Usage and safety of direct oral anticoagulants at patients with atrial fibrillation and planned diagnostic procedures, interventions, and surgery Marko Mornar Jelavic, Goran Krstacic, Hrvoje Pintaric Heart and Mind 2019 3(1):1-6 Atrial fibrillation (AF) affects about 2% of the population, with the increasing prevalence with age. It is associated with poorer quality of life, effort intolerance, frequent hospitalizations, heart failure, and increased risk of systemic embolization, stroke, and mortality. Warfarin has been the only choice of chronic anticoagulant therapy for over 50 years. Its disadvantages are reflected by interaction with various foods, drugs, and alcohol, while its action is highly dependent on liver function, age, and genetic background. Administration of direct oral anticoagulants (DOACs) to patients with AF and acceptable bleeding risk reduces the risk of systemic thromboembolic complications and stroke; these drugs are superior or at least as effective as warfarin. Their use is safer than warfarin in terms of reduced risk of major bleeding. This is a group of drugs with wide clinical use, except in patients with severely impaired renal and hepatic function. Proper use is a guarantee of the safety of DOACs, which in the future will be even more pronounced with the advent of new antidotes, such as Praxbind.

The role of Val66Met single nucleotide polymorphism in brain-derived neurotropic factor gene in prediction of adverse outcomes after ST-segment elevation myocardial infarction Olga V Petyunina, Mykola P Kopytsya, Alexander E Berezin, Olga V Skrynnyk Heart and Mind 2019 3(1):7-14 Background: The single nucleotide polymorphism of Val66Metgen of the brain-derived neurotrophic factor (BDNF) gene is a possible candidate that is associated with the development of psychopathology and combines it with cardiovascular events. The purpose of this study was to research the possible associations of single-nucleotide polymorphism of Val66Met BDNF gene with the occurrence of endpoints after 6 months of follow-up after ST-segment elevation myocardial infarction (STEMI). Materials and Methods: 256 acute STEMI patients after successful primary percutaneous coronary intervention (PCI) were enrolled in the study. Thrombolysis in myocardial infarction III blood flow restoring through culprit artery was determined. The study of single-nucleotide polymorphism of Val66Met gene BDNF (rs6265) was performed by real-time polymerase chain reaction. The emotional state of the patients and its relationship with stress were assessed with the questionnaire “Depression, Anxiety, and Stress-21”. Results: The frequency of genotypes Val66Met gene for BDNF in STEMI patients (n = 256) was the following: 66ValVal = 74.2% (n = 190), 66ValMet + 66MetMet - 25.8% (n = 66). The 66ValMet + 66MetMet polymorphism in the BDNF gene, stress, and anxiety on 10–14 days before the event, as well as reduced left ventricular ejection fraction, were independently associated with combined 6 months' clinical endpoint after STEMI. Conclusion: The Val66Met polymorphism in BDNF gene was found as an independent predictor for combined 6-month clinical endpoints after acute STEMI-treated primary PCI.

Prevalence rates of chronic fatigue complaints in a probability sample of Arab college students Ahmed M Abdel-Khalek Heart and Mind 2019 3(1):15-20 Objectives: Fatigue is a common complaint in the community. The twofold aims of the present study were (a) to estimate the prevalence rate of reported chronic fatigue syndrome-like (CFS-like) complains, and (b) to explore the sex-related differences in it. Methods: A probability non-clinical sample of 3,465 Kuwaiti volunteer undergraduate men (n = 1,745) and women (n = 1,720) was recruited. Their ages ranged between 16 and 43 years. They responded to the Arabic Scale of Chronic Fatigue (ASCF). It has good internal consistency, temporal stability, criterion-related validity, and factorial validity (its loading on a CFS factor = 0.81). Principal component analysis disclosed 2 factors: Mental fatigue and Physical fatigue. The prevalence rate was computed based on 2 criteria, i.e., the percentage of persons which have total scores greater than (a) the M + 1 SD, and (b) greater than the M + 2 SD. Results: Based on criterion (a), prevalence rates were 13.47% for men and 20.98% for women. As to criterion (b), the rates were 2.35% for men and 5.76 % for women. These rates lie in the rage of the international studies on CFS-like complaints (from 1.2% to 30.5%). Women obtained significantly higher mean score and prevalence rates than did their male counterparts. Conclusion: It is highly probable that the participants obtained the higher scores than did their M + 2 SD are in need of therapeutic intervention. It was concluded that psychological scales may be useful in screening disorders to detect the cases.

Differentiation of T-wave inversion changes with borderline left ventricular hypertrophy in an asymptomatic young athlete – Case report and literature review Lukasz A Malek Heart and Mind 2019 3(1):21-26 This is a case of initially 15 years of age, white, male from junior football team. He was completely asymptomatic, with no previous medical history or family history of sudden cardiac death and cardiac diseases. He has been playing football for 8 years. On periodic preparticipation screening, he presented T-wave inversions (TWIs) in leads V4–V6 and II, III, and aVF, which were not observed before on yearly screenings. Subsequently, he underwent echocardiography, which showed mildly increased myocardial thickness (13 mm) without other abnormalities. He was then referred to for further testing, which is discussed in the context of the current literature. Finally, management is presented.

Culture-negative fungal endocarditis Rohit Kumar, J Kirtana, Parul Kodan, Yogiraj Ray, Prabhat Kumar, Ashutosh Biswas Heart and Mind 2019 3(1):27-30 A 54-year-old female, known case of hypertension and diabetes mellitus (controlled), was admitted with prolonged fever for 1½ months. On evaluation, fever workup was inconclusive and multiple cultures were negative. On re-assessment of history, she gave a history of cardiac catheterization 1 month back. Further evaluation revealed aortic valve vegetation on two-dimensional echo with raised beta-D glucan levels. She was managed with antifungal therapy followed by valve replacement surgery. The patient improved following the management and is doing fine. This case highlights the importance of detailed history-taking and evaluation. It also highlights the not uncommon occurrence of fungal endocarditis in patients with healthcare contact and the role of biomarkers as surrogate in case of culture-negative endocarditis.

Implantable cardioverter-defibrillator therapy at end of life: A commentary Peter Magnusson, Joseph V Pergolizzi, Jo Ann LeQuang Heart and Mind 2019 3(1):31-33