. Plasma levels of 13 microRNAs (endothelial cell-related miR-126, -92a/b; vascular smooth muscle cell-related miR-145; inflammation-related miR-16, -21, -125b, -146a/b, -147b, -150, -155; lipom etabo lism-r elat ed miR-27b, -122, -370) were evaluated by using real-time polymerase chain reaction.

Results: In patients with early onset coronary artery disease, plasma expressions of the lipometabolism-related miR-27b, miR-122; inflammation-related miR-125b, miR-146a/b, miR-147b, miR-150, miR-155; and VSMC-related miR-145 were significantly downregulated and endothelial cell-related miR-126 was significantly upregulated compared to age- and sex-matched healthy controls. Circulating microRNA profile of patients with early onset coronary artery disease was also different from that of older patients with late-onset coronary artery disease. Plasma levels of miR-21, miR-27b, miR-122, miR-125b, miR-146b, miR-147b, and miR-155 were lower and plasma levels of miR-16 and miR-92a were higher in patients with early onset coronary artery disease compared to older patients with late-onset coronary artery disease.

Conclusion: MicroRNAs are promising biomarkers for early onset coronary artery disease.

Objective: Cardiac autonomic neuropathy is a serious microvascular complication of type 2 diabetes mellitus that affects a significant portion of patients. Due to decreased parasympathetic activity, the sympathetic nervous system becomes dominant, causing several problems that lead to increased cardiovascular morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors have been shown to reduce sympathetic nervous system activity previously. This is a promising finding for restoring the impaired sympathovagal balance in cardiac autonomic neuropathy. The aim of this study is to evaluate the effect of at least 6 months of sodium-glucose cotransporter-2 inhibitor treatment on sympathetic nervous system activity with sympathetic activity index and heart rate variability parameters in patients with type 2 diabetes mellitus.

Methods: Holter-electrocardiogram recordings of 50 patients who were using a sodium-glucose cotransporter-2 inhibitor (empagliflozin or dapagliflozin) for at least 6 months and 50 patients who did not were analyzed retrospectively. The sympathetic activity index and heart rate variability parameters of these 2 groups, which were similar in terms of age, gender, hemoglobin A1c, and duration of diabetes, were compared.

Results: The ratio of low-frequency to high-frequency power reflecting the sympathovagal balance [−1.495 (−2.165/−1.196) vs. −1.224 (−1.619/−0.863), P =.008] and sympathetic activity index [1.44 (1.06/2.76) vs. 2.47 (1.42/3.68), P =.009] was lower in the sodium-glucose cotransporter-2 inhibitor group than in the control group. In addition, the sympathetic activity index was correlated with the ratio of low-frequency to high-frequency power (r = 0.418, P <.001).

Conclusion: Sodium-glucose cotransporter-2 inhibitor treatment for at least 6 months was found to result in lower values of sympathetic activity index and the ratio of low-frequency to high-frequency power in patients with type 2 diabetes mellitus. These findings indicate lower sympathetic nervous system activity, which supports the sympathoinhibitor effects of sodium-glucose cotransporter-2 inhibitors.

Objective: Discontinuation of metformin therapy is a frequent clinical practice to reduce the risk of contrast-induced acute kidney injury (CI-AKI) in diabetic ST-segment elevation myocardial
infarction patients using metformin. There is insufficient evidence in the literature to support this approach. The aim of this study is to determine whether the risk of contrastinduced
acute kidney injury is different in diabetic ST-segment elevation myocardial infarction patients using metformin compared to those not taking metformin.

Methods: The study population consisted of patients with ST-segment elevation myocardial infarction admitted to the centers that participated in this study between 2014 and 2019 and
underwent primary percutaneous intervention. Diabetic patients (n = 343) that met the study inclusion criteria were divided into 2 groups as who have been receiving metformin and who
have not. Patients’ creatinine values on admission and peak creatinine values were compared in order to determine whether they have developed contrast-induced acute kidney injury. The
2 groups were compared using conditional logistic regression analysis conducted with the inverse probability weighting method.

Results: Non-weighted classic multivariable logistic regression analysis revealed that metformin use was not associated with acute kidney injury. Weighted conditional multivariable logistic
regression revealed that the increase in the risk of acute kidney injury was associated with baseline creatinine levels [odds ratio: 1.49 (1.06-2.10; 95% CI) P =.02] and that the increase
in the risk of contrast-induced acute kidney injury was not associated with metformin usage [odds ratio: 0.92 (0.57-1.50, 95% CI) P =.74].

Conclusion: No statistically significant difference was found between the metformin and nonmetformin users among the diabetic ST-segment elevation myocardial infarction patients who underwent primary percutaneous intervention in the risk of contrast-induced acute kidney injury.

Objective: Parallel to the aging of the world population, the complexity of patients with cardiac problems has increased, especially in intensive cardiology care units, and the importance of multidisciplinary care has become more evident. The aim of this study was to analyze the clinical characteristics and gender-related differences of patients hospitalized in a large intensive cardiology care unit.

Methods: This single-center, retrospective, cross-sectional study includes all hospitalizations in a large intensive cardiology care unit between January 2016 and March 2021. All data were obtained using data collection software and transferred to MEDULLA, Turkey’s general database system.

Results: Of the 55 737 consecutive patients included in the analysis, 16 342 (29%) were women. The mean age of males was 59.71 ± 12 years, and the mean age of females was 63.3 ± 14 years (P <.001). Over a period of 5 years, the most common reason for hospitalization in the intensive cardiac care unit was acute coronary syndrome. The number of acute coronary syndrome patients who underwent coronary angiography was found to be 17 478 (31%), of which 12 878 were males and 26.3% were female. The number of patients who underwent at least 1 stent implantation was 13 952 (80% of coronary angiography procedures), and 2960 (21%) were women. The second cause of hospitalization in the intensive cardiology care unit was arrhythmias (5654 patients [10%]) followed by advanced heart failure (932 patients [1.7%]). During follow-up in the intensive cardiology care unit, the percentage of development of multiorgan failure was found to be approximately 18%. The mortality rate was 7% in women, which was higher than in men (4%). While the most common cause of death was acute coronary syndrome, the highest rate of death was found in patients with advanced heart failure. Among the patients who died, the mean age of females was higher than that of males, and the length of hospital stay was longer.

Conclusion: Although numerically the highest death rate was observed in male acute coronary syndrome patients, the highest mortality rate was found in patients with advanced heart failure. Due to the elderly population and the increase in the number of patients requiring multidisciplinary treatment, the development of multiorgan failure in intensive cardiology care units seems to be one of the most important causes of death. Although the number of females hospitalized in the intensive cardiology care unit is lower than that of males, the mean age and mortality rate were found to be higher than males.

Objective: Despite efforts spent on promotion of gender equity in the academia, the gender gap is feared to have widened after the coronavirus disease 2019 pandemic. Herein, we aimed to compare the distribution of female authorship by Turkish adult cardiologists in journals indexed at PubMed before and after the pandemic.

Methods: In this cross-sectional study, an advanced search on PubMed (https: //pu bmed. ncbi. nlm.n ih.go v/) was carried out based on the following criteria: “entrez date” and keywords “Turkey” and “cardiology” to identify papers that entered the online database in April-September 2019 and April-September 2020. After the study sample was determined, type of the article and details of the author list were recorded.

Results: Of 1318 articles screened, 708 met the inclusion criteria. Overall, 85 (12.0%) of first authors and 67 (10.0%) of senior authors were female. Females were less likely to first author original articles, editorials, case reports/series, and papers with international participation (9.5%, P =.012; 33.3%, P =.045; 18.3%, P =.033; 4.8%, P =.032, respectively). A higher proportion of females were in first and corresponding author positions in original articles (73.2%,
P =.032; 76.5%, P =.019, respectively) but not in other article types (all P >.05), after emergence of the pandemic.

Conclusion: These suggest that significant gender differences exist with regard to authorships of scientific publications that were submitted by Turkish adult cardiologists. Future studies may aim to evaluate the trends across a wider time span and based on a more extensive scientific output follow-up.

Objective: Heart failure is a public health problem worldwide. Employment is vital in terms of personal, social, and economic aspects for patients with chronic diseases. The aim of this study is to investigate returning to work and the associated factors after first hospitalization for heart failure in working-age patients.

Methods: In this retrospective cohort study, patients with the first hospitalization for heart failure in 2017-2020 who were employed before hospitalization were included. The demographic, occupational, and disease-related variables were compared in subjects with and without returning to work. Next, the relationship between the variables and the number of days off work was examined in participants who had returned to work.

Results: The data of 204 participants were analyzed. About 90% of the participants returned to work after 1 year. There was a significant relationship between not returning to work and
higher age, female sex, higher New York Heart Association class, ejection fraction ≤40%, and history of chronic kidney disease. Among the participants who had returned to work, income level, cause of work exit, employer support, and the number of rehabilitation sessions had a significant relationship with the number of days off work.

Conclusion: The results of this study showed that gender, age, ejection fraction level, history of chronic kidney disease, and New York Heart Association class were the most influential factors in returning to work after first heart failure hospitalization. Furthermore, income, cause of work exit, employer support, and the number of rehabilitation sessions were the most important factors contributing to the number of days off work.

Thirty years ago, a distinct new clinical-electrocardiographic syndrome was described, now known as Brugada syndrome. Typical for this syndrome is EKG with ST elevation in the right precordial leads. The clinical presentation of the disease is highly variable: Patients may remain completely asymptomatic but may also develop episodes of syncope, atrial fibrillation, sick sinus syndrome, conduction disturbances, asystole, and ventricular fibrillation. The disease is caused by mutations in the genes responsible for the action potential of the heart cells. The most frequently involved gene is the SCN5A which controls the structure and function of the cardiac sodium channel. Describing this new syndrome has had very positive implications in all fields of medicine.

Hemoptysis, accompanying various chronic lung diseases, some systemic diseases, infections, structural heart diseases, or syndromes is a clinical condition that is quite mortal when it is massive. Hemoptysis is a common complication of Eisenmenger syndrome. Its frequency increases with age. It is an important cause of mortality in patients with Eisenmenger syndrome. Embolization of systemic–pulmonary collateral arteries is an effective method in the treatment of hemoptysis in eligible patients with Eisenmenger syndrome. In this case report, a patient with Eisenmenger syndrome, developed due to large patent ductus arteriosus, received dual pulmonary arterial hyper tension-specific treatment, after the development of hemoptysis, medical stabilization was provided with initial inhaled nitric oxide therapy and then treated with bronchial artery embolization without complications is presented.

Whole-body electrical myostimulation is an alternative exercise training method. The effects of this exercise program on hemodynamics and coronary circulation have recently been investigated. However, an acute coronary syndrome associated with whole-body electrical myostimulation has not been reported before. In this case report, we present a patient who underwent whole-body electrical myostimulation in a sports center for weight control and was admitted to the emergency department with chest pain started in the second session of the training. Her electrocardiogram showed ischemic T-wave changes in the inferior leads. Additionally, troponin levels were elevated. A coronary angiogram was performed with the diagnosis of non-ST- segment elevation myocardial infarction. The coronary angiogram revealed severe vasospasm in the right coronary artery, which resolved with intracoronary nitroglycerin. She was uneventfully discharged with medical treatment. This case report is the first patient with acute coronary syndrome associated with whole-body electrical myostimulation in the literature.

Coronavirus disease 2019 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus. Hypoxic respiratory failure, multiorgan dysfunction, septic shock, thrombosis, and thromboembolic complications have been associated with the severe acute respiratory syndrome coronavirus 2 infection. We report the presentation of the severe acute respiratory syndrome coronavirus 2 infection with acute upper extremity ischemia and mesenteric ischemia clinic. We also report that this patient had an aortic arch mural thrombus as a possible source of thromboembolism, and we emphasize that the aorta should also be carefully evaluated in thromboembolic patients with coronavirus disease 2019.