{"title":"Lipoprotein(a)-associated thrombus formation and plaque healing in acute coronary syndromes: insights from optical coherence tomography.","authors":"Yusaku Shibata, Osamu Kurihara, Nobuaki Kobayashi, Fumitaka Okajima, Masamichi Takano, Kuniya Asai","doi":"10.1097/MCA.0000000000001637","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001637","url":null,"abstract":"<p><strong>Background: </strong>Elevated lipoprotein(a) levels are associated with myocardial infarction; however, in-vivo evidence linking lipoprotein(a) to intracoronary thrombosis remains limited. We evaluated phase-specific lipoprotein(a) levels during the hyperacute, acute, and stable phases of acute coronary syndrome and their associations with angiographic and optical coherence tomography findings.</p><p><strong>Methods: </strong>We analyzed 142 patients with acute coronary syndrome who underwent optical coherence tomography during percutaneous coronary intervention and for whom lipoprotein(a) was measured in the hyperacute (n = 58), acute (n = 125), or stable (n = 51) phases.</p><p><strong>Results: </strong>Baseline demographics, laboratory data, angiographic findings, and optical coherence tomography characteristics were similar across phases. Patients with intracoronary thrombus had significantly higher hyperacute-phase lipoprotein(a) levels than did those without [10.2 (interquartile range: 5.4-18.8) vs. 3.7 (3.0-10.3) mg/dl; P = 0.033]. In addition, a greater increase in lipoprotein(a) from the hyperacute to the acute phase was associated with thrombus presence [12.1 (4.0-18.4) vs. 2.35 (0.0-7.1) mg/dl; P = 0.027]. Conversely, patients with layered plaque on acute-phase optical coherence tomography demonstrated significantly lower stable-phase lipoprotein(a) levels than did those without [4.1 (3.0-7.1) vs. 13.0 (5.7-21.3) mg/dl; P = 0.014]. No significant associations were observed for acute-phase lipoprotein(a) levels.</p><p><strong>Conclusion: </strong>Elevated hyperacute-phase lipoprotein(a) levels were associated with intracoronary thrombus, whereas low stable-phase lipoprotein(a) levels were associated with layered plaque. These phase-specific relationships suggest that lipoprotein(a) influences thrombosis and plaque healing in acute coronary syndrome, and that stable-phase lipoprotein(a) levels may better reflect baseline biology and help identify prior subocclusive events.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616019","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":"Long-term evolution of a 5-cm giant right coronary artery-to-left ventricular fistula: a 6-year clinical follow-up.","authors":"Zhenzhen Xiao, Xiaojing Ma, Li Zhu","doi":"10.1097/MCA.0000000000001633","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001633","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497764","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}
Antonios Kouparanis, Konstantinos C Theodoropoulos, Anastasia Nikolaidou, Emmanouil Fardoulis, Matthaios Didagelos, Stefanos Charitos, George Kassimis, Antonios Ziakas
{"title":"ST-elevation myocardial infarction due to spontaneous coronary artery dissection of a septal perforator branch accompanied by severe rhythm disturbances.","authors":"Antonios Kouparanis, Konstantinos C Theodoropoulos, Anastasia Nikolaidou, Emmanouil Fardoulis, Matthaios Didagelos, Stefanos Charitos, George Kassimis, Antonios Ziakas","doi":"10.1097/MCA.0000000000001628","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001628","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376358","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}
Mustafa Tunahan Öz, Revan Israfilov, Umut Şahin, Adnan Kaya
{"title":"Comment on 'Mechanistic insights into lumen reduction after implantation of a drug-eluting bioresorbable metallic scaffold assessed with serial intracoronary imaging: from the OPTIMIS trial'.","authors":"Mustafa Tunahan Öz, Revan Israfilov, Umut Şahin, Adnan Kaya","doi":"10.1097/MCA.0000000000001630","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001630","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347474","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}
Coronary artery diseasePub Date : 2026-03-01Epub Date: 2025-07-31DOI: 10.1097/MCA.0000000000001558
Cihan Yücel, Serkan Ketenciler, Yaşar Gökkurt, İlhan Ozgol, İkra Gol, Mehmet Ali Yesiltas
{"title":"Evaluation of the relationship between carotid artery stenosis and CALLY index in patients undergoing isolated coronary artery bypass surgery.","authors":"Cihan Yücel, Serkan Ketenciler, Yaşar Gökkurt, İlhan Ozgol, İkra Gol, Mehmet Ali Yesiltas","doi":"10.1097/MCA.0000000000001558","DOIUrl":"10.1097/MCA.0000000000001558","url":null,"abstract":"<p><strong>Background: </strong>Carotid artery stenosis is a significant predictor of perioperative stroke risk in patients undergoing coronary artery bypass grafting (CABG). Identifying noninvasive, simple, and clinically relevant biomarkers for risk stratification is crucial in this population. The CALLY index, a composite marker reflecting systemic inflammation and nutritional status, has shown prognostic value in various diseases. However, its relationship with carotid artery stenosis in patients undergoing isolated CABG remains unclear. This study aimed to evaluate the relationship between carotid artery stenosis and the CALLY index in patients undergoing isolated CABG.</p><p><strong>Methods: </strong>This retrospective, single-center study included 820 patients who underwent isolated CABG and preoperative carotid Doppler ultrasonography between January 2020 and December 2024. The degree of carotid artery stenosis was classified into three groups (<50, 50-70, >70%). CALLY index values were calculated using lymphocyte count, albumin, and C-reactive protein (CRP) levels. Statistical analyses included Kruskal-Wallis H and Spearman's rank correlation tests.</p><p><strong>Results: </strong>The CALLY index was significantly lower in patients with higher degrees of carotid artery stenosis ( P < 0.001). A strong negative correlation was found between the CALLY index and carotid stenosis severity (Spearman's rho = -0.831, P < 0.001).</p><p><strong>Conclusion: </strong>Low CALLY index values are significantly associated with the presence and severity of carotid artery stenosis in patients undergoing isolated CABG. The CALLY index may serve as a simple and practical biomarker for preoperative risk assessment, aiding in the identification of high-risk patients and potentially improving surgical outcomes.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"78-83"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741429","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}
Coronary artery diseasePub Date : 2026-03-01Epub Date: 2025-09-01DOI: 10.1097/MCA.0000000000001572
Andrew P Rabenstein, Rishabh Matta, Brent A Williams, Jeanette Brocious, Rodrigo Campana, Aryan Meknat, Sean Forrest, Stephen Bailey, Michael S Halbreiner
{"title":"Association between perioperative prealbumin level and outcomes in coronary bypass surgery patients.","authors":"Andrew P Rabenstein, Rishabh Matta, Brent A Williams, Jeanette Brocious, Rodrigo Campana, Aryan Meknat, Sean Forrest, Stephen Bailey, Michael S Halbreiner","doi":"10.1097/MCA.0000000000001572","DOIUrl":"10.1097/MCA.0000000000001572","url":null,"abstract":"<p><strong>Background: </strong>Albumin and BMI have been used as nutritional markers of morbidity and mortality. Recently, prealbumin has grown in interest in other surgical disciplines, but less so in cardiac surgery. Thus, this study examined the association between prealbumin and bleeding, mortality, and readmission in coronary artery bypass graft (CABG) patients.</p><p><strong>Methods: </strong>A retrospective review was performed on all patients undergoing CABG at a single institution from July 2017 to December 2021. Study patients underwent CABG as part of an isolated or combined procedure and had a perioperative prealbumin measurement. The primary study endpoints were intra- and post-operative bleeding, and mortality and hospital readmission within 30 days.</p><p><strong>Results: </strong>A total of 1211 patients underwent CABG surgery and had a documented perioperative prealbumin. Prealbumin levels were stratified as ≤10, 10-15, 15-20, or >20 mg/dl. There were no differences across prealbumin groups in preoperative antiplatelet use, anticoagulant use, or concomitant procedures. Patients with low prealbumin were more likely to be older, female, and to have an urgent myocardial infarction presentation with lower preoperative BMI and albumin. In adjusted models including albumin and BMI, CABG patients with prealbumin ≤10 mg/dl were more likely to receive any intraoperative [odds ratio (OR) = 3.11, 95% confidence interval (CI): 1.43, 6.75] or postoperative transfusion (OR = 2.54, 95% CI: 1.27, 5.08) compared to patients with prealbumin >20 mg/dl. Patients with a lower prealbumin had higher 30-day mortality ( P < 0.001) and readmission rates ( P = 0.06).</p><p><strong>Conclusion: </strong>Perioperative prealbumin levels were associated with blood transfusions, mortality, and readmissions in CABG patients.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"127-132"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014076","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}
Coronary artery diseasePub Date : 2026-03-01Epub Date: 2025-11-03DOI: 10.1097/MCA.0000000000001581
Matthaios Didagelos, Andreas S Papazoglou, Dimitrios V Moysidis, Areti Pagiantza, Dimitrios Afendoulis, Charalambos Kakderis, Stylianos Daios, Vasileios Anastasiou, Konstantinos C Theodoropoulos, Antonios Kouparanis, Athanasios Kartalis, Vasileios Kamperidis, George Kassimis, Antonios Ziakas
{"title":"Radial artery occlusion after cardiac catheterization and impact of anticoagulation as medical treatment: a meta-analysis.","authors":"Matthaios Didagelos, Andreas S Papazoglou, Dimitrios V Moysidis, Areti Pagiantza, Dimitrios Afendoulis, Charalambos Kakderis, Stylianos Daios, Vasileios Anastasiou, Konstantinos C Theodoropoulos, Antonios Kouparanis, Athanasios Kartalis, Vasileios Kamperidis, George Kassimis, Antonios Ziakas","doi":"10.1097/MCA.0000000000001581","DOIUrl":"10.1097/MCA.0000000000001581","url":null,"abstract":"<p><strong>Background: </strong>Radial artery occlusion (RAO) is one of the most common complications associated with transradial access in cardiac catheterization procedures. To date there are no standardized protocols, and only a few studies have evaluated the use of anticoagulation for RAO treatment. The current meta-analysis aimed to assess the impact of various anticoagulation strategies on RAO treatment after cardiac catheterization via the transradial route.</p><p><strong>Methods: </strong>Literature search was performed in PubMed, Web of Science, and CENTRAL databases, from inception until September 2024. The primary outcome of this study was the incidence of radial artery recanalization. The secondary outcomes were the incidence of any bleeding events and symptom resolution during patient follow-up.</p><p><strong>Results: </strong>A total of six studies with 398 patients were included in the analysis. Patients with RAO under anticoagulation had a sevenfold increased chance of radial artery recanalization [pooled odds ratio (pOR) = 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there was no statistically significant difference between patients receiving and not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41]. Regarding bleeding events, no pooled data could be extracted; however, no major bleeding events were reported in any study.</p><p><strong>Conclusion: </strong>This meta-analysis provides compelling evidence that anticoagulation therapy significantly improves radial artery recanalization rates in patients with RAO without increasing the risk of major bleeding events; however, its effect on symptom resolution remains limited, suggesting the need for a comprehensive approach to RAO management.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"133-141"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430330","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}
Coronary artery diseasePub Date : 2026-03-01Epub Date: 2025-11-17DOI: 10.1097/MCA.0000000000001595
Mucahit Yetim, Abdülmelik Birgün, Abdullah Sarihan, Macit Kalçik, Muhammet Cihat Çelik, Lütfü Bekar, Yusuf Karavelioğlu
{"title":"Current evidence and future directions in antiplatelet therapy for spontaneous coronary artery dissection: balancing ischemic and bleeding risks.","authors":"Mucahit Yetim, Abdülmelik Birgün, Abdullah Sarihan, Macit Kalçik, Muhammet Cihat Çelik, Lütfü Bekar, Yusuf Karavelioğlu","doi":"10.1097/MCA.0000000000001595","DOIUrl":"10.1097/MCA.0000000000001595","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) has emerged as an increasingly recognized cause of acute coronary syndromes (ACSs), particularly in young women without traditional atherosclerotic risk factors. While conservative management has become the preferred strategy in most stable patients, the role of antiplatelet therapy in this unique setting remains uncertain. Current clinical practice often extrapolates from ACS guidelines, recommending aspirin monotherapy or dual antiplatelet therapy, despite a paucity of direct evidence. Observational registries have provided conflicting results, with some suggesting a benefit of antiplatelet therapy in reducing recurrent ischemic events, whereas others highlight the potential risks of intramural hematoma propagation and bleeding. This review aims to critically examine the available literature on antiplatelet therapy following conservatively managed SCAD, highlighting mechanistic rationale, guideline perspectives, registry data, and evolving clinical approaches. The discussion emphasizes the need for individualized therapy, the limitations of current evidence, and the urgent requirement for randomized controlled trials to establish optimal antiplatelet strategies in this unique population.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"149-156"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533875","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}