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    A Cross-Sectional Study on the Relationship between the HEART Score and the Severity of CAD using the SYNTAX Score in Patients with NSTEMI Admitted to the Emergency Department: A Study from Turkey
    (Wolters Kluwer Medknow Publications, 2025) Pepele, M. S.; Aktas, I; Demiroz, O.; Derya, S.; Yildirim, E.; Bilen, M. N.; Demir, B.
    Background:The HEART score is a risk stratification tool for acute chest pain, evaluating history, ECG, age, risk factors, and troponin. The SYNTAX (synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) score assesses the extent and complexity of coronary artery disease (CAD) and is widely used in patients undergoing coronary interventions.Aim:To determine the relationship between the HEART and SYNTAX scores in patients with non-ST elevation myocardial infarction (NSTEMI).Method:A total of 222 NSTEMI patients who underwent coronary angiography were included. The HEART score was calculated at admission, and all patients underwent angiography within 12 hours. SYNTAX was used to evaluate CAD severity. Patients were divided into two groups based on SYNTAX scores. Comparisons were made according to demographic data, laboratory findings, and risk factors. Variables associated with high SYNTAX scores were identified. A P value of < 0.05 was considered statistically significant.Results:The mean age was 63.67 +/- 11.89 years, and 74.77% of the patients were male. Patients with high SYNTAX scores had significantly higher HEART scores and more frequent diabetes and hypertension. High HEART score (OR: 3.09; 95% confidence intervals [CI]: 2.06-4.63; P < 0.001) and diabetes mellitus (OR: 4.57; 95% CI: 1.44-14.47; P = 0.010) were independently associated with high SYNTAX scores. A HEART score >7.5 predicted high SYNTAX scores with 82.1% sensitivity and 84.3% specificity (area under curve [AUC]: 0.892; P < 0.001). A strong positive correlation was found between HEART and SYNTAX scores (P < 0.001, R-2 =0.672).Conclusion:The HEART score was significantly associated with the severity and complexity of CAD in patients with NSTEMI.
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    Neutrophil Percentage-to-Albumin Ratio as a Novel Biomarker in Patients with Group 1 Pulmonary Arterial Hypertension
    (Wolters Kluwer Medknow Publications, 2026) Aktas, I; Yasar, E.
    Background: Pulmonary arterial hypertension (PAH) is a progressive and life-threatening disease characterized by increased pulmonary vascular resistance, right ventricular failure, and systemic inflammation. Novel biomarkers reflecting disease severity and prognosis are needed for improved risk stratification in PAH. Aim: To evaluate the relationship between neutrophil percentage-to-albumin ratio (NPAR) and disease severity in patients with Group 1 pulmonary arterial hypertension, and to determine its prognostic value as an inflammatory biomarker. Methods: This was a retrospective cohort study conducted on patients with Group 1 PAH. The study included 50 PAH patients (30 New York Heart Association [NYHA] class I-II, 20 class III-IV) and 25 healthy controls without cardiovascular or inflammatory disease for biomarker analysis. Clinical characteristics, laboratory parameters, and echocardiographic data were collected. NPAR was calculated, and its correlation with disease severity and other inflammatory markers was assessed. Results: High-sensitivity C-reactive protein (hs-CRP) (P = 0.02), N-Terminal Pro-Brain Natri & uuml;retic Peptid (NT-proBNP) (P = 0.03), NPAR (P = 0.01), white blood cell (WBC) (P = 0.03), neutrophil (P = 0.02), and albumin (P = 0.02) levels were significantly elevated in PAH patients compared to healthy controls. There was a strong correlation between NPAR and established markers of disease severity, specifically systolic pulmonary artery pressure (sPAP), right atrial (RA) area, NT-proBNP, and 6-min walk distance. According to the receiver operating characteristic (ROC) analysis, an NPAR threshold exceeding 18.2 proved to be a significant predictor for PAH (P < 0.05) and yielded a sensitivity of 80% and a specificity of 71%, with an area under the curve (AUC) of 0.966 (95% confidence interval (CI): 0.95-0.98). NPAR emerged as an independent predictor of PAH and high-risk PAH in multivariate analysis [1.029 (1.018-1.039), P < 0.01]. Conclusion: The study demonstrates that NPAR is a promising biomarker for assessing disease severity and predicting prognosis in PAH. Elevated NPAR levels may reflect systemic inflammation and contribute to the pathogenesis of PAH. Further research is needed to explore the potential therapeutic implications of targeting inflammation in PAH.