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Background: An imbalance between pro- and anti-inflammatory mechanisms is indicated in the pathophysiology of atherosclerotic plaque. The coronary artery and carotid disease, despite sharing similar risk factors, are developed separately. The aim of this study was to analyze possible mechanisms between trace element hair–scalp concentrations and whole blood counts that favor atherosclerotic plaque progression in certain locations. Methods: There were 65 (36 (55%) males and 29 (45%) females) patients with a median age of 68 (61–73) years enrolled in a prospective, preliminary, multicenter analysis. The study group was composed of 13 patients with stable coronary artery disease (CAD group) referred for surgical revascularization due to multivessel coronary disease, 34 patients with carotid artery disease (carotid group) admitted for vascular procedure, and 18 patients in a control group (control group). Results: There was a significant difference between the CAD and carotid groups regarding lymphocyte (p = 0.004) counts. The biochemical comparison between the coronary and carotid groups revealed significant differences regarding chromium (Cr) (p = 0.002), copper (Cu) (p < 0.001), and zinc (Zn) (p < 0.001) concentrations. Spearman Rank Order Correlations between lymphocyte counts and trace elements in the analyzed groups were performed, revealing a strong correlation with zinc (R = 0.733, p < 0.001) in the control group (non-CAD, non-carotid). Conclusion: Significant differences in hair–scalp concentrations related to atherosclerosis location were observed in our analysis. The interplay between zinc concentration and lymphocyte count may play a pivotal role in cardiovascular disease development. [ABSTRACT FROM AUTHOR]

(1) Background: Estimates suggest that up to 10% of global annual cardiovascular deaths could be related to environmental factors. Not only air pollution components, but also noise exposure and climate changes, are highlighted as nontraditional causes of cardiovascular morbidity. The aim of this study was to identify possible urbanization risk factors for the progression of coronary artery disease in a group of patients with chronic coronary syndrome. (2) Method: There were 77 patients (50 (65%) males and 27 (35%) females) with a median age of 70 (60–74) years who underwent repetitive angiography due to chronic coronary syndrome between 2018 and 2022. The Gensini score was calculated for assessment of coronary artery disease advancement. Environmental factors including neighboring developments were taken into account in this analysis, including housing, commercial, and industrial developments within 300, 500, and 700 m distances (buffer) from the place of habitation. (3) Results: The multivariable analysis results for prediction of Gensini score progression in relation to 700 m buffer urbanization pointed out the significance of hyperlipidemia (OR: 4.24, 95% CI 1.34–13.39, p = 0.014), initial Gensini score (OR: 1.02, 95% CI 1.00–1.05, p = 0.112), and neighborhood housing (OR: 0.03, 95% CI 0.01–0.49, p = 0.025). (4) Conclusions: Hyperlipidemia and housing neighborhood can be regarded as possible factors for coronary disease progression in patients with chronic coronary syndrome with the use of optimal medical therapy. [ABSTRACT FROM AUTHOR]

(1) Background: The increase in cardiovascular risk related to air pollution has been a matter of interest in recent years. The role of particulate matter 2.5 (PM2.5) has been postulated as a possible factor for premature death, including cardiovascular death. The role of long-term exposure to PM10 is less known. The aim of the study was to assess the individual relationship between air pollution in habitation and the development of coronary artery disease. (2) Methods: Out of 227 patients who underwent coronary angiography, 63 (38 men and 25 women) with a mean age of 69 (63–74) years, with nonsignificant atherosclerotic changes at the initial examination, were included in the study. The baseline and repeated coronary angiography were compared to reveal patients with atherosclerotic progression and its relation to demographic and clinical factors and exposure to air pollution in the habitation place. (3) Results: In the performed analysis, we found a significant correlation between Syntax score in de novo lesions and BMI (Spearman's rho −0.334, p = 0.008). The significant and strong correlation between median annual PM10 values of 20 µg/m3 and at least 25 µg/m3 in air pollution and the risk of de novo coronary disease was noticed (Spearman's rho = 0.319, p = 0.011 and Spearman's rho = 0.809, p < 0.001, respectively). (4) Conclusions: There is a positive correlation between long-term exposure to PM10 air pollution and coronary artery disease progression, demonstrated by the increase in Syntax score. The presented analysis revealed increased morbidity at lower PM10 concentrations than generally recommended thresholds. Therefore, further investigations concerning air pollution's influence on cardiovascular risk should be accompanied by promoting lifestyle changes in the population and revisiting the needs for environmental guidelines. [ABSTRACT FROM AUTHOR]

Introduction: The role of immune system activation in development and progression of atherosclerotic plaques has been postulated. Previous studies on inflammation have focused on the severity of coronary disease, the risk of acute coronary syndrome, and the prediction of outcomes based on hematological indices obtained from whole blood count analysis. Aim: To analyze simple data of the whole blood count in relation to the location of calcified atherosclerotic lesions in patients treated with coronary rotational atherectomy (RA). Material and methods: Eighty-one patients (57 (70%) males, mean (SD) age of 70.4 ±8 years) who underwent RA were enrolled in the study. The study group was divided into two subgroups depending on the proximal (group 1) and non-proximal (group 2) location of the culprit lesions in coronary arteries. The angiographic results were compared with demographic and clinical data and whole blood count analysis. Results: The multivariable analysis revealed the predictive value of low neutrophil (OR = 0.75, 95% CI: 0.58–0.97, p = 0.030) and lymphocyte counts (OR = 0.27, 95% CI: 0.11–0.68, p = 0.005) for the proximal location of the culprit lesions. In the ROC analysis, combined neutrophil and lymphocyte counts showed the best prediction of proximal location, with the area under the curve of 0.747 (p < 0.001), yielding a sensitivity of 79.07% and specificity of 73.68%. Conclusions: The lower neutrophil and lymphocyte counts in peripheral blood count analysis may be more representative of proximal calcified coronary lesions. The relationship between neutrophil and lymphocyte blood count and calcific atherosclerotic plaque location can indicate the inflammatory background of epicardial atheroma formation and distribution. [ABSTRACT FROM AUTHOR]

Background: The potentially harmful effects of air pollution on the human health have been already presented in epidemiological studies, suggesting a strong association with increased morbidity and mortality. The aim of the study was to evaluate a possible relationship between coronary artery lesion progression related to habitation place (cities vs. villages) and air pollution. Methods: There were 148 (101 men and 47 women) patients with a median age of 70 (63–74) years enrolled into retrospective analysis based on the coronary angiography results and their habitation place. Patients with stable coronary syndrome, who underwent repeated percutaneous coronary interventions were enrolled into the analysis based on demographical and clinical characteristics combined with annual exposure to air pollution (PM2.5, PM10, and NO2). Results: The results of multivariable regression analysis showed a significant relationship between coronary artery lesion progression requiring percutaneous intervention and NO2 chronic exposure in patients living in cities of Poland (OR 2.00, 95% CI: 0.41–9.62, p < 0.001). The predictive value of air pollution exposure at habitation place for coronary artery lesion progression requiring percutaneous intervention was evaluated by receiver-operator curve analysis, which revealed an area under the curve of 0.939, yielding a sensitivity of 87.1% and specificity of 90.7%. Conclusions: Coronary artery lesion progression can be related to chronic exposure to NO2 air pollution in patients living in cities in Poland. [ABSTRACT FROM AUTHOR]

Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59–64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17–17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001). [ABSTRACT FROM AUTHOR]

Introduction: Mean platelet volume (MPV) is claimed to be a useful marker to predict long-term risk for major adverse cardiac effects (MACE) in patients undergoing percutaneous coronary interventions (PCI). Aim: To explore the possible dependence on MPV and postoperative PCI risk in patients with complex coronary artery disease undergoing coronary artery bypass grafting in off-pump technique (OPCAB). Material and methods: We retrospectively analyzed 236 consecutive patients (180 (76%) males and 56 (24%) women) referred for surgery due to complex coronary artery disease between 2015 and 2016 in our department. The mean 5.1 ±0.8 year follow-up included profound analysis of MACE events including acute coronary syndromes and percutaneous interventions. Results: The 5 ±1 year follow-up was completed by 213 (90%) patients with 2 (1%) deaths within the first year after surgery. In logistic univariate and multivariate model regression analysis two parameters were found significant, i.e. preoperative white blood cells and postoperative MVP, for PCI risk in long-term follow-up. The odds ratio values for postoperative MPV were 1.78 (95% CI, p = 0.0036) and 1.76 (95% CI, p = 0.005) in univariate and multivariate models with cutoff point > 8.7, sensitivity 45.65%, specificity 78.72%. Conclusions: MPV can be regarded as a simple marker of PCI risk following OPCAB procedures. The preoperative MPV indicates the individual tendency for worse prognosis more than procedure dependence. [ABSTRACT FROM AUTHOR]

Introduction: The severity of coronary artery disease (CAD) may have an impact on the outcomes of patients (pts) after aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). Aim: The aim of the study was to analyze survival after simultaneous AVR and CABG with respect to CAD severity. Material and methods: The study involved 143 consecutive pts (40 women and 103 men) with a mean age of 65.1 ± 7.7 years treated between 2006 and 2009. The indication for surgery was aortic stenosis accompanied by left main or threevessel disease (group A; n = 43) and by single- or two-vessel disease (group B; n = 100). In-hospital and late mortality were analyzed. Post-discharge survival was estimated using the Kaplan-Meier method. Moreover, selected preoperative clinical and echocardiographic data as well as intraoperative variables were compared between the groups. Results: In-hospital mortality was 4.7% in group A and 3.0% in group B (NS). The 12-month and 48-month survival probability rates were 0.88 ± 0.05 and 0.83 ± 0.06 in group A, and 0.97 ± 0.01 and 0.92 ± 0.03 in group B, respectively (p < 0.05). Patients in group A and B differed (p < 0.05) with respect to the preoperative prevalence of arterial hypertension (65.1% vs. 42.0%) and atrial fibrillation (18.6% vs. 6.0%) as well as with regard to the rate of complete revascularization (20.9% vs. 85.0%, group A and B, respectively). Conclusions: Coronary artery disease severity impacts longterm survival after combined AVR and CABG. Patients with left main or three-vessel disease more often undergo incomplete surgical revascularization, and this fact may be one of the predictors of an unfavorable outcome. [ABSTRACT FROM AUTHOR]

Simple Summary: Coronary artery bypass graft (CABG) surgery is a procedure in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. CABG is associated with myocardial damage due to ischemia/reperfusion injury. In addition, postoperative complications, including perioperative myocardial infarction, atrial fibrillation and graft failure, remain important clinical challenges. So far, no reliable diagnostic and prognostic tools to predict outcomes after CABG surgery have been established. MiRNAs are noncoding, 21–24 nucleotide-long RNA particles, expressions of which alter during CABG surgery. Here, we summarize the potential clinical applicability of miRNAs as promising biomarkers to predict post-CABG procedure outcomes. MiRNAs are noncoding, 21–24 nucleotide-long RNA particles that control over 60% of genes. MiRNAs affect gene expression through binding to the 3'-untranslated region of messenger RNA (mRNA), thus inhibiting mRNA translation or inducing mRNA degradation. MiRNAs have been associated with various cardiovascular diseases, including heart failure, hypertension, left ventricular hypertrophy, or ischemic heart disease. In addition, miRNA expression alters during coronary artery bypass grafting (CABG) surgery, which could be used to predict perioperative outcomes. CABG is an operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. Despite a very low perioperative mortality rate and excellent long-term survival, CABG is associated with postoperative complications, including reperfusion injury, graft failure, atrial fibrillation and perioperative myocardial infarction. So far, no reliable diagnostic and prognostic tools to predict prognosis after CABG have been developed. Changes in the perioperative miRNA expression levels could improve the diagnosis of post-CABG myocardial infarction and atrial fibrillation and could be used to stratify risk after CABG. Herein, we describe the expression changes of different subtypes of miRNAs during CABG and review the diagnostic and prognostic utility of miRNAs in patients undergoing CABG. [ABSTRACT FROM AUTHOR]

Background: Off-pump coronary artery bypass grafting (OPCAB) comprises 15–30% of all bypass grafting surgeries. The currently available perioperative scores such as Euroscore and STS score do not specifically predict long-term mortality after off-pump procedures. The neutrophil-to-lymphocyte ratio (NLR) is one of the new, easily accessible markers of inflammation with proven predictive value in cardiovascular diseases. We aimed to develop the first risk score for long-term mortality after OPCAB and to determine if the perioperative value of NLR predicts long-term mortality in OPCAB patients. Methods: In total, 440 consecutive patients with multivessel stable coronary artery disease undergoing OPCAB were recruited. Differential leukocyte counts were obtained by a routine hematology analyzer. Data regarding mortality during a median follow-up time of 5.3 years were obtained from the Polish National Health Service database. An independent population of 242 patients served as a validation cohort. Results: All-cause mortality was influenced by different clinical risk factors. In multivariate regression analysis, chronic obstructive pulmonary disease, stroke history, post-operative NLR and LVEF were independent predictors of mortality. Combing all independent predictors predicted long-term all-cause mortality with 68.5% sensitivity and 71.5% specificity (AUC = 0.704, p < 0.001). After weighing these variables according to their estimates in a multivariate regression model, we developed a score to predict mortality in patients undergoing OPCAB (PREDICT-OPCAB Score, ranging from 0 to 10). Patients with a high score were at higher risk of mortality within the median 5.3 years of follow-up (score 0–3: 8.3%; 4–6: 27.0%; 7–10: 40.0%; p < 0.001 for score 0–3 vs. 4–6 and 7–10). This association was confirmed in the validation cohort. Conclusions: We developed and validated the first simplified risk score to predict mortality following OPCAB based on easily accessible clinical factors. This risk score can be used when obtaining a patient's informed consent and as an aid in determining treatment. [ABSTRACT FROM AUTHOR]