Coronary artery disease最新文献

{"title":"The value of fractional flow reserve based on coronary computed tomography angiography with low-dose contrast agent in noninvasive diagnosis of coronary artery disease.","authors":"Zengkun Wang, Xiaomei Luan, Qian Zhang, Chu Chu, Xiaodie Xu, Huijing Chai, Peiji Song","doi":"10.1097/MCA.0000000000001448","DOIUrl":"10.1097/MCA.0000000000001448","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed, using invasive coronary angiography (ICA) as the gold standard, to investigate the noninvasive diagnostic value of flow reserve fraction derived from coronary computed tomography angiography (CCTA) with low-dose contrast agent in coronary artery disease (CAD).</p><p><strong>Methods: </strong>A total of 163 patients with clinical symptoms related to CAD were enrolled between 1 January 2022 and 30 January 2023. The patients received CCTA with a low dose of contrast agent to rule out CAD. If significant (CCTA ≥ 50%) stenosis is suspected, ICA is performed to further evaluate the CCTA for coronary lesions. CT-FFR is calculated from the CCTA dataset using a machine learning-based algorithm. Compared with ICA as a reference standard, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of low-dose contrast agent CT-FFR in the diagnosis of myocardial ischemia were calculated. Coronary lesions with CT-FFR ≤0.80 were defined as hemodynamically significant.</p><p><strong>Results: </strong>Obstructive CAD was excluded by low-contrast CCTA in 87 of 163 patients (53.7%). In the remaining 75 patients (42.35%), at least one coronary artery stenosis was greater than 50%. The accuracy, sensitivity, specificity, PPV, and NPV of low-dose contrast agent CT-FFR on a patient-based evaluation in diagnosing CAD were 93.06, 93.44, 90.01, 98.28, and 71.43%, respectively (Kappa = 0.759). The accuracy, sensitivity, specificity, PPV, and NPV of low-dose contrast agent CT-FFR on a vessel-based evaluation in diagnosing CAD were 86.72, 82.76, 91.58, 92.31, and 81.31%, respectively (Kappa = 0.735). Pearson correlation analysis showed that the ICA examination had a good correlation with CT-FFR value of low-dose contrast media ( r  = 0.731, P  < 0.01). Moreover, in 81.31% of cases, additional analysis of CT-FFR correctly excluded the hemodynamic significance of stenosis.</p><p><strong>Conclusion: </strong>CT-FFR based on low-dose contrast agent CCTA is a very promising noninvasive approach to exclude hemodynamically significant coronary artery stenosis in patients with suspected coronary heart disease while reducing renal burden and helping to reduce the rate of ICA in this high-risk population.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"158-165"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767099","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":"Observance of rare congenital anomaly: dual right coronary artery.","authors":"Rachelle Bishay, Jairo Aldana-Bitar, Matthew J Budoff","doi":"10.1097/MCA.0000000000001423","DOIUrl":"10.1097/MCA.0000000000001423","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"178-179"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281588","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":"Comment on: 'The triglyceride-glucose index as a new predictor of coronary artery complexity in elderly patients with non-ST-segment elevation acute coronary syndrome'.","authors":"Cihan Aydin, Mesut Engin, Aykut Demirkiran","doi":"10.1097/MCA.0000000000001482","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001482","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 2","pages":"177"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064232","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":"Timing of coronary angiography in high-risk non-ST-elevation acute coronary syndrome: results from the Portuguese Registry for Acute Coronary Syndromes (ProACS).","authors":"Catarina Ribeiro Carvalho, Marta Catarina Bernardo, Isabel Martins Moreira, Pedro Mateus, Ana Baptista, Ilídio Moreira","doi":"10.1097/MCA.0000000000001457","DOIUrl":"10.1097/MCA.0000000000001457","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend an early invasive coronary angiography (ICA) within 24 h of admission for high-risk patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Nevertheless, meta-analyses failed to demonstrate a clear advantage of this strategy in reducing hard endpoints such as death or nonfatal myocardial infarction compared to a delayed approach. Thus, the optimal timing of ICA in high-risk NSTE-ACS remains undetermined.</p><p><strong>Objective: </strong>This study aimed to determine the optimal timing for ICA in high-risk NSTE-ACS, regarding 1-year all-cause mortality and cardiovascular rehospitalizations.</p><p><strong>Methods: </strong>We conducted a national multicenter retrospective study of high-risk NSTE-ACS patients included in the Portuguese Registry for Acute Coronary Syndromes. Patients were divided into three groups according to the time of ICA: within the first 24 h, between 24 and 48 h, and between 48 and 72 h. The incidence of in-hospital complications and mortality, 1-year mortality, and cardiovascular rehospitalizations were assessed.</p><p><strong>Results: </strong>Of the 9949 patients included, 46.7% underwent early ICA. This was associated with a lower incidence of acute heart failure (8.5% vs. 11.1% vs. 11.5%, P  < 0.001) and shorter length of stay (3 vs. 4 vs. 6 days, P  = 0.012). It, however, did not reduce in-hospital complications or mortality (1.2 vs. 0.7 vs. 0.8%, P  = 0.066). We also found no significant association with the composite endpoint of 1-year mortality or cardiovascular rehospitalization (15.1 vs. 15.9 vs. 15.7%, P  = 0.887).</p><p><strong>Conclusions: </strong>Early ICA was associated with a lower incidence of acute heart failure and shorter length of stay, without a significant impact on 1-year mortality risk or cardiovascular rehospitalizations.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"166-172"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590371","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":"Impact of the fibrosis-4 index in patients with ST-elevated myocardial infarction.","authors":"Naoki Shibata, Takanori Ito, Yasuhiro Morita, Hidenori Toyoda, Yasunori Kanzaki, Naoki Watanabe, Naoki Yoshioka, Hiroyuki Miyazawa, Kazuki Shimojo, Takuma Ohi, Hiroki Goto, Hoshito Karasawa, Itsuro Morishima","doi":"10.1097/MCA.0000000000001431","DOIUrl":"10.1097/MCA.0000000000001431","url":null,"abstract":"<p><strong>Background: </strong>The fibrosis-4 (FIB4) index, a simple, noninvasive marker used for hepatic diseases, represents adverse outcomes. The aim of the present study was to evaluate whether the FIB4 index can predict adverse outcomes in patients with ST-elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>We investigated patients with STEMI who underwent primary percutaneous coronary intervention (PCI) and were alive at discharge. The cut-off FIB4 index at discharge was investigated using the survival classification and regression tree (CART) model to predict adverse outcomes. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Between January 2006 and December 2018, 1354 patients with STEMI (median age, 68 years; men, 76.1%) were investigated. The median value of the FIB4 index was 1.21 (0.84-1.78). The CART model divided the study population into low (FIB4 index <0.945; n  = 435), intermediate (0.945 ≤ FIB4 index < 2.185; n  = 692), and high (FIB4 index ≥2.185; n  = 227) groups based on the significant predictive values for all-cause death. During a median follow-up period of 4.3 years, all-cause death occurred in 208 patients (15.4%). The Kaplan-Meier analysis showed a significant increase in mortality with higher FIB4 index values (log-rank, P  < 0.001). The multivariate Cox regression model revealed that the FIB4 index was an independent risk predictor for all-cause death in patients with STEMI [low group as reference vs. intermediate group, hazard ratio: 1.975; 95% confidence interval (CI): 1.166-3.346; P  = 0.011 and vs. high group, hazard ratio: 4.633; 95% CI: 2.549-8.418; P  < 0.001].</p><p><strong>Conclusions: </strong>The FIB4 index was associated with the risk of all-cause mortality in patients with STEMI who underwent primary PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"99-107"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380239","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":"Drug-coated balloon coronary angioplasty: where are we going?","authors":"Fernando Alfonso, Islam Y Elgendy, Bernardo Cortese","doi":"10.1097/MCA.0000000000001474","DOIUrl":"10.1097/MCA.0000000000001474","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"173-176"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845872","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":"Congenital systemic and coronary-to-pulmonary artery fistulas with a coronary aneurysm rupture.","authors":"Leizhi Ku, Zheng Liu, Xiaojing Ma","doi":"10.1097/MCA.0000000000001516","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001516","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522772","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":"Clinical outcomes of rotational atherectomy followed by cutting balloon for calcified coronary lesions.","authors":"Tingquan Zhou, Xian Jin, Shixin Ma, Jiming Han, Chengxing Shen","doi":"10.1097/MCA.0000000000001515","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001515","url":null,"abstract":"<p><strong>Objective: </strong>Rotational atherectomy is an effective method for treating severe coronary artery calcification; however, several challenges in its clinical application persist. This study aimed to compare the safety and effectiveness of rotational atherectomy combined with cutting balloon (RACB) versus rotational atherectomy with plain balloon (RAPB) in patients with heavily calcified coronary lesions.</p><p><strong>Methods: </strong>This retrospective observational cohort study included 326 patients who underwent rotational atherectomy at Shanghai Sixth People's Hospital from January 2016 to December 2022. Patients were divided into two groups (RACB and RAPB) on the basis of the type of balloon used. The primary outcome was the incidence of major adverse cardiovascular events (MACE) 1 year after percutaneous coronary intervention. Propensity score matching (PSM) was applied to minimize bias, and survival analyses were performed with the Cox proportional hazards model.</p><p><strong>Results: </strong>The procedural complication rates of the patients in the RACB and RAPB groups were comparable. Baseline covariates were balanced between groups after adjustment via PSM. Patients receiving RACB during their procedures had a lower MACE rate during the first postprocedural year in the unadjusted analysis (6.7% vs 16.2%, P < 0.05) and after adjustment with PSM (5.6% vs 16.1%, P < 0.01). The Kaplan-Meier survival curves revealed hazard ratios of 0.44 (95% CI: 0.23-0.82; P < 0.05) for the unadjusted model and 0.36 (95% CI: 0.17-0.76; P < 0.01) for the PSM-adjusted model.</p><p><strong>Conclusion: </strong>Performing RACB before stent implantation was demonstrated to be a safe and effective strategy for managing severely calcified coronary lesions.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467127","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":"Arteria lusoria: a rare challenge to coronary angiography.","authors":"Anderson Ariaga, Pradnya Brijmohan Bhattad, Eddison Ramsaran","doi":"10.1097/MCA.0000000000001511","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001511","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381826","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":"Coronary artery dominance influences the distribution of calcified plaques in the coronary tree.","authors":"Leili Pourafkari, Salman Ansari, April Kinninger, Matthew J Budoff","doi":"10.1097/MCA.0000000000001500","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001500","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery dominance is determined by the coronary artery emitting the posterior descending artery. In the left dominant system, a greater proportion of coronary flow enters the left coronary artery, potentially influencing calcified plaque development in the left anterior descending artery (LAD).</p><p><strong>Methods: </strong>This retrospective single-center cohort study analyzed patients who underwent computed tomography angiography from September 2006 to December 2022 at Harbor-UCLA in Los Angeles, California. Coronary artery calcium (CAC) was quantified for the three coronary vessels. The LAD calcium score was divided by the total calcium score to calculate the LAD calcium percentage, which was compared between left and right dominant coronary systems. Multivariable linear regression assessed the association between LAD calcium percentage and coronary dominance, adjusting for age, gender, BMI, hyperlipidemia, hypertension, family history of cardiovascular disease, and past smoking.</p><p><strong>Results: </strong>Among 9560 subjects, 6766 with CAC greater than zero were enrolled. The average age was 64.8 ± 10.7 years: 68% were male, and 9% had left dominant coronary systems. The median CAC was 51 [0-352] in the right dominant and 49 [0-358] in the left dominant system (P = 0.73). Adjusted analysis revealed that individuals with left dominant coronary systems had a 10.1% higher (CI 7.5-12.8%, P < 0.001) LAD calcium percentage than those with right dominant systems.</p><p><strong>Conclusion: </strong>Although coronary dominance does not influence overall plaque burden of atherosclerosis, it affects calcified plaque distribution. The left dominant system is associated with a higher proportion of calcified plaque in the LAD, potentially heightening the risk of adverse cardiovascular events.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058439","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}