Objective: Indications and appropriateness of aspirin use have not been well investigated in Turkey. Therefore, the aim of this study is to investigate the prescription patterns and appropriateness of aspirin in a real-world clinical setting. Methods: The ASSOS study is a cross-sectional, multicenter registry involving consecutive cardiology patients who were using aspirin. Patients were divided into two groups according to the use of aspirin; primary prevention and secondary prevention group. The indication of aspirin use was evaluated according to 2016 the European Society of Cardiology (ESC) and 2016 the United States Preventative Services Task Force (USPTF) guidelines in the primary prevention group. Results: A total of 5007 patients (mean age 62.15± 11.05, 39% female) were enrolled. The primary prevention group included 1132 (22.6%) patients and the secondary prevention group included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use of aspirin was determined in 100% of the patients according to the ESC guidelines, and 71 % of the patients according to the USPTF guidelines. Conclusion: Although there are considerable differences between the USPTF and the ESC guidelines with respect to recommendations for aspirin use in primary prevention, inappropriate use of aspirin in Turkey is frequent in real-world practice for both guidelines.

INTRODUCTION: The epidemic of pneumonia caused by a new coronavirus disease 2019 (COVID-19) rapidly spread all over the world. Pathophisyology of the cardiovascular effects of COVID-19 is still not well known. Myocardial dysfunction may occur in cytokine-based immune reactions. Myocardial performance index (MPI) is a feasible parameter that reflects systolic and diastolic cardiac functions. We aimed to evaluate the MPI in patients with COVID-19. METHODS: The study consisted of 40 patients diagnosed with COVID-19 who had mild pneumonia and did not need intensive care treatment. All patients underwent echocardiographic evaluation. The MPI and laboratory parameters were compared between the acute period of infection and after clinical recovery in patients with COVID-19. RESULTS: Statistically significant higher MPI (0.56±0.09 versus 0.44±0.07, p<0.001), longer isovolumic relaxation time (112.3 ±13.4 versus 91.8±12.1ms, p<0.001), longer deceleration time (182.1 ± 30.6 versus 161.5 ± 43.5ms, p=0.003), shorter ejection time (279.6±20.3 versus 298.8±36.8ms, p<0.001) and higher E/A ratio (1.53±0.7 versus 1.22±0.4, p<0.001), were observed during acute period of infection compared to ones after clinical recovery. Compared with basal values, no significant change in left ventricular (LV) systolic ejection fraction was observed after clinical recovery (60.3 ± 3.2% versus 61.7±2.4%, p>0.05). CONCLUSION: Our study showed that although, LV systolic function appear normal in COVID-19 patients, they have globally reversible LV diastolic dysfunction, based on tissue Doppler derived MPI. This could be due to isolated subclinical diastolic dysfunction. The underlying mechanism and its clinical significance can be established by further studies.

Background: Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in chronic kidney disease (CKD) patients. Aortic propagation velocity (APV), epicardial fat thickness (EFT), and carotid intima-media thickness (CIMT) measurements could provide additional information on assessing renal decline in CKD patients. The study aimed to evaluate EFT, AVP, and CIMT in CKD patients and then investigate the association among those parameters. Methods and Results: A total of 170 CKD consecutive subjects were enrolled in the study. Patients were divided into five groups according to their GFR values. Each patient underwent complete transthoracic echocardiography examination. APV, EFT and CIMT were measured for analyses. A multivariate linear regression model was used for analysis to determine the independent predictors of GFR. The lowest APV was observed in stage IV-V, and the highest APV was observed in stage I-II (p<0.001). Stage IV-V patients had the highest EFT, and stage I-II patients had the lowest EFT (p<0.001). Moreover, the lowest CIMT was observed in stage III, and the highest APV was observed in stage V (p<0.001). GFR was significantly and positively correlated with APV and negatively correlated with EFT and CIMT. In multivariate analyses, APV (OR: 0.289, p<0.001), EFT (OR: -0.135, p<0.001) and CIMT (OR: -0.388, p<0.001) were independent predictors of GFR. Conclusion: We found that APV decreased, and EFT and CIMT increased as CKD progress. The present study suggests that APV, EFT, and CIMT might be incorporated with the examination of CKD patients in daily practice.