Objective: Drug-coated balloons (DCBs) and ultrathin-strut sirolimus-eluting stents (SES) are both treatment options for small-vessel coronary artery disease. However, comparative real-world data between these strategies are limited.

Method: In this single-center retrospective study, 178 consecutive patients with stable angina who underwent percutaneous coronary intervention with either a DCB (n = 89) or an ultrathin-strut SES (n = 89) between January 2017 and May 2025 were analyzed. Baseline demographics, angiographic and procedural features, and clinical outcomes were assessed. The primary outcome of this study was major adverse cardiac events (MACE), defined as a composite of target-lesion revascularization (TLR), long-term all-cause mortality, stroke, and myocardial infarction.

Results: Baseline characteristics were generally comparable, although SES-treated patients were older and had higher SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores. During a median follow-up of 293 days, MACE occurred in 2.2% of the DCB group and 5.6% of the SES group (P = 0.441). Rates of TLR, myocardial infarction, bleeding, and all-cause mortality were not significantly different. Kaplan–Meier analysis likewise demonstrated no significant difference in cumulative MACE between the two groups (log-rank P = 0.068).

Conclusion: In this real-world study, DCB treatment demonstrated similar safety and efficacy compared to ultrathin-strut SES for small-vessel coronary artery disease. DCB therapy may represent a viable alternative to DES in selected patients, supporting the “leave nothing behind” strategy.

Objective: Despite growing awareness of sex-based disparities in heart failure (HF), their impact on clinical outcomes in advanced stages remains poorly understood, largely due to confounding in observational data. This study aimed to assess the independent effect of biological sex on clinical outcomes in advanced HF.

Method: In this retrospective cohort study, 522 patients with advanced HF (85.2% male) evaluated between 2021 and 2024 underwent comprehensive assessments, including echocardiography, cardiopulmonary exercise testing, and cardiac catheterization. Covariate balance was achieved using inverse probability weighting (IPW) based on propensity scores. Primary outcomes included left ventricular assist device (LVAD) implantation, heart transplantation, all-cause mortality, and a composite of these events. Cox proportional hazards models were applied, with a median follow-up of 864 days.

Results: At baseline, male patients were older (54.0 vs. 49.5 years; P = 0.025), had higher rates of ischemic etiology (49.9% vs. 22.7%; P < 0.001), larger cardiac dimensions, and superior exercise capacity. Following IPW adjustment, female sex was associated with a significantly lower risk of LVAD implantation (hazard ratio [HR]: 0.13; 95% confidence interval [CI]: 0.04–0.40; P < 0.001). In contrast, no significant sex-related difference was found in all-cause mortality (HR: 0.75; 95% CI: 0.36–1.58; P = 0.43). The composite outcome showed a non-significant trend toward better outcomes in women (HR: 0.53; 95% CI: 0.26–1.06; P = 0.076). These findings should be interpreted in the context of the relatively small female cohort (14.8%).

Conclusion: In patients with advanced HF, female sex was associated with a lower likelihood of LVAD implantation without an effect on overall mortality. These findings suggest that advanced HF may follow distinct pathophysiological trajectories in women and men, underscoring the importance of sex-informed clinical decision-making frameworks to optimize management and outcomes.

Objective: Detection and monitoring of electrolyte imbalances are essential for the appropriate treatment of many metabolic diseases. However, no reliable and noninvasive tool currently exists for such detection. Electrolyte disorders, particularly in heart failure patients, can lead to life-threatening situations, which may often develop as a result of medications used in routine treatment.

Method: In this study, we developed a deep learning model (DLM) using electrocardiography (ECG) to detect electrolyte imbalances in heart failure patients and evaluated its performance in a multicenter setting. Seventeen different centers participated in this study. Heart failure patients (ejection fraction ≤ 45%) who had blood electrolyte measurements and ECG taken on the same day were included. Patients were divided into four groups: those with normal electrolyte values, those with hypokalemia, those with hyperkalemia, and those with hyponatremia. Patients who developed electrolyte disorders due to medications used for heart failure were classified in the relevant group. Confidence intervals (CI): We computed 95% CIs for area under the receiver operating characteristic curve (AUROC) via stratified bootstrap (2,000 resamples at the patient level) and 95% CIs for accuracy using the Wilson score interval for binomial proportions.

Results: The accuracy rates of the DLM in detecting hyponatremia, hypokalemia, and hyperkalemia were 83.33%, 95.33%, and 95.77%, respectively.

Conclusion: The proposed DLM demonstrated high performance in detecting electrolyte imbalances. These results suggest that a DLM can be used to detect and monitor electrolyte imbalances using ECG on a daily basis.

Objective: Hypertension (HT) is a complex clinical syndrome influenced by lifestyle, genetics, mental stress, and environmental factors. High-altitude (H-ALT) is one environmental factor that affects the development of HT. This study aimed to analyze the clinical and demographic features of patients residing at moderate altitude (M-ALT).

Method: A total of 515 patients with hypertension, confirmed through 24-hour ambulatory blood pressure monitoring (ABPM), were screened. After exclusions, the final study population consisted of 452 patients. Participants were divided into two groups: dippers and non-dippers.

Results: Patients in the non-dipper group were older (standard deviation [SD]: 61 ± 13 vs. 54 ± 12 years, P < 0.001) and had a significantly higher waist circumference (SD: 104 ± 13 vs. 107 ± 12 cm, P = 0.022). However, patients in the dipper group had a significantly higher daytime mean systolic blood pressure (SBP) (SD: 144 ± 16 vs. 141 ± 17 mmHg, P = 0.027) and daytime mean diastolic blood pressure (DBP) (SD: 89 ± 12 vs. 87 ± 13 mmHg, P = 0.037). Patients in the non-dipper group also had a significantly higher proportion of abnormal left ventricular global longitudinal strain (LVGLS) (n = 218 (65.6%) vs. n = 53 (46.7%), P = 0.009).

Conclusion: In our study, patients with a non-dipper pattern of hypertension, which is associated with poor multisystemic outcomes, were found to have a higher waist circumference and subclinical left ventricular dysfunction (abnormal LVGLS). Furthermore, patients with a non-dipper pattern of hypertension comprised 76% of the study population.

Objective: Coronary artery ectasia (CAE) is increasingly recognized as an active inflammatory vascular disorder rather than a benign anatomical variant. The pan-immune-inflammation value (PIV) is a novel biomarker integrating neutrophil, monocyte, platelet, and lymphocyte counts, providing a comprehensive measure of systemic inflammation. This study aimed to evaluate the association between PIV and CAE and to compare their diagnostic performance with that of conventional inflammatory indices.

Method: In this retrospective case-control study, 17,538 patients who underwent elective coronary angiography between 2018 and 2024 were screened. A total of 228 patients with isolated CAE and 296 age-, sex-, and Body Mass Index (BMI)-matched controls with normal coronary arteries were included. Hematologic and biochemical parameters were analyzed, and inflammatory indices were calculated. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent predictors and assess diagnostic performance.

Results: Patients with CAE had significantly higher PIV levels compared to controls (801.6 [504.4–1301.8] vs. 491.8 [302.4–872.7], P < 0.001). In multivariable logistic regression, log-transformed PIV remained independently associated with CAE (odds ratio [OR]: 1.987, 95% confidence interval [CI]: 1.057–3.737, P = 0.033), along with hypertension, triglycerides, high-density lipoprotein (HDL) cholesterol, and serum creatinine. PIV demonstrated the highest discriminative ability among all inflammatory indices (area under the curve [AUC]: 0.674, 95% CI: 0.623–0.722), and correlated strongly with the Systemic Immune-Inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and Systemic Inflammation Response Index (SIRI) (P = 0.75–0.94).

Conclusion: Elevated PIV levels are independently associated with CAE, reflecting the pivotal role of systemic inflammation in its pathogenesis. Given its simplicity and availability, PIV may serve as a practical adjunctive marker for identifying patients at risk of CAE, warranting validation in larger prospective studies.

Objective: Cardiovascular disease (CVD) remains the main cause of mortality worldwide for both women and men. However, women are often overlooked as victims of CVD, leading to underdiagnosis and undertreatment. We aimed to assess public awareness of CVD as the leading cause of death in women.

Method: This nationwide survey was conducted to evaluate awareness of CVD as the primary cause of female mortality. Individuals aged 18 to 80 years from across Türkiye were invited to complete a brief, structured questionnaire.

Results: A total of 7,920 individuals were surveyed, of whom 59% were female. Only 34% of women and 38% of men correctly identified CVD as the leading cause of death in women (P = 0.0001). In contrast, malignant diseases—particularly breast cancer—were cited as the leading cause by 46% of women and 42% of men. Educational attainment was not associated with greater awareness. Among women, age was the only factor independently correlated with awareness, while in men both age and a history of coronary artery disease (CAD) were significantly associated with awareness.

Conclusion: Public awareness of CVD as the leading cause of death in women remains alarmingly low in Türkiye. Neither higher education nor the presence of cardiovascular risk factors was associated with increased awareness. Age emerged as the primary correlate in women, and both age and CAD history in men. These findings suggest that awareness of female CVD mortality may be shaped more by personal experience than by formal education, highlighting a critical gap in national health literacy.

We report the case of a 72-year-old man with end-stage renal disease on maintenance dialysis and advanced right heart failure with severe tricuspid regurgitation, chronic atrial fibrillation, and cardiac cachexia. The patient presented with profound hypotension and cardiogenic shock, leading to recurrent failure of renal replacement therapy despite inotropic support. Given the prohibitive surgical risk, transcatheter edge-to-edge repair was deemed unsuitable due to extensive annular dilation, and the patient underwent urgent percutaneous caval valve implantation with the TricValve® system. The procedure was technically successful, resulting in immediate hemodynamic stabilization, improved tolerance of dialysis, and rapid clinical recovery. Follow-up imaging confirmed optimal device positioning without complications. To our knowledge, this represents the first TricValve® implantation in a dialysis-dependent patient in Europe, demonstrating the feasibility and therapeutic value of this approach in carefully selected, high-risk patients with severe tricuspid regurgitation.

The peri-procedural management of novel oral anticoagulants (NOAC) should be individualized based on patient-specific factors (age, body weight, renal function, concomitant medications, history of thromboembolic or bleeding events, and the presence of prosthetic valve) as well as procedural characteristics (bleeding risk). Less invasive procedures carry a relatively low bleeding risk and may be performed with minimal or no interruption of NOAC therapy. However, upgrading from an implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy (CRT) is more complex than initial implantation. Therefore, the timing of the last NOAC dose before an elective procedure requires careful judgment, balancing individual risks and benefits. Herein, we present the case of an elderly patient with atrial fibrillation, grade IIIb chronic renal disease, low body weight, and a bioprosthetic mitral valve, who underwent an upgrade from an implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy with a defibrillator (CRT-D). The patient developed bioprosthetic valve thrombosis 24 hours after edoxaban interruption without heparin bridging, which was successfully treated with ultraslow tissue plasminogen activator (tPA) therapy.

Cardiac lipoma is a rare primary tumor of the heart. With advances in diagnostic and treatment methods, an increasing number of cases have been reported. This trend suggests that the clinical presentation, previously believed to follow classic patterns, may actually exhibit atypical features. In such cases, multimodal imaging facilitates accurate diagnosis and the selection of the most appropriate treatment. This case report presents a 28-year-old female with progressive exertional dyspnea. Transthoracic and transesophageal echocardiography revealed a large mass in the left ventricle, originating from the posteromedial papillary muscle. The mass exhibited a low-density focus with a well-defined boundary and regular shape and, fortunately, had no significant effect on the valves or hemodynamics. Cardiac magnetic resonance imaging confirmed the diagnosis of a cardiac lipoma. Although surgical intervention was offered, the patient ultimately declined the procedure. Most patients diagnosed with cardiac lipoma are asymptomatic, and the diagnosis is often made incidentally. The use of multimodality imaging greatly aids in diagnosis. Echocardiography is a suitable modality for ongoing monitoring.