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Background Statins are commonly used in the secondary prevention of coronary artery disease. Studies have shown that the rate of statin use is low among patients with coronary artery disease. In this study, we aimed to investigate the reasons for poor patient compliance with statin treatment. Methods A total of 504 patients diagnosed with coronary heart disease were included in the study. Patients were asked 5 questions to assess their level of knowledge about statin therapy. Results Among the patients not using statins, 42% stated they did not take the medication because their cholesterol was not high or they did not know they should renew their prescription when they ran out and 35% because they were influenced by news reports in the media suggesting that cholesterol-lowering drugs were harmful. When patients who were aware of the pleiotropic/cardioprotective effects of statins were compared with patients who were not, the more knowledgeable patients had lower noncompliance rate and mean LDL-C level and a higher rate of LDL-C level optimization. Conclusion We found that patients who are aware of the pleiotropic effects of statins were more compliant with treatment. We believe that spending more time explaining and emphasizing the mechanisms of action, reason for prescribing, and necessary treatment duration of drugs that patients must use will result in greater compliance and improve patient care. In this way, patients may be less influenced by misinformation presented by the media.

Aim    In heart failure (HF) patients with iron deficiency, cardiac electrical irregularity is a cause of arrhythmias. The aim of our study was to evaluate the effect of ferric carboxymaltose (FCM) treatment on T wave peak to end (Tp-e) interval and the Tp-e / QT and Tp-e / corrected QT (QTc) ratios that reflect the transmural dispersion of repolarization in HF patients with iron deficiency.Material and methods    Forty HF patients with iron deficiency that were treated with FCM were included in our single center, observational study. Repolarization parameters on electrocardiograms recorded before and 12 wks after FCM treatment were compared. Additionally, these parameters were compared with ventricular repolarization parameters of 40 healthy age and gender matched individuals and with another group of 40 HF patients without iron deficiency.Results    In the HF patients with iron deficiency, the Tp-e interval and the Tp-e / QT and Tp-e / QTc ratios before FCM treatment were 103.7±19.1 ms, 0.25± 0.04, 0.23±0.04, respectively. These values were higher compared to the healthy the group and HF group without iron deficiency (p<0.001). In the HF patients with iron deficiency, the Tp-e interval and the Tp-e / QT and Tp-e / QTc ratios after FCM treatment were lower compared to pre-treatment and similar to the HF patients without iron deficiency (89.4±18.6 ms, 0.22±0.04, 0.20±0.04, respectively; p<0.001).Conclusion    FCM treatment of HF patients with iron deficiency corrects prolonged Tp-e interval and high Tp-e / QT and Tp-e / QTc ratios, which are risk factors for ventricular arrhythmias.

Background: Activation of the renin–angiotensin–aldosterone system has an important role in the pathophysiology of heart failure with reduced ejection fraction. While the effects of systemic renin–angiotensin–aldosterone system activation on heart failure with reduced ejection fraction are well known, the impact of the local renin–angiotensin–aldosterone system on heart failure with reduced ejection fraction is not fully understood because of limited clinical research. This study aimed to investigate the effect of urinary angiotensinogen level, an accepted indicator of local renin–angiotensin–aldosterone system activation, on all-cause mortality in patients with heart failure with reduced ejection fraction. Methods: This retrospective, single-center study included 60 patients with baseline urinary angiotensinogen data and survival/mortality data at 4 years. Urinary angiotensinogen values were standardized to the urinary creatinine value measured from the same urine sample. The median urinary angiotensinogen/urinary creatinine value among all patients (114 µg/g) was used as a cutoff to divide the patients into 2 groups. Mortality data were obtained from the national registry systems or by telephone. Results: Comparison of all-cause mortality in the 2 groups showed that 22 deaths (71%) occurred in the group with a urinary angiotensinogen/urinary creatinine ratio above the median and 10 deaths (35.5%) occurred in the group of patients with urinary angiotensinogen/urinary creatinine equal to or below the median value ( P = .005). Conclusion: Our study suggests that urinary angiotensinogen can be used as a new biomarker in the prognosis and follow-up of heart failure patients.

Background: No-reflow phenomenon (NRP) is one of the most important factors affecting myocardial reperfusion. Objective: In this study, we investigated the effect of ticagrelor and clopidogrel on the development of NRP in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods: Our single-center, retrospective study included 200 patients with AMI who underwent PCI. The patients were divided into two groups according to the antiplatelet regimen given before PCI: clopidogrel- and ticagrelor-loaded groups. NRP was defined based on TIMI flow classification or post-procedural ST segment resolution. The difference in the parameters between patients with no-reflow and patients with normal flow as well as the effect of ticagrelor and clopidogrel on NRP were evaluated. Results: There was no difference in baseline characteristics between patients with no-reflow and patients with normal flow. The number of patients with ST-elevation myocardial infarction was higher in the ticagrelor-loaded group compared with the clopidogrel-loaded group (P = 0.013). Age, aspartate aminotransferase (AST), C-reactive protein (CRP), peak creatine kinase MB (CK-MB), diabetes mellitus (DM) rate, length of stent, number of stents, and number of patients with low ejection fraction were significantly higher in the no-reflow group compared with the normal flow group. The rate of NRP development was significantly lower in ticagrelor-loaded patients (19% P = 0.001), independent of other independent variables, including age, DM, AST, CRP level, number of stents implanted, and type of myocardial infarction (odds ratio = 0.228, 95% confidence interval = 0.102–0.512, P < 0.001). Conclusion: Ticagrelor is superior to clopidogrel in preventing the development of NRP.