Can the efficacy of a medical treatment be predicted based on the type of idiopathic premature ventricular contraction?

BACKGROUND: Premature ventricular contractions (PVCs) are common arrhythmias with diverse clinical implications. This retrospective study aimed to evaluate the efficacy of medical treatments using various clinical, imaging, and electrocardiographic parameters in patients with idiopathic PVCs. METHODS: A total of 1051 patients with idiopathic PVCs were retrospectively analyzed. Patients were categorized into three groups based on treatment response: beta-blocker (BB) responders (479 patients), calcium-channel blocker (CCB) responders (335 patients), and class 1c antiarrhythmic (AA) responders (237 patients). Clinical, imaging, and electrocardiographic data were collected and analyzed to assess the factors influencing treatment response. RESULTS: Age, left ventricular ejection fraction (LVEF), PVC QRS duration, CI variability, and multiple PVC morphologies were identified as significant factors affecting treatment response. Older age and lower LVEF were associated with better response to BB treatment, whereas CCB responders showed narrower QRS complexes. BB responders also exhibited higher CI variability, possibly linked to automaticity mechanisms. Moreover, the BB responder group had a higher frequency of multiple PVC morphologies. CONCLUSION: These findings emphasize the importance of tailored treatment approaches based on individual patient characteristics.

Rationale, Design, and Methodology of the MORCOR-TURK Trial: Predictors of In-hospital MORtality in CORonary Care Patients in Turkey.

BACKGROUND: Coronary care units are sophisticated clinics established to reduce deaths due to acute cardiovascular events. Current data on coronary care unit mortality rates and predictors of mortality in Turkey are very limited. The MORtality predictors in CORonary care units in TURKey (MORCOR-TURK) trial was designed to provide information on the mortality rates and predictors in patients followed in coronary care units in Turkey. METHODS: The MORCOR-TURK trial will be a national, observational, multicenter, and noninterventional study conducted in Turkey. The study population will include coronary care unit patients from 50 centers selected from all regions in Turkey. All consecutive patients admitted to coronary care units with cardiovascular diagnoses between 1 and 30 September 2022 will be prospectively enrolled. All data will be collected at one point in time, and the current clinical practice will be evaluated (ClinicalTrials.gov number NCT05296694). In the first step of the study, admission diagnoses, demographic characteristics, basic clinical and laboratory data, and in-hospital management will be assessed. At the end of the first step, the predictors and rates of in-hospital mortality will be documented. The second step will be in cohort design, and discharged patients will be followed up till 1 year. Predictors of short- and long-term mortality will be assessed. Moreover, a new coronary care unit mortality score will be generated with data acquired from this cohort. RESULTS: The short-term outcomes of the study are planned to be shared by early 2023. CONCLUSION: The MORCOR-TURK trial will be the largest and most comprehensive study in Turkey evaluating the rates and predictors of in-hospital mortality of patients admitted to coronary care units.

Prognostic significance of serum galectin-3 in hospitalized patients with COVID-19.

BACKGROUND: There are no major tools that could predict disease severity in COVID-19. The aim of this study is to evaluate if serum galectin-3 levels can identify disease progression in COVID-19. METHODS: Patients that were hospitalized due to COVID-19 between March and June 2020 were included in this cross-sectional prospective study. Baseline demographic and clinical data in addition to levels of serum parameters including galectin-3 were measured at the time of hospital admission. Patients with COVID-19 were categorized into two groups (non-severe and severe illness). The need for ICU during hospital stay, duration from hospital admission to the transfer to the ICU, and the total length of hospital stay were recorded. RESULTS: A total of 175 patients were included in the study and among these, 64 patients formed the severe illness group whereas 111 comprised the non-severe illness group. There was statistically significant difference in terms of galectin-3 levels between groups (1.07 ± 0.75 vs 0.484 ± 0.317, p < 0.0001, respectively). Our results showed that galectin-3, IL-6 and CRP levels at admission were independent risk factors associated with transfer to the ICU whereas only galectin-3 was an independent factor for the need for advanced ventilatory support. Also, galectin-3 and IL-6 were independent risk factors related to in-hospital mortality. CONCLUSION: In conclusion, our results indicated that galectin-3 had moderate power in outlining disease severity and the need for ICU transfer throughout the clinical course in COVID-19.