Coronary artery disease最新文献

{"title":"Feasibility of an artificial intelligence based fractional flow reserve assessment for coronary artery disease.","authors":"Chun-Chin Chang, Song-Po Chen, Ya-Wan Lu, Wei-Ting Sung, Ting-Yung Chang, Ruey-Hsing Chou, Shu-Mei Guo, Po-Hsun Huang","doi":"10.1097/MCA.0000000000001647","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001647","url":null,"abstract":"<p><strong>Background: </strong>The implementation of artificial intelligence has been investigated in many aspects of cardiovascular disease.</p><p><strong>Objectives: </strong>To develop deep learning models based on coronary angiograms to detect functionally significant coronary stenoses.</p><p><strong>Methods: </strong>A total of 610 frames from 122 coronary arteries that received pressure wire-based fractional flow reserve (FFR) assessment were analyzed. Deep learning models were developed for the segmentation and classification of coronary stenoses. Both internal and external validation of the deep learning models were performed.</p><p><strong>Results: </strong>The mean FFR value was 0.84 ± 0.08. The artificial intelligence-based FFR was significantly correlated with wire-based FFR with an average correlation coefficient of 0.68 and a mean absolute error of 0.05. The diagnostic performance of artificial intelligence-based FFR versus wire-based FFR was accuracy 87.6%, F1 score = 83.6%, and recall = 81.1%. The artificial intelligence-based FFR showed good discriminative performance with an area under the receiver operating characteristic curve of 86.5% (95% CI: 79.3-93.6).</p><p><strong>Conclusion: </strong>The artificial intelligence-based FFR showed moderate agreement with pressure wire-based FFR and showed promising diagnostic performance in the internal cohort, although reduced performance was observed in external validation, warranting further refinement and multicenter validation.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834296","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":"The clinical role and regulatory mechanism of KMT2E-AS1 in coronary heart disease.","authors":"Jie Zhang, Yue Bai, Lixin Wang, Yiming Ren, Ya Zhong","doi":"10.1097/MCA.0000000000001646","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001646","url":null,"abstract":"<p><strong>Objective: </strong>Coronary heart disease (CHD) is a common cardiovascular disease with high incidence and mortality rates. This study aims to explore the role of KMT2E-AS1 in the progression of CHD and its potential regulatory mechanisms.</p><p><strong>Methods: </strong>The research included 135 CHD patients and 103 healthy volunteers. And CHD patients were categorized into major adverse cardiovascular events (MACE) and non-MACE groups. Differential expression of KMT2E-AS1 in various groups and its diagnostic value were analyzed. Correlation of KMT2E-AS1 expression with myocardial injury markers was investigated. The predictive potential of KMT2E-AS1 for MACE risk was evaluated. The interaction between KMT2E-AS1 and miR-2681-5p was verified, and their effects on human aortic smooth muscle cells (HASMCs) proliferation, inflammation, and oxidative stress response were examined.</p><p><strong>Results: </strong>KMT2E-AS1 is significantly downregulated in the CHD and MACE group. KMT2E-AS1 is significantly negatively correlated with myocardial injury markers, such as Gensini score, creatine kinase-myocardial band, cardiac troponin I, and N-terminal pro-B-type natriuretic peptide. KMT2E-AS1 exhibits favorable diagnostic performance for the occurrence of CHD and serves as an independent protective factor against MACE following surgery. KMT2E-AS1 directly targets and regulates miR-2681-5p. Moreover, KMT2E-AS1 overexpression promotes proliferation, alleviates inflammation, and oxidative stress response in oxidized low-density lipoprotein-induced HASMCs, while miR-2681-5p overexpression counteracts the effects of KMT2E-AS1 overexpression.</p><p><strong>Conclusion: </strong>KMT2E-AS1 is a promising biomarker for predicting CHD occurrence and postoperative MACE risk. KMT2E-AS1 protects HASMCs and inhibits CHD progression by targeting miR-2681-5p.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834517","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 aspiration catheter size on thrombus removal and slow-flow/no-reflow in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Phutharet Chaturonrutsamee, Panuwat Lertlaksameewilai, Numchai Numkiatsakul","doi":"10.1097/MCA.0000000000001580","DOIUrl":"10.1097/MCA.0000000000001580","url":null,"abstract":"<p><strong>Background: </strong>Thrombus aspiration during primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients with a high thrombus burden remains an important clinical consideration. This study aimed to evaluate the impact of aspiration catheter size on thrombus removal and the slow-flow/no-reflow phenomenon.</p><p><strong>Methods: </strong>This retrospective study included 208 STEMI patients presenting within 12 h of symptom onset with high thrombus burden. All underwent primary PCI with thrombus aspiration. Patients were divided based on catheter size: 7-French ( n = 85) and 6-French ( n = 123). Clinical characteristics, procedural outcomes, and angiographic results were compared. Multivariate logistic regression identified independent predictors of slow-flow/no-reflow.</p><p><strong>Results: </strong>Patients treated with a 7-French catheter had a lower incidence of slow-flow/no-reflow after stent deployment (14.0 vs. 36.6%; P < 0.001) and postdilatation (25.0 vs. 55.2%; P = 0.003). Final thrombolysis in myocardial infarction 3 flow was more frequently achieved in the 7-French group (100 vs. 90.2%; P = 0.032). History of stroke or transient ischemic attack [odds ratio (OR): 5.16; P = 0.021] and ischemic time greater than 330 min (OR: 2.13; P = 0.032) were predictors of no-reflow, while use of a 7-French catheter was protective (OR: 0.26; P < 0.001).</p><p><strong>Conclusion: </strong>In STEMI patients with high thrombus burden, using a 7-French aspiration catheter was associated with higher procedural success and lower incidence of slow-flow/no-reflow. Larger-caliber catheters may offer a clinical advantage in selected patients undergoing primary PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"222-228"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426640","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":"The effects of delays at each stage of care on mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Omid Rafizadeh, Saghar Erfani, Sobhan Zarbafti, Sahel Erfani","doi":"10.1097/MCA.0000000000001578","DOIUrl":"10.1097/MCA.0000000000001578","url":null,"abstract":"<p><strong>Background: </strong>Timely restoration of blood flow is critical for ST-segment elevation myocardial infarction (STEMI) management. We evaluate the effects of time intervals - total ischemic time, time from symptom onset to first medical contact, delay within the healthcare system, and time from hospital arrival to balloon inflation and from arrival at the catheterization laboratory to balloon inflation - on in-hospital mortality among patients with STEMI undergoing primary percutaneous coronary intervention.</p><p><strong>Methods: </strong>We analyzed data from 315 patients with STEMI who underwent primary percutaneous coronary intervention in a hospital between 2020 and 2021. A random forest model was used to assess the predictive importance of time delay components for in-hospital mortality.</p><p><strong>Results: </strong>Of the total sample, 35 patients died. The median (interquartile range) for total ischemic time was 310.0 (215.0-547.5) min. Univariate analysis showed significant differences between the two groups in time to first medical contact [120.0 (60.0-245.0) vs. 210.0 (120.0-272.5); P  = 0.007] and total ischemic time [300.0 (210.0-531.2) vs. 370.0 (320.0-720.0); P = 0.001]; however, the multivariable model (accuracy = 0.971, sensitivity = 0.800, specificity = 0.999, and an area under the curve = 0.93) identified total ischemic time as the most important time-based predictor of mortality, followed by system delay, time from hospital arrival to balloon inflation, from symptom onset to first medical contact, and from arrival at the catheterization laboratory to balloon inflation.</p><p><strong>Conclusion: </strong>Each delay component in STEMI management carries distinct clinical consequences that necessitate targeted intervention.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"179-186"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353783","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 perivascular adipose tissue fat attenuation index in patients with ischemia with no obstructive coronary arteries and coronary microvascular dysfunction.","authors":"Nathaniel R Smilowitz, Barbara Jerome, David W Rhee, Robert Donnino, Jill E Jacobs, Anaïs Hausvater, Amanda Joa, Claudia Serrano-Gomez, Lindsay Elbaum, Ayman Farid, Judith S Hochman, Jeffrey S Berger, Harmony R Reynolds","doi":"10.1097/MCA.0000000000001583","DOIUrl":"10.1097/MCA.0000000000001583","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) is present in approximately 40% of patients with ischemia with no obstructive coronary arteries (INOCA) and has been associated with inflammation. We investigated associations between measures of inflammation of the coronary perivascular adipose tissue assessed by coronary computed tomography angiography (CCTA) and results of invasive coronary function testing (CFT) to diagnose CMD.</p><p><strong>Methods: </strong>Adults referred for clinically indicated invasive coronary angiography who had less than 50% stenosis in all epicardial arteries were prospectively enrolled. CMD was defined as a coronary flow reserve (CFR) less than 2.5 or index of microvascular resistance (IMR) greater than or equal to 25 using bolus thermodilution in the left anterior descending (LAD) coronary artery. Coronary perivascular fat attenuation index was assessed by CCTA in the right coronary artery (RCA) and LAD. T tests were used to evaluate differences in perivascular FAI by CMD status.</p><p><strong>Results: </strong>A total of 31 participants underwent CFT and CCTA. The mean age was 58 ± 11.7 years, 77% were female, and 61% were white. CMD was present in 15 participants (48%). No differences in perivascular FAI were observed in patients with and without CMD, either in the RCA [-74.2 ± 9.8 vs. -69.9 ± 10.3 Hounsfield units (HU), P  = 0.24] or LAD (-76.4 ± 10.2 vs. -74.8 ± 12.7 HU, P  = 0.69). Perivascular FAI was not correlated with CFR or IMR measurements in the RCA or LAD.</p><p><strong>Conclusion: </strong>There were no associations between CMD diagnosed by invasive CFT and perivascular FAI by CCTA in patients with INOCA. Further research is needed to understand the relationship between vascular inflammation and CMD in INOCA.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"187-194"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430384","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 duration of renin-angiotensin system inhibition after ST-elevation myocardial infarction with drug-eluting stent-percutaneous coronary intervention: Real-World Landmark Evidence from the Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry.","authors":"Byoung Geol Choi, Hae Don Kim, Seung-Woon Rha, Seung Uk Lee, Soohyung Park, Manda Satria Chesario, Melly Susanti, Cheol Won Choi, Cheol Ung Choi, Myung Ho Jeong, Dong Joo Oh","doi":"10.1097/MCA.0000000000001622","DOIUrl":"10.1097/MCA.0000000000001622","url":null,"abstract":"<p><strong>Background: </strong>Renin-angiotensin system inhibitors (RASi), including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, improve outcomes after acute myocardial infarction. However, in the drug-eluting stent (DES) era with routine percutaneous coronary intervention (PCI), the duration and timing of benefit after ST-elevation myocardial infarction (STEMI) remain uncertain.</p><p><strong>Methods: </strong>Using the nationwide prospective Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry, we identified STEMI patients who underwent successful DES-PCI and survived to discharge ( n = 5017). RASi exposure was defined at discharge for analyses from 0 to 12 months and reassigned at a 12-month landmark for analyses from 12 to 36 months, reflecting real-world switching or discontinuation. The primary outcome was all-cause mortality. Confounding was addressed using 1 : 1 propensity-score matching (851 pairs) and Cox proportional hazards models.</p><p><strong>Results: </strong>At discharge, 4093 patients received RASi and 924 did not. At 12 months, all-cause mortality was lower with RASi in the overall cohort [2.1 vs. 4.5%, hazard ratio: 0.45, 95% confidence interval (CI): 0.31-0.66, P < 0.001] and matched cohort (3.0 vs. 4.9%, hazard ratio: 0.61, 95% CI: 0.37-1.00, P = 0.050), driven by fewer cardiac deaths. Over 36 months, RASi was associated with lower mortality overall and after matching. From 12 to 36 months, landmark analyses showed neutral associations. First-year left ventricular ejection fraction and blood pressure improved more with RASi (both P < 0.01).</p><p><strong>Conclusion: </strong>In STEMI treated with DES-PCI, RASi at discharge offers a survival benefit concentrated within the first year. After 12 months, associations were neutral among event-free survivors, supporting early initiation and maintenance of RAS inhibition with individualized reassessment beyond 1 year.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"167-178"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141455","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":"'Septal-to-septal' retrograde LAD CTO intervention: an alternative approach to a demanding case.","authors":"Konstantinos Filippou, Konstantinos A Manousopoulos, Panagiotis N Varelas, Dimitrios F Karelas, Ioannis S Papadopoulos, Ioannis P Nenekidis, Ioannis N Tsiafoutis","doi":"10.1097/MCA.0000000000001621","DOIUrl":"10.1097/MCA.0000000000001621","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"241-243"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140861","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":"A rare constellation: Behcet's disease, moyamoya syndrome, and recurrent ostial coronary occlusions.","authors":"Aziz Inan Celik, Burcu Kodal, Tahir Bezgin","doi":"10.1097/MCA.0000000000001619","DOIUrl":"10.1097/MCA.0000000000001619","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"244-245"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112588","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":"ST-elevation myocardial infarction in a patient with extremely rare single coronary artery anatomy.","authors":"Konstantinos C Theodoropoulos, Spyridon-Filippos Papadopoulos, Alexandra Liakopoulou, Charalambos Kakderis, Matthaios Didagelos, George Kassimis, Antonios Ziakas","doi":"10.1097/MCA.0000000000001620","DOIUrl":"10.1097/MCA.0000000000001620","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"246-247"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112613","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":"The efficacy of orbital atherectomy is associated with prior rotational atherectomy and a greater preprocedural lumen area.","authors":"Ryosuke Amisaki, Tomomi Watanabe, Masaru Kato","doi":"10.1097/MCA.0000000000001585","DOIUrl":"10.1097/MCA.0000000000001585","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) in severely calcified lesions remains challenging. While orbital atherectomy is a treatment option for calcified lesions, the specific patient and lesion characteristics that predict successful debulking with orbital atherectomy remain unclear. This study aimed to identify the factors associated with a greater minimum lumen area (MLA) after orbital atherectomy.</p><p><strong>Methods: </strong>We retrospectively identified 77 lesions in 68 patients who underwent PCI with orbital atherectomy at Tottori University Hospital from May 2020 to June 2024. Among these, 62 lesions with a measurable intraluminal area by intravascular imaging were included in the analysis. The lesions were divided into two groups on the basis of a median post-orbital atherectomy MLA of 2.5 mm 2 : the large group (≥2.5 mm 2 ) and the small group (<2.5 mm 2 ). We compared the patients' background, characteristics of the lesions, procedural details, and imaging findings between the two groups.</p><p><strong>Results: </strong>The large group more frequently had prior rotational atherectomy use (35.5 vs. 3.2%; P  = 0.004) and had a greater pre-orbital atherectomy MLA [2.36 (2.01-3.10) vs. 1.37 mm 2 (0.99-1.76); P  < 0.001] than the small group. No significant differences in major complications or 1-year outcomes were observed between the two groups.</p><p><strong>Conclusion: </strong>Optimal lumen gain following orbital atherectomy was associated with a greater pre-orbital atherectomy MLA and prior rotational atherectomy. Pretreatment with rotational atherectomy may establish a sufficient lumen, subsequently enhancing the efficacy of orbital atherectomy. These results suggest the effectiveness of a strategy of using rotational atherectomy before orbital atherectomy.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"215-221"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426663","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}