Background: Advances in neonatal cardiac care have improved survival in infants with congenital heart disease (CHD), shifting clinical attention toward early neurological morbidity. While cardiac anatomical complexity has traditionally been considered a major determinant of brain injury, emerging evidence suggests that genetic and systemic factors may play a more important role. Transfontanellar ultrasound (TFUS) is widely used as a bedside screening tool for early detection of neonatal brain abnormalities. Aim: To assess the incidence of abnormal TFUS findings in neonates with CHD and identify clinical and genetic predictors of early neurological vulnerability independent of cardiac anatomy. Materials and Methods: We conducted an observational cohort study including 138 neonates with CHD who underwent TFUS evaluation at a tertiary care center in Iași, Romania. Demographic, perinatal, clinical, genetic, and therapeutic data were collected retrospectively. CHD complexity was classified using the Bethesda classification. Univariate and multivariate logistic regression analyses were performed to identify predictors of abnormal TFUS findings. Results: Abnormal TFUS findings were identified in 42 neonates (30.4%), most commonly ventricular dilatation, intracranial hemorrhage, and choroid plexus cysts. In multivariate analysis, positive genetic testing was the strongest independent predictor (OR 3.9, 95% CI 1.5–10.2), followed by mechanical ventilation dependence (OR 2.7, 95% CI 1.1–6.5) and high Bethesda risk category (OR 2.2, 95% CI 1.0–4.8). Cardiac anatomical classification and gestational age were not independently associated with abnormal TFUS findings. Conclusions: In neonates with CHD, early TFUS abnormalities appear to be driven mainly by genetic and systemic factors rather than cardiac anatomy alone, supporting integrative risk stratification approaches for targeted neurological surveillance.

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Accurate assessment of coronary lesion severity is essential for guiding revascularization. Fractional flow reserve (FFR) is the gold standard for functional evaluation of coronary stenoses, but data on intracoronary hemodynamic assessment in patients with acute myocardial infarction are limited. Optical coherence tomography (OCT) provides highresolution intravascular imaging and may offer additional insights into lesion severity. Aim: To investigate the correlation between OCT-derived measurements and FFR values in patients with acute myocardial infarction. Methods: The study included 114 patients with acute myocardial infarction (STEMI or NSTEMI) undergoing primary percutaneous coronary intervention (PCI) of the culprit lesion. Intermediate stenoses in non-culprit vessels (151 lesions) were evaluated during staged procedures with OCT and FFR. Minimal luminal area (MLA) and percent luminal area stenosis (PAS) were analyzed in relation to FFR values. Results: OCT-derived parameters showed good correlation with FFR values. In multivariable logistic regression, MLA and PAS were independent predictors of FFR <0.80. The optimal cut-off values were 2.08 mm2 for MLA and 76.85% for PAS. Conclusions: OCT-derived parameters may help identify functionally significant non-culprit lesions in patients with acute myocardial infarction and can complement physiological assessment in clinical practice.

Background: Pulmonary embolism (PE) is a major cause of cardiovascular death and was increasingly diagnosed during and after the COVID-19 pandemic, highlighting the role of inflammation alongside genetic and acquired risk factors. Despite effective therapies, PE remains underdiagnosed. This study analyzed patient characteristics, risk factors, inflammatory markers, and management strategies. Materials and Methods: We conducted a retrospective study of 97 patients with PE admitted to the Cardiology Department of the County Emergency Clinical Hospital Brașov between March 2021 and April 2022. Clinical, biological, and therapeutic data were systematically evaluated. Results: The mean age was 66.8 years, with near-equal sex distribution. The most frequent symptoms were dyspnea, unilateral lower limb edema, and chest pain; hemodynamic instability was rare. Major risk factors included age >60 years, hypertension, and obesity. One-third of patients had recent SARS-CoV-2 infection or vaccination (<4 months). Inflammatory and thrombotic markers (leukocytosis, CRP, fibrinogen, D-dimer) were frequently abnormal. Most patients received low-molecularweight heparin; thrombolysis was used selectively. Conclusions: PE management during the pandemic emphasized the importance of inflammation in risk stratification, monitoring, and prognosis. Identifying patient-specific risk factors and refining treatment strategies remain essential for improving outcomes in this high-risk population.

Background: Acute coronary syndrome (ACS) is a leading cause of death, with significant disparities in risk factors and outcomes. The relationship between periodontal disease (PD), periostin (PN), and cardiovascular disease is complex, with both conditions sharing inflammatory pathways and risk factors. This study investigates the link between PN serum levels and cardiovascular risk factors in patients with ACS and concomitant PD. Methods: This case–control study involved 92 patients with ACS and PD admitted to the County Emergency Clinical Hospital of Târgu Mureș, Romania. Patients were divided into low PN (LP) and high PN (HP) groups based on a median PN level of 30.63 ng/ml. Clinical data, lipid profiles, and biomarkers were compared between groups. Results: Patients in the LP group had significantly higher total HDL cholesterol and triglyceride levels, and significantly lower LDL cholesterol levels compared to the HP group. Linear regression analysis showed a positive correlation between serum PN and LDL cholesterol (p < 0.0001) and a negative correlation between PN and HDL cholesterol (p < 0.0001). There were no statistically significant differences in apolipoprotein B, serum uric acid, creatinine, or blood glucose levels between the groups. However, patients in the HP group had a significantly higher prevalence of ST-elevation myocardial infarction (p < 0.05). Conclusion: In patients with ACS and PD, PN levels correlate with lipid profiles, particularly LDL and HDL cholesterol, and are associated with the type of myocardial infarction. These findings suggest PN may play a role in the complex interplay between PD, ACS, and cardiovascular risk, warranting further research to clarify its potential as a biomarker.

Background: Acute coronary syndrome (ACS) includes ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), each with distinct clinical profiles and outcomes. While STEMI is typically associated with more extensive infarcts, emerging data suggest NSTEMI may carry a greater burden of comorbidities and anatomical complexity. Objective: To compare the incidence of ventricular arrhythmias and hemodynamic instability in patients with STEMI vs. NSTEMI and to analyze the distribution of culprit coronary lesions. Methods: This retrospective single-center study included 172 patients who underwent coronary revascularization between April and July 2021. Clinical outcomes, arrhythmias, and hemodynamic instability were compared between groups with STEMI (n = 108) and NSTEMI (n = 64). Culprit lesions were evaluated by angiography and categorized by vessel. Results: Hemodynamic instability was significantly more common in patients with NSTEMI (10.93%) compared to STEMI (0.18%) (p = 0.005). Ventricular arrhythmias occurred in 12.03% of patients with STEMI and 7.81% of patients with NSTEMI, with no significant difference. Left main coronary artery lesions were notably more frequent in NSTEMI (47.4% vs. 2.04%; p < 0.0001), whereas right coronary artery involvement was higher in STEMI (40.81% vs. 7.4%; p < 0.0001). Ventricular arrhythmias were significantly associated with circumflex artery lesions in patients with NSTEMI (p = 0.0001). Conclusions: Despite often being perceived as lower risk, patients with NSTEMI exhibited a higher rate of hemodynamic instability and more complex coronary involvement, particularly left main disease. These findings highlight the need for vigilant monitoring and individualized treatment strategies in populations with NSTEMI.

Background: Peripheral artery disease (PAD), traditionally affecting older adults, is increasingly diagnosed in younger patients, highlighting the need for early, non-invasive biomarkers such as the leukocyte glycemic index (LGI) that reflect the inflammatory mechanisms driving atherosclerosis. The aim of this study was to determine whether the LGI can be associated with the presence of symptomatic atherosclerotic disease on patients under 45 years. Methods: We conducted a retrospective observational study, enrolling all patients under the age of 45 years who were admitted to the Department of Vascular Surgery of Targu Mures County Emergency Clinical Hospital between January 2019 and May 2024. Patients were categorized into two groups based on the presence or absence of systemic atherosclerosis. Results: Patients with systemic atherosclerosis had a higher incidence of cerebrovascular events (p = 0.006) and ischemic heart disease (p = 0.038), as well as elevated counts of white blood cells (WBCs) (p = 0.003), platelets (p = 0.038), neutrophils (p = 0.002), monocytes (p = 0.024), lymphocytes (p = 0.01), and LGI (p = 0,006). At the receiver operating characteristics analysis, we observed a significant correlation between the baseline values of the LGI and systemic atherosclerosis (p = 0.004). The area under the curve (AUC) was determined to be 0.707, with an optimal cut-off value established at 0.683, resulting in a sensitivity of 79.2% and a specificity of 60.6%. Additionally, elevated baseline values for platelets (OR 2.18; p = 0.017), WBCs (OR 2.06; p = 0.020), neutrophils (OR 2.75; p = 0.004), lymphocytes (OR 2.47; p = 0.021), monocytes (OR 2.03; p = 0.021), and LGI (OR 2.90; p = 0.024) were also identified as predictive factors of systemic atherosclerosis. Conclusions: Elevated values of LGI are associated with the presence of symptomatic atherosclerotic disease in patients under 45 years.