Coronary artery disease最新文献

{"title":"Chronic opioid use for noncancer pain and risk of cardiovascular events: a National Health Insurance database analysis.","authors":"Jeonggeun Moon, In Cheol Hwang, Hyunsun Lim, Youngmin Park","doi":"10.1097/MCA.0000000000001601","DOIUrl":"10.1097/MCA.0000000000001601","url":null,"abstract":"<p><strong>Objective: </strong>Although opioids primarily act on the central nervous system, they also affect the cardiovascular (CV) system. This study aimed to examine the association between long-term opioid use and the risk of CV events in individuals with noncancer pain.</p><p><strong>Methods: </strong>We conducted a nationwide observational cohort study using data from the Korean National Health Insurance Service, linked to the national health check-up database, between 2009 and 2018. Patients prescribed opioids for ≥90 days were defined as chronic users. After 1:10 propensity score matching, Cox proportional hazards models were used to estimate the risk of myocardial infarction (MI) and ischaemic stroke (IS), reported as hazard ratios (HRs) with 95% confidence intervals (CIs), compared to nonopioid users.</p><p><strong>Results: </strong>The final analysis included 36 300 opioid users and 334 590 matched controls. Chronic opioid use was significantly associated with increased risk of MI (HR 1.20, 95% CI: 1.12-1.30; P  = 0.001) and IS (HR 1.16, 95% CI: 1.12-1.21; P  < 0.001). Subgroup analyses indicated that the association between opioid use and CV events varied by factors such as prior major CV diseases, anticoagulant use, area of residence, and gabapentinoid use.</p><p><strong>Conclusion: </strong>Long-term opioid use in patients with noncancer pain is associated with an increased risk of CV events. These findings underscore the need for careful CV risk assessment when initiating or maintaining chronic opioid treatment.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"308-315"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of polymer-free versus biodegradable-polymer drug-eluting stents in percutaneous coronary intervention: an updated systematic review and meta-analysis.","authors":"Sebastian Jaramillo, Juan Pinilla, Francesco Stabile, Vinicius Bittar de Pontes, Mohammad Cheikh Ibrahim, Webster Donaldy, Wilton Gomes","doi":"10.1097/MCA.0000000000001602","DOIUrl":"10.1097/MCA.0000000000001602","url":null,"abstract":"<p><strong>Background: </strong>Biodegradable polymer drug-eluting stents (BP-DES) are currently used in percutaneous coronary intervention (PCI). Polymer-free drug-eluting stents (PF-DES) have the potential to mitigate any risk associated with BP-DES; however, the relative efficacy and safety of these interventions remain to be fully elucidated.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Cochrane Central was performed from inception to January 2025 to identify randomized controlled trials and observational studies comparing PF-DES with BP-DES in patients undergoing PCI. Heterogeneity was assessed using the I ² statistic. A two-sided P value less than 0.05 was considered statistically significant. Prespecified subgroup analyses were conducted based on follow-up duration.</p><p><strong>Results: </strong>A total of seven randomized controlled trials (RCTs) and four observational studies comprising 11 954 patients were included, of whom 5947 (49.7%) received PF-DES. In the pooled analysis, no statistically significant differences were observed between PF-DES and BP-DES in terms of cardiac death [risk ratio: 1.12, 95% confidence interval (CI): 0.96-1.31, P  = 0.15], target lesion failure (risk ratio: 1.09, 95% CI: 0.81-1.46, P  = 0.58), stent thrombosis (risk ratio: 0.90, 95% CI: 0.58-1.41, P  = 0.64), target lesion revascularization (risk ratio: 1.28, 95% CI: 0.81-2.02, P  = 0.28), or target vessel revascularization (risk ratio: 1.05, 95% CI: 0.70-1.58, P  = 0.79). Likewise, no significant subgroup effect was observed regarding longer-term follow-up outcomes.</p><p><strong>Conclusion: </strong>This meta-analysis found comparable safety and efficacy outcomes between PF-DES and BP-DES in patients undergoing PCI; however, further RCTs are needed to evaluate long-term outcomes and newer-generation stent models.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"316-326"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matrix metalloproteinase-1 and interleukin-17A are associated with previous plaque disruption: a combined proteomics and optical coherence tomography study.","authors":"Marco Covani, Giampaolo Niccoli, Takayuki Niida, Yoshiyasu Minami, Riccardo Scalamera, Daichi Fujimoto, Sunao Nakamura, Akihiro Nakajima, Kahraman Tanriverdi, Rocco Vergallo, Italo Porto, Iris McNulty, Hang Lee, Taishi Yonetsu, Ik-Kyung Jang","doi":"10.1097/MCA.0000000000001593","DOIUrl":"10.1097/MCA.0000000000001593","url":null,"abstract":"<p><strong>Objectives: </strong>Plaque disruption and subsequent healing are important contributors to coronary plaque progression; however, the biological mechanisms underlying this process remain incompletely understood. Optical coherence tomography (OCT) enables the identification of previously disrupted plaques, referred to as layered plaques. Proteomic analysis can characterize the molecular signature of layered plaques, providing insights into the biology of plaque disruption and healing. Furthermore, layered plaques indicate a more advanced stage of atherosclerotic disease, and their noninvasive identification could enhance patient risk stratification. This study aimed to identify plasma proteins associated with layered plaques at the culprit lesion in patients with stable angina pectoris (SAP).</p><p><strong>Methods: </strong>Patients undergoing coronary angiography and OCT for SAP, with periprocedural blood sample collection, were enrolled. A proteomic analysis was subsequently performed, assessing 1470 proteins using the Olink explore 1536 reagent kit.</p><p><strong>Results: </strong>Among 51 patients, OCT identified 31 (60.8%) patients with layered plaques at the culprit lesion. Patients with layered plaques exhibited 2.23- and 2.11-fold higher concentrations of interleukin-17A (IL17A) and matrix metalloproteinase-1 (MMP1), respectively ( P  = 0.013 and P  < 0.001), compared to those without layered plaques. Multivariable regression models demonstrated that IL17A and MMP1 were associated with layered plaques independent of known predictors (diameter stenosis > 70%, B2/C American College of Cardiology/American Heart Association lesion, and multivessel disease). Adding both proteins to the known predictors significantly improved the area under the curve (AUC) for layered plaque detection (AUC 0.831 vs. 0.581; P  = 0.007).</p><p><strong>Conclusion: </strong>In patients with SAP, IL17A, and MMP1 were independently associated with layered plaques identified by OCT.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"271-279"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Kawasaki coronary artery aneurysms and acute myocardial infarction: multimodal imaging.","authors":"Wei-Feng Yan, Xue-Ming Li, Zhi-Gang Yang","doi":"10.1097/MCA.0000000000001598","DOIUrl":"10.1097/MCA.0000000000001598","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"327-328"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial clinical evaluation of photon-counting detector computed tomography for coronary artery disease in Taiwan.","authors":"Ya-Wen Lu, Kang-Ling Wang, Yu-Wei Wang, Ming-Cheng Liu, Yun-Chung Cheng, Wen-Hsien Chen, David E Newby, Michelle C Williams, Wen-Lieng Lee, Jung-Hsuan Chen","doi":"10.1097/MCA.0000000000001591","DOIUrl":"10.1097/MCA.0000000000001591","url":null,"abstract":"<p><strong>Background: </strong>Photon-counting detector computed tomography (PCD-CT) is an emerging technology that improves dose efficiency, image resolution, and noise performance. We aimed to compare the safety and effectiveness of the first-generation PCD-CT with a third-generation energy-integrating detector computed tomography (EID-CT) for the detection of coronary artery disease in the participants from a health check programme in Taiwan.</p><p><strong>Methods: </strong>In this retrospective, single-centre study, we included 205 asymptomatic individuals undergoing coronary computed tomography angiography as part of their health screening: 103 with EID-CT in July 2024 and 102 with PCD-CT in January 2025. All scans were acquired using the helical mode. Radiation exposure, iodinated contrast volume, and referral outcomes were compared between those scanned with PCD-CT and with EID-CT.</p><p><strong>Results: </strong>Baseline characteristics were generally balanced between the two groups except for height, smoking habit, and plasma lipid and glucose concentrations. The PCD-CT group had a lower radiation dose indexed by dose length product (401.0 vs. 633.6 mGy·cm and 421.5 vs. 690.0 mGy·cm for the main scan and for the total procedure, respectively; both P  < 0.001) but received higher contrast volume (65.0 vs. 49.0 ml; P  < 0.001), as compared with the EID-CT group. All images were of good diagnostic quality, and the rates of referral to invasive coronary angiography (3.9 vs. 4.9%) were similar between the two groups ( P  > 0.999).</p><p><strong>Conclusions: </strong>The first-generation PCD-CT, compared with a third-generation EID-CT, offered a substantial reduction in radiation exposure without additional needs for invasive cardiac catheterisation. Further studies using contrast-optimisation technologies and dose-optimisation strategies are warranted to assess diagnostic quality.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"264-270"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High lipoprotein(a) attenuates the mortality benefit of elevated high-density lipoprotein cholesterol with sex-specific variation: a retrospective cohort study.","authors":"Hesham Sheashaa, Kamal Awad, Mohammed Tiseer Abbas, Juan M Farina, Milagros Pereyra Pietri, Isabel G Scalia, Nima Baba Ali, Nadera N Bismee, Sogol Attaripour Esfahani, Omar Ibrahim, Fatmaelzahraa Abdelfattah, Ahmed K Mahmoud, Mahmoud Abdelnabi, Ramzi Ibrahim, Steven Lester, Chadi Ayoub, Reza Arsanjani","doi":"10.1097/MCA.0000000000001589","DOIUrl":"10.1097/MCA.0000000000001589","url":null,"abstract":"<p><strong>Background: </strong>Elevated lipoprotein(a) [Lp(a)] and low high-density lipoprotein-cholesterol (HDL-C) are established cardiovascular (CV) risk factors, but their combined impact on mortality and sex differences remains unclear.</p><p><strong>Methods: </strong>This retrospective study analyzed 97 396 patients with measured Lp(a) and HDL-C. Groups were stratified by Lp(a) (≥50 vs. <50 mg/dl) and HDL-C [low (<40), optimal (40-60), high (>60 mg/dl)]. Mortality was assessed using the Kaplan-Meier curve and Cox models.</p><p><strong>Results: </strong>Over a median of 5.9 years, 7794 deaths occurred. Compared to optimal HDL-C/low Lp(a) (reference), high HDL-C/low Lp(a) had the lowest mortality [adjusted hazard ratio (aHR): 0.85; 95% confidence interval (CI): 0.80-0.91], while low HDL-C/high Lp(a) had the highest risk (aHR: 1.55; 1.41-1.71). High HDL-C protective effect was insignificant with elevated Lp(a) (aHR: 0.98; 0.89-1.08). Sex-stratified analyses revealed divergent effects: women with high HDL-C/high Lp(a) retained the HDL-C protective effect (aHR: 0.82; 0.72-0.93), whereas men faced increased risk (aHR: 1.22; 1.05-1.42).</p><p><strong>Conclusion: </strong>Elevated Lp(a) enhances mortality risk despite elevated HDL-C levels, with sex-specific differences: women retain mortality benefits from high HDL-C despite elevated Lp(a), whereas men with concurrent elevations in HDL-C and Lp(a) experienced mortality risks comparable to those with low HDL-C. Findings underscore sex-specific CV risk stratification incorporating HDL-C and Lp(a), challenging the HDL-C universal protective role.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"258-263"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic agreement of non-ECG-gated chest computed tomography for coronary artery calcium scoring: comparison with ECG-gated cardiac computed tomography using Agatston and volume methods.","authors":"Kotaro Ouchi, Toru Sakuma, Shota Tachioka, Hiroya Ojiri","doi":"10.1097/MCA.0000000000001592","DOIUrl":"10.1097/MCA.0000000000001592","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the agreement and comparative performance of non-ECG-gated computed tomography (CT) for coronary artery calcification (CAC) quantification compared with ECG-gated CT and to assess measurement variability between Agatston and volume scoring methods.</p><p><strong>Methods: </strong>In this retrospective diagnostic accuracy study, 130 patients undergoing pretranscatheter aortic valve implantation received both ECG-gated cardiac CT (3-mm slice) and non-ECG-gated chest CT (5-mm slice) in the same session. Agatston and volume scores were calculated for total CAC and individual vessels. Analyses included receiver operating characteristic curves, Pearson correlation, Fisher's z -transformation, Bland-Altman plots, and Deming regression.</p><p><strong>Results: </strong>Both methods showed excellent agreement for detecting high-risk CAC [Agatston: area under the curve (AUC), 0.994; volume: AUC, 0.996; P  = 0.24]. Correlation between ECG-gated and non-ECG-gated CT was very strong (Agatston: r  = 0.978; volume: r  = 0.981), with volume scoring significantly outperforming Agatston in the left anterior descending artery ( z = -2.02, P  = 0.044). Bland-Altman analysis revealed greater bias and wider limits of agreement for Agatston scores. Deming regression showed Agatston scores were consistently underestimated (slope = 0.61), whereas volume scores had slopes closer to unity (1.07), reflecting stronger agreement.</p><p><strong>Conclusion: </strong>Calcium quantification on non-ECG-gated CT demonstrated strong agreement with ECG-gated reference values. Volume scoring showed superior reproducibility and reduced susceptibility to variability inherent in non-ECG-gated imaging.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"280-288"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of crossover from transradial to transfemoral access in coronary angiography and intervention: insights from 9081 consecutive procedures.","authors":"Melike Oksak, Ibrahim Donmez, Emrah Acar, Isa Sincer, Yilmaz Gunes","doi":"10.1097/MCA.0000000000001596","DOIUrl":"10.1097/MCA.0000000000001596","url":null,"abstract":"<p><strong>Background: </strong>The transradial approach (TRA) for coronary angiography (CAG) and percutaneous coronary intervention (PCI) offers reduced bleeding, earlier mobilization, and improved comfort compared with the transfemoral approach (TFA). Anatomical and technical challenges may necessitate crossover to TFA, prolonging procedures and increasing complications.</p><p><strong>Objectives: </strong>To identify patient, lesion, and procedural predictors of TRA-to-TFA crossover in an all-comers cohort.</p><p><strong>Methods: </strong>This retrospective single-center study included all TRA CAG or PCI procedures between September 2020 and April 2023, excluding distal TRA, cardiogenic shock, mechanical support, prior radial harvest, or dialysis fistula indication. Demographic, clinical, and angiographic variables were compared between crossover and noncrossover patients. Independent predictors were identified by logistic regression.</p><p><strong>Results: </strong>Among 9081 TRA patients, 836 (9.2%) required crossover to TFA. Independent predictors included female sex [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.75-2.39], operator experience <2 years (OR 2.05, 95% CI 1.44-2.16), radial/brachial artery spasm (OR 1.37, 95% CI 0.78-1.59), lack of support (OR 1.24, 95% CI 0.94-1.62), PCI of circumflex-obtuse marginal (OM) territory (OR 4.76, 95% CI 1.68-8.33), bifurcation lesions (OR 2.54, 95% CI 1.23-5.25), moderate/severe calcification (OR 2.01, 95% CI 1.49-3.17), long lesions (OR 2.75, 95% CI 1.69-4.03), severely angulated lesions (OR 2.33, 95% CI 0.87-3.72), and chronic total occlusions (OR 2.86, 95% CI 1.21-5.29).</p><p><strong>Conclusion: </strong>Although TRA offers multiple advantages, specific patient, lesion, and procedural factors significantly increase crossover risk. Recognizing these predictors preprocedurally may optimize access strategy, reducing procedure time, radiation exposure, and complications.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"289-296"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing distal radial access: clinical and anatomical predictors of failure from the multicenter DISTAL registry.","authors":"Kristian Rivera, Diego Fernández-Rodríguez, Juan Bullones, Susana Gorriño, Juan Casanova-Sandoval, Marcos Garcia-Guimarães, Esther Papiol, Tania Ramírez-Martínez, Humberto Coimbra, Joan Costa-Mateu, María Tornel-Cerezo, Alejandro Sánchez Espino, Fernando Worner, José Luis Ferreiro","doi":"10.1097/MCA.0000000000001599","DOIUrl":"10.1097/MCA.0000000000001599","url":null,"abstract":"<p><strong>Background: </strong>Distal radial access (DRA) is a promising alternative to conventional transradial access for coronary procedures, offering fewer vascular complications, shorter hemostasis, and greater patient comfort. However, the predictors of DRA failure remain insufficiently defined. This study aimed to evaluate the feasibility, safety, and predictors of DRA failure in an all-comer population and to develop an evidence-based strategy to optimize procedural success.</p><p><strong>Methods: </strong>A prospective multicenter cohort included 1387 patients who underwent 1454 coronary procedures through DRA between August 2020 and September 2024. Multivariate logistic regression and conditional inference trees (CITs) were used to identify and visualize independent predictors of failure.</p><p><strong>Results: </strong>DRA was successful in 96.5% of cases, with 99% of coronary procedures completed through the initial access. Access-related complications were infrequent (2.5%), including 0.8% inhospital radial artery occlusion. Weak distal radial pulse was the strongest independent predictor of failure (odds ratio: 10.07, 95% confidence interval: 5.22-20.21; P  < 0.001), while preprocedural ultrasound (US) evaluation, US-guided puncture, right-sided access, and operator experience independently predicted success. US guidance markedly improved outcomes in patients with weak pulses (98.2% vs. 61.0%; P  < 0.001). The learning curve plateaued after 60 cases.</p><p><strong>Conclusion: </strong>DRA is a safe, feasible, and effective access strategy for coronary procedures in an all-comer population. The success of the procedure depends on the strength of the arterial pulse, the US guidance, and the experience of the operator. The CIT-derived evidence-based framework provides a practical and reproducible approach to optimize access-site selection and improve procedural outcomes.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"297-307"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the incidence of heart failure following drug-eluting stent use in patients with high bleeding risk: a population-based cohort study.","authors":"Li-Nien Chien, Yan-Jun Chen, Ya-Hui Chang, Chao-Feng Lin","doi":"10.1097/MCA.0000000000001588","DOIUrl":"10.1097/MCA.0000000000001588","url":null,"abstract":"<p><strong>Objective: </strong>Features of high bleeding risk (HBR) determined by the Academic Research Consortium (ARC) are linked to an enhanced risk of bleeding events among patients undergoing percutaneous coronary intervention. This population-based study investigated whether patients with ARC-HBR are at an increased risk of hospitalization for heart failure (HHF) following drug-eluting stent (DES) implantation by analyzing a large-scale national healthcare database.</p><p><strong>Methods: </strong>A total of 124 891 patients undergoing DES implantation between 1 January 2007 and 31 December 2019 were identified and divided into two groups: the ARC-HBR group and the non-ARC-HBR group. The incidence rates of HHF of patients were observed. The risk of HHF following DES implantation associated with ARC-HBR features was analyzed using a multivariable Cox proportional hazards model.</p><p><strong>Results: </strong>The incidence rates (per 1000 person-year) of HHF were 86.9 [95% confidence interval (CI): 84.3-89.6] for ARC-HBR patients and 28.8 (95% CI: 28.3-29.3) for non-ARC-HBR patients during a mean follow-up of 4.6 ± 2.9 years. After adjustment for clinical variables, ARC-HBR patients exhibited an increased risk of HHF [adjusted hazard ratio (aHR): 1.13, 95% CI: 1.08-1.19, P  < 0.001], particularly among patients without a prior history of HHF (aHR: 1.31, 95% CI: 1.24-1.39, P  < 0.001). These results remained consistent for patients who adhered to greater than or equal to 6 months of dual antiplatelet therapy.</p><p><strong>Conclusion: </strong>ARC-HBR patients exhibited a higher risk of HHF following DES implantation than non-ARC-HBR patients. These results highlight that the ARC-HBR feature is of clinical importance in identifying individuals at a heightened risk of developing HHF following DES implantation.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"249-257"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}