Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir最新文献

{"title":"Inflammatory, Lipid, and Angiographic Differences in Young Versus Middle-Aged Hospital Survivors of Myocardial Infarction with Obstructive, Revascularization-Requiring Coronary Artery Disease.","authors":"Ecem Gürses, İbrahim Duygu","doi":"10.5543/tkda.2026.57173","DOIUrl":"https://doi.org/10.5543/tkda.2026.57173","url":null,"abstract":"<p><strong>Objective: </strong>To compare composite inflammatory indices, the Atherogenic Index of Plasma (AIP), and angiographic findings between patients with acute myocardial infarction (MI) aged <55 years and those aged 55-65 years.</p><p><strong>Method: </strong>Patients with acute coronary syndrome were retrospectively screened (n=205). Forty patients who died during hospitalization were excluded post hoc, along with 10 patients with normal coronary arteries and 10 with noncritical stenosis not requiring revascularization, leaving 145 patients: Group 1 (<55 years, n=72) and Group 2 (55-65 years, n=73). The Systemic Inflammatory Response Index (SIRI), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), AIP, and C-reactive protein were compared between groups, together with lipid, angiographic, and left ventricular ejection fraction (LVEF) parameters.</p><p><strong>Results: </strong>Younger patients had significantly higher SIRI (1.63 vs. 1.11, P < 0.001), NLR (2.65 vs. 2.26, P = 0.004), MLR (0.261 vs. 0.200, P < 0.001), and AIP (0.440 vs. 0.298, P = 0.039). Because SIRI and MLR were collinear, each index was modeled separately with AIP and ST-segment elevation myocardial infarction (STEMI)/non-ST-segment elevation myocardial infarction (NSTEMI) status; when modeled separately, each was independently associated with younger age after adjustment for MI type (all P ≤ 0.009). LVEF was better preserved (P < 0.001), and among patients with a single identifiable culprit vessel, the right coronary artery was more frequently implicated in younger patients (47.3% vs. 22.2%, P = 0.006).</p><p><strong>Conclusion: </strong>Young patients with MI and obstructive coronary disease showed higher inflammatory indices and a more atherogenic lipid profile than middle-aged patients. SIRI, NLR, MLR, and AIP were each independently associated with younger age in the primary multivariable models; however, across exploratory sensitivity analyses using stricter age thresholds, a continuous age model, and a death-inclusive cohort, complete blood count (CBC)-derived inflammatory indices-particularly SIRI and MLR-showed relatively consistent age-associated differences, whereas the association with AIP was more dependent on how age was defined and modeled. These findings support further investigation of CBC-derived inflammatory indices, particularly SIRI and MLR, as candidate markers of age-associated inflammatory and lipid differences among MI survivors rather than as biomarkers of premature MI or as a basis for clinical recommendations.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Follow-up of Spontaneous Coronary Artery Dissection in Young Women: A Single-Center Tertiary Referral Cohort.","authors":"Kevser Gülcihan Balcı, Güldane Nevra Güner, Erdeniz Eriş, Kerem Özbek, Mustafa Mücahit Balcı, Ender Örnek","doi":"10.5543/tkda.2026.09144","DOIUrl":"https://doi.org/10.5543/tkda.2026.09144","url":null,"abstract":"<p><strong>Objective: </strong>Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome (ACS) and sudden cardiac death, particularly in women aged 50 years or younger, including those without typical atherosclerotic coronary lesions. This study aimed to evaluate the clinical presentation, angiographic features, management strategies, and outcomes of patients with SCAD.</p><p><strong>Method: </strong>This retrospective, single-center study included female patients aged 50 years or younger who underwent coronary angiography for ACS between January 2019 and January 2025. Patients presenting with chest pain, ST-T segment changes, and/or elevated high-sensitivity cardiac troponin levels were evaluated. The diagnosis of SCAD was established according to angiographic criteria and categorized using the Yip-Saw classification system.</p><p><strong>Results: </strong>Among 352 women screened, 40 patients were diagnosed with SCAD, including 18 with ST-segment elevation myocardial infarction and 22 with non-ST-segment elevation myocardial infarction. According to the Yip-Saw classification, Type 3 SCAD was the most frequently observed angiographic pattern. The left anterior descending artery was the most commonly involved vessel. Most patients (n=35) underwent percutaneous coronary intervention, whereas 3 patients were managed conservatively and 2 underwent coronary artery bypass grafting. During follow-up, repeat revascularization was required in only one patient. Two patients died: one from cardiogenic shock during the index event and the other from complications of heart failure.</p><p><strong>Conclusion: </strong>SCAD is an important but underdiagnosed cause of ACS in young women. The mortality rate in the study population was 5%. These findings provide real-world observational data and should be confirmed in larger, multicenter, prospective studies.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cluster-Based Analysis of Lipid-Derived Profiles and Clinical Presentation in Premature Acute Coronary Syndrome.","authors":"Aykan Çelik, Semih Babacan, Elif Naz Uçak, Harun Erdem, Ali Efe Afşin, Tuncay Kırı Kırış, Mustafa Karaca","doi":"10.5543/tkda.2026.46948","DOIUrl":"https://doi.org/10.5543/tkda.2026.46948","url":null,"abstract":"<p><strong>Objective: </strong>Premature acute coronary syndrome (ACS) is clinically heterogeneous, and routine lipid parameters may not fully capture lipid-related risk profiles in young patients. We investigated whether lipid-derived indices could identify clusters associated with index ACS presentation and long-term outcomes.</p><p><strong>Method: </strong>This retrospective, single-center observational cohort study included patients aged ≤50 years who presented with first documented angiographically obstructive premature ACS and had complete lipid data. Standardized non-HDL-C, remnant cholesterol, TG/HDL-C ratio, and atherogenic index of plasma were analyzed using k-means clustering. Associations with STEMI presentation and a composite cardiovascular/cerebrovascular endpoint were evaluated using logistic and Cox regression analyses.</p><p><strong>Results: </strong>Of 1106 screened records, 195 were excluded because of incomplete lipid data or implausible lipid values, leaving 911 patients for analysis. At presentation, 152 patients (16.7%) had unstable angina, 224 (24.6%) had NSTEMI, and 535 (58.7%) had STEMI. Two clusters were identified: a lower atherogenic pattern (n=673, 73.9%) and a high atherogenic pattern (n=238, 26.1%). STEMI was less frequent in the high atherogenic pattern than in the lower atherogenic pattern (51.7% vs. 61.2%; P = 0.010) and remained independently associated after adjustment (OR, 0.69; 95% CI, 0.50-0.93; P = 0.016). In the MI-only sensitivity analysis, this association was attenuated and was no longer statistically significant. Sensitivity clustering yielded similar results. During a median clinical follow-up of 1370 days (IQR, 706-1991), 228 patients (25.0%) experienced the composite endpoint; the high atherogenic pattern was not independently associated with this outcome (HR, 1.11; 95% CI, 0.83-1.48; P = 0.496).</p><p><strong>Conclusion: </strong>Lipid-derived clustering identified two phenotypic patterns associated with index ACS presentation but not with long-term composite outcomes. Prospective external validation is required.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance Abuse as a Trigger for Myocardial Infarction in Young Adults: An Underrecognized Major Risk.","authors":"Ali Yağız Üresin, Burak Aydın, Can Birkan","doi":"10.5543/tkda.2026.88639","DOIUrl":"https://doi.org/10.5543/tkda.2026.88639","url":null,"abstract":"<p><p>Myocardial infarction (MI) remains a major public health problem worldwide. The use of illicit substances is increasing. These substances may be associated with an increased incidence of MI through various mechanisms, regardless of the presence of pre-existing risk factors. Although data on this subject are limited, it is important to highlight this issue. The aim of this review is to establish the association between substance misuse and MI, particularly in young adults, and to evaluate the underlying mechanisms based on the current literature. This review was prepared using publications identified through searches of the PubMed/MEDLINE, Scopus, and Web of Science databases using the names of the relevant substances in combination with terms associated with MI. The most commonly misused substances are classified as stimulants, depressants, and performance-enhancing hormones. Stimulants (cocaine, amphetamines, etc.) cause an imbalance between myocardial oxygen supply and demand through effects such as tachycardia, coronary vasospasm, and thrombosis resulting from increased sympathetic activity. Opioids, which belong to the depressant class, cause an imbalance between myocardial oxygen supply and demand by altering coronary hemodynamics secondary to complications such as hypotension, hypoxemia due to respiratory depression, and infection. In the case of cannabis and synthetic cannabinoids, coronary vasospasm, thrombosis, and plaque rupture are important effects. Anabolic-androgenic steroids (AAS) adversely affect the lipid profile. Furthermore, effects associated with AAS use include atherosclerosis, thrombosis, and erythrocytosis. These effects resulting from substance use are recognized as mechanisms underlying the development of MI.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Considerations for the Use of GLP-1 and Dual GIP/GLP-1 Receptor Agonists in Obesity: A Clinician-Oriented Guide.","authors":"Gizem Tuğçe Alp, Asena Gökçay Canpolat","doi":"10.5543/tkda.2026.41542","DOIUrl":"https://doi.org/10.5543/tkda.2026.41542","url":null,"abstract":"<p><p>Obesity is a chronic and frequently relapsing disease associated with a substantial burden of cardiometabolic morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), along with newer dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists (GIP/GLP-1 RAs), have emerged as effective pharmacological treatments for obesity, producing clinically meaningful weight loss and improving several markers of metabolic health. However, the effective use of these agents requires more than prescribing alone: patients must be selected appropriately, contraindications must be assessed, counseling must be provided, doses must be titrated gradually, side effects must be managed, and long-term follow-up must be maintained. This practical guideline offers clinicians a step-by-step framework, from determining eligibility and performing baseline evaluation to initiating therapy, monitoring response, managing commonly encountered side effects, and maintaining weight loss in the months and years that follow. Practical differences between semaglutide and tirzepatide are also summarized to support day-to-day prescribing decisions.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No-Reflow in Young Acute Coronary Syndrome Patients: Association with the Inflammatory Prognostic Index.","authors":"Ahmet Can Çakmak, Şevval Özdemir, Muhammet Taşdemir, Yusuf Can","doi":"10.5543/tkda.2026.91987","DOIUrl":"https://doi.org/10.5543/tkda.2026.91987","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The no-reflow phenomenon (NRP) is an important complication associated with adverse outcomes in patients undergoing PCI for acute coronary syndrome (ACS). Inflammation plays a central role in the pathophysiology of NRP. The inflammatory prognostic index (IPI), calculated using the neutrophil-to-lymphocyte ratio and C-reactive protein-to-albumin ratio, has recently emerged as a novel inflammatory marker. This study aimed to investigate the relationship between IPI and NRP in young patients with ACS undergoing PCI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;In this single-center retrospective study, a total of 443 consecutive patients aged ≤45 years who underwent PCI for ACS between 2022 and 2025 were included. The study population comprised 305 patients with ST-segment elevation myocardial infarction (STEMI; 68.8%), 126 with non-ST-segment elevation myocardial infarction (NSTEMI; 28.4%), and 12 with unstable angina (2.7%). Laboratory parameters were obtained from the first venous blood sample collected before coronary angiography during the index hospitalization. NRP was defined as a final Thrombolysis in Myocardial Infarction (TIMI) flow grade of 0-2 in the absence of mechanical obstruction or a final TIMI flow grade of 3 with a myocardial blush grade of 0-1. Clinical, laboratory, angiographic, and procedural characteristics were compared according to NRP status. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independently associated factors and evaluate the discriminatory performance of inflammatory indices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;NRP developed in 112 patients (25.3%), whereas 331 patients (74.7%) had normal flow. Patients with NRP had significantly higher IPI levels than those without NRP [6.88 (4.66-12.67) vs. 3.50 (2.03-7.41), P &lt; 0.001]. The multivariable model included IPI modeled using a natural cubic spline with 4 degrees of freedom, STEMI presentation, left anterior descending (LAD) coronary artery as the culprit vessel, serum creatinine, and an initial TIMI flow grade of 0-1. IPI showed a significant nonlinear association with NRP in the multivariable analysis (p for overall association &lt;0.001; p for nonlinearity &lt;0.001). An initial TIMI flow grade of 0-1 and LAD involvement as the culprit vessel also remained independently associated with NRP. In the standalone ROC analysis, IPI demonstrated the highest discriminatory performance among the inflammatory indices evaluated for NRP [area under the curve (AUC): 0.725, 95% confidence interval (CI): 0.677-0.772], with a cutoff value of 3.45, providing 92.0% sensitivity and 49.8% specificity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;IPI showed a significant nonlinear association with NRP in young patients with ACS undergoing PCI and may provide additional information for identifying patients at increased risk of this procedural complication. However, its relatively low specificity limits its use as a standalone ma","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anabolic-Androgenic Steroid Use and Acute Coronary Thrombosis: Lessons From a Very Young Patient with ST-Elevation Myocardial Infarction.","authors":"Lale Dinç Asarcıklı, Taner Şen","doi":"10.5543/tkda.2026.50250","DOIUrl":"https://doi.org/10.5543/tkda.2026.50250","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No-Stent Management of High Coronary Thrombus Burden in Young Patients with STEMI: A Four-Case Series.","authors":"Muhammed Emre Güleşir, Mehmet İnanır, Berkay Topal, Umut Ata Uğraş","doi":"10.5543/tkda.2026.25422","DOIUrl":"https://doi.org/10.5543/tkda.2026.25422","url":null,"abstract":"<p><p>Atherosclerotic plaque rupture is the most common mechanism underlying ST-segment elevation myocardial infarction (STEMI); however, young patients (≤50 years old) may present with a massive coronary thrombus in the absence of clearly demonstrated flow-limiting severe atherosclerotic stenosis. Routine direct stent implantation in these highly thrombotic lesions may increase the risk of distal embolization, impaired coronary blood flow, and long-term stent thrombosis. This report describes the angiographic outcomes of a retrospective case series of four young male patients managed without permanent stent implantation using tirofiban-based antithrombotic therapy, with or without initial mechanical reperfusion, guided by clinical stabilization and Thrombolysis in Myocardial Infarction (TIMI) flow. Tirofiban-based antithrombotic therapy was followed by substantial thrombus regression, while mechanical reperfusion was used when necessary to restore epicardial flow. In carefully selected patients with preserved coronary flow, a high thrombus burden, and no clearly demonstrated flow-limiting fixed lesion, a no-stent management strategy, with or without initial mechanical reperfusion, may be considered following individualized assessment and close angiographic follow-up.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Arrest in Premature Myocardial Infarction: A Window for Etiologic Evaluation.","authors":"Uğur Canpolat","doi":"10.5543/tkda.2026.80582","DOIUrl":"https://doi.org/10.5543/tkda.2026.80582","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Eosinophil-to-Monocyte Ratio and ST-Segment Resolution in Young STEMI Patients Undergoing Primary Percutaneous Coronary Intervention.","authors":"İsmail Balaban, Simay Erdal, Ayşe Nur Küçük, Barkın Kültürsay, Kadir Bıyıklı, Çağrı Kafkas","doi":"10.5543/tkda.2026.80962","DOIUrl":"https://doi.org/10.5543/tkda.2026.80962","url":null,"abstract":"<p><strong>Objective: </strong>Impaired myocardial reperfusion after primary percutaneous coronary intervention (pPCI) is associated with adverse outcomes in ST-segment elevation myocardial infarction (STEMI). This study investigated the relationship between the eosinophil-to-monocyte ratio (EMR) and ST-segment resolution in young patients with STEMI undergoing pPCI.</p><p><strong>Method: </strong>This retrospective, single-center study included 492 consecutive patients with STEMI younger than 45 years who underwent pPCI between January 2022 and January 2026. The primary endpoint was incomplete ST-segment resolution (<70%), while no-reflow was evaluated as a secondary endpoint. Univariable and multivariable logistic regression, restricted cubic spline, and receiver operating characteristic (ROC) analyses were performed.</p><p><strong>Results: </strong>Lower EMR was associated with greater thrombus burden, impaired postprocedural Thrombolysis in Myocardial Infarction (TIMI) flow, increased glycoprotein IIb/IIIa inhibitor use, incomplete ST-segment resolution, and no-reflow (all P < 0.001). Incomplete ST-segment resolution occurred in 52 patients (10.6%), no-reflow in 25 (5.1%), and in-hospital death in 1 (0.2%). Lower EMR remained independently associated with incomplete ST-segment resolution (odds ratio [OR] 0.245, 95% confidence interval [CI] 0.127-0.475, P < 0.001). In a secondary analysis, lower EMR was associated with no-reflow (adjusted OR 0.079, 95% CI 0.021-0.238, P < 0.001). Restricted cubic spline analysis showed a nonlinear inverse association between EMR and impaired myocardial reperfusion. EMR demonstrated acceptable discriminatory performance for incomplete ST-segment resolution (area under the curve [AUC] 0.757) and no-reflow (AUC 0.827).</p><p><strong>Conclusion: </strong>Lower admission EMR was associated with impaired myocardial reperfusion in young patients with STEMI undergoing pPCI. EMR may represent an admission reperfusion-associated marker, but its biological and clinical significance remains uncertain and requires prospective external validation.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}