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Introduction: Atrial fibrillation (AF) is the most common arrhythmia associated with heart failure (HF).1 Previous studies have shown correlation of cardiac markers such as NT-proBNP and high-sensitivity Troponin I (hsTnI) with increased risk for thromboembolic and adverse cardiovascular events in patients with AF.2 Goals of this study were to evaluate the risk for ischemic stroke (IS) and significant bleeding, to examine clinical and laboratory characteristics, and to determine potential associations of NT-proBNP and hsTnI with aforementioned risks in patients with acute decompensated HF (ADHF) and AF. Patients and Methods: This study included a total of 47 patients with ADHF and AF, diagnosed according to the current criteria of the European Society of Cardiology (ESC)1, which were hospitalized in University Hospital Centre Split during 2018 (Table 1). Patients with an acute coronary syndrome and/or infectious disease were excluded. Results: Mean annual risk for IS without therapy was 8.74% while bleeding risk was 0.60% (p<0.001). After risk adjustment for individual antithrombotic therapy, mean risks for IS and bleeding were 3.46% and 3.10%, respectively, without significant difference between these risks (p=0.430). Use of non-vitamin K oral anticoagulants was almost equated with warfarin use (47.5% vs. 52.5%). Mean levels of hsTnI and NT-proBNP on admission were 56.7 ng/mL and 6550 pg/mL, respectively. Levels of hsTnI above the upper reference limit adjusted by sex were found in 26 (55.3%) patients. Levels of NT-proBNP on admission were significantly higher (p=0.014) in patients with higher risk for IS, as well as levels of hsTnI but without statistical significance (p=0.388). hsTnI showed positive correlation with NTproBNP (r=0.545, p=0.010) and C-reactive protein (r=0.559, p<0.001), while NT-proBNP exhibited positive correlation with mean annual risk for IS (r=0.587, p=0.002) (Figure 1). Conclusion: The antithrombotic management reduced the risk for IS by nearly threefold, with an acceptable bleeding risk. Levels of hsTnI were increased in a large number of patients suggesting that myocardial injury is common during the hospitalization event of ADHF with AF. Levels of NT-proBNP on admission, in presented population, may aid in annual risk stratification for IS and thromboembolic event. [ABSTRACT FROM AUTHOR]

Introduction: Heart failure (HF) is a syndrome characterized by the activation of the complex cascade of neurohumoral mechanisms in order to maintain cardiac output.1 Previous studies have shown that activation of a sympathetic nervous system (SNS) is more pronounced in patients with ischemic cardiomyopathy (IC) compared to those with non-ischemic cardiomyopathy (NIC).2,3 On the other hand, catestatin is a pleiotropic endogenous peptide that inhibits nicotinic receptor-mediated catecholamine release into the circulation and, therefore, exhibits inhibitory action on SNS activity. The main goal of the study was to determine and compare circulating catestatin levels among HF patients with IC and NIC. Patients and Methods: This study included a total of 38 patients admitted to the University Hospital Centre Split during the March-June of 2018 with an acute decompensation of HF determined by the current diagnostic criteria for HF laid out in the European Society of Cardiology guidelines from 2016. Patients with the acute coronary syndrome and/or infectious disease were excluded. Serum levels of catestatin were determined by the enzymelinked immunosorbent assay (ELISA). Results: Twenty-one (55%) patient had IC while 17 (45%) had NIC. Both groups did not significantly differ in baseline anthropometric, clinical and echocardiographic parameters as well as medication intake (Table 1). Almost all patients were in NYHA III or IV class regarding the functional classification of HF (N=36, 95%). Patients with IC had significantly higher mean NYHA degree compared to NIC patients (3.4±0.6 vs. 3.1±0.4, p=0.039). Serum catestatin levels did not significantly differ between women and men (18.9 vs. 15.7 ng/mL, p=0.570). HF patients with IC had more than 2-fold higher catestatin serum levels compared to HF patients with NIC (22.8±20 vs. 10.6±8.5 ng/mL, p=0.025) (Figure 1). Catestatin showed positive significant correlation with NT-proBNP in a total sample of patients, independent of sex, age, body mass index and estimated glomerular filtration rate (r=0.516, p<0.001). Conclusion: Significantly increased circulating catestatin levels in HF patients with ischemic etiology of the disease might indirectly reflect an increased neurohumoral activation in this population, as well as ventricular pressure overload. [ABSTRACT FROM AUTHOR]

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