Coronary artery disease最新文献

{"title":"Urinary sodium-potassium ratio as a genetic predictor of myocardial infarction.","authors":"Ziyang Wu, Dong Wang, Chengchun Tang","doi":"10.1097/MCA.0000000000001532","DOIUrl":"10.1097/MCA.0000000000001532","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the urinary sodium - potassium ratio (USPR) and risk factors for heart disease has been observed over time. We evaluated the relationship between USPR and myocardial infarction (MI).</p><p><strong>Methods: </strong>Causal relationships were estimated based on USPR and MI data from genome-wide association studies. The main analysis method for bidirectional two-sample Mendelian randomization was inverse-variance weighting (IVW), with four other supplementary methods used.</p><p><strong>Results: </strong>The IVW method indicated a positive correlation between USPR levels and MI (IVW, odds ratio = 1.504, 95% confidence interval: 1.108-2.041, P  = 0.009). In contrast, the inverse analysis provided evidence suggesting that MI affected USPR ( P  > 0.05). The Cochran Q test showed heterogeneity, while the intercept test revealed no horizontal pleiotropy, and the leave-one-out analysis demonstrated that the analyses were reliable.</p><p><strong>Conclusions: </strong>This study provides evidence for the causal effect of the USPR on MI; however, this was not the case in the opposite situation. It is plausible that the USPR serves as a promoting factor for MI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"561-568"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955438","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":"Late stent strut apposition and coverage after drug-eluting stent implantation by optical coherence tomography in patients with acute myocardial infarction.","authors":"Cheol Hyun Lee, Seonhwa Lee, Jongmin Hwang, In-Cheol Kim, Yun-Kyeong Cho, Hyuck-Jun Yoon, Hyungseop Kim, Chang-Wook Nam, Seung-Ho Hur","doi":"10.1097/MCA.0000000000001536","DOIUrl":"10.1097/MCA.0000000000001536","url":null,"abstract":"<p><strong>Background: </strong>Although drug-eluting stents (DES) are effective, stent thrombosis (ST) remains a major concern in patients with acute myocardial infarction (AMI) who undergo DES implantation. We aimed to evaluate the incidence of late stent malapposition (SM) and uncovered struts 12 months after implantation of a bioabsorbable polymer everolimus-eluting stent (BP-EES) or a durable polymer zotarolimus-eluting stent (DP-ZES) in patients with AMI using optical coherence tomography (OCT).</p><p><strong>Methods: </strong>Sixty-nine patients with AMI were randomly assigned 2:1 to the BP-EES (46 patients) or DP-ZES (23 patients) groups. The coprimary endpoints were the incidences of late SM and uncovered stent struts in OCT strut-level analysis at 12 months postimplantation.</p><p><strong>Results: </strong>The 51 patients who completed the 12-month follow-up OCT (BP-EES, 36 patients, 39 lesions; DP-ZES, 15 patients, 18 lesions) showed no intergroup differences in the incidence of acute SM (BP-EES vs. DP-ZES; 12.25 ± 14.27% vs. 12.35 ± 10.55%, P  = 0.981) at the index procedure. The incidence of late SM (0.12 ± 0.42% vs. 0.14 ± 0.25%, P  = 0.873) and uncovered struts (1.69 ± 3.44% vs. 2.45 ± 3.23%, P  = 0.532) also did not differ between the two DES groups at 12-month postimplantation.</p><p><strong>Conclusion: </strong>Twelve-month OCT measurements showed no significant differences in late SM and uncovered struts between the BP-EES and DP-ZES stents. Thus, contemporary second-generation DES show a very low rate of late SM and uncovered struts after 12 months in AMI, regardless of stent polymer type.</p><p><strong>Trial registration: </strong>Late stent strut apposition and coverage after drug-eluting stent implantation by OCT in patients with AMI (APPOSITION AMI-II) (NCT02770651).</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"610-617"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149745","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":"Why colchicine is not beneficial in patients with acute coronary syndrome? In search of a CLEAR answer.","authors":"Stefano De Servi, Mauro Molteni, Claudio Cimminiello","doi":"10.1097/MCA.0000000000001551","DOIUrl":"10.1097/MCA.0000000000001551","url":null,"abstract":"<p><p>Neutrophil count is a risk factor for myocardial infarction (MI). Colchicine, a drug known as an anti-inflammatory, acts by selectively concentrating on neutrophils and impairing their function. Colchicine has been used successfully in the prevention of vascular events in patients with coronary artery disease (CAD), but recently the largest clinical trial carried out with colchicine in this clinical setting was unexpectedly neutral in the comparison of placebo and colchicine in patients with recent MI. Among the characteristics that distinguish patients with acute coronary syndromes (ACS) from established CAD is the dual antiplatelet therapy (DAPT), often consisting of aspirin and clopidogrel. Clopidogrel significantly reduces neutrophil count and could play a competitive role with colchicine by blunting its clinical effect.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"630-632"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599628","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":"Dual anomalous origins of the left anterior descending and left circumflex from the right coronary sinus with interarterial and retroaortic course.","authors":"Kurtulus Karauzum, Didar Mirzamidinov, Ozgur Cakir, Irem Yilmaz, Tayfun Sahin","doi":"10.1097/MCA.0000000000001538","DOIUrl":"10.1097/MCA.0000000000001538","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"626-627"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301283","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":"Sex differences in the impact of marital status on coronary artery disease outcomes in Korea.","authors":"Ha Jeong Lim, Lee Bom, Seung-Yul Lee, Jae Youn Moon, Sang-Hoon Kim, Jung-Hoon Sung, In Jai Kim, Sang-Wook Lim, Dong-Hun Cha, Se Hun Kang","doi":"10.1097/MCA.0000000000001527","DOIUrl":"10.1097/MCA.0000000000001527","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) outcomes are influenced by social determinants, including marital status. However, research on the sex-specific effects of marital status on CAD outcomes is limited. This study aimed to evaluate the relationship between marital status and clinical outcomes of patients with CAD stratified according to sex in Korea.</p><p><strong>Methods: </strong>A total of 3476 patients with CAD who underwent percutaneous coronary intervention (PCI) were enrolled in this retrospective observational study. Patients were categorized into married and nonmarried groups based on demographic data at the time of admission. The primary endpoint was all-cause mortality.</p><p><strong>Results: </strong>Among the study population, 20.7% of women and 11.5% of men who underwent PCI for CAD were nonmarried. For 87.1% of nonmarried women, the cause of being nonmarried was the death of a spouse, whereas for 48.3% of unmarried men, the most common cause was being unmarried. During a median follow-up of 53.3 months, in analysis using the Cox proportional hazard regression model, nonmarried status was associated with higher all-cause [adjusted hazard ratio (HR): 2.24, 95% confidence interval (CI): 1.22-4.09, P  = 0.009] and cardiovascular (adjusted HR: 2.63, 95% CI: 19.91-5.80, P  = 0.017) deaths in men but not in women.</p><p><strong>Conclusion: </strong>Marital status independently predicted the adverse outcomes in men with CAD but not in women, highlighting the importance of sex-specific approaches to the assessment of social determinants in cardiovascular care. Future studies should explore broader social and economic factors to inform targeted interventions.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"554-560"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991723","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":"Feasibility of biodegradable polymer everolimus-eluting stent overexpansion: the SYNOVER study.","authors":"Seung Hun Lee, Yong-Kyu Lee, Joon Ho Ahn, Yongcheol Kim, Seongho Park, Donghyeon Joo, Kyung Hoo Cho, Min Chul Kim, Doo Sun Sim, Ju Han Kim, Youngkeun Ahn, Young Joon Hong","doi":"10.1097/MCA.0000000000001529","DOIUrl":"10.1097/MCA.0000000000001529","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in percutaneous coronary intervention (PCI), stent-related complications continue to occur, emphasizing the necessity for stent optimization. This study employed optical coherence tomography (OCT) to investigate the safety and efficacy of overexpanding the biodegradable polymer everolimus-eluting stent (SYNERGY; Boston Scientific, Marlborough, Massachusetts, USA) stent in large coronary arteries.</p><p><strong>Methods: </strong>This single-center observational study enrolled patients with ischemic heart disease requiring stent placement in large coronary arteries (≥4.5 mm). The patients underwent PCI guided by OCT using SYNERGY stents, incorporating postdilation techniques to enhance expansion. Stent parameters were evaluated through OCT imaging. The primary endpoints focused on the maximum stent diameter and the maximum percentage of overexpansion. Secondary clinical outcomes, including death, myocardial infarction (MI), revascularization, stent thrombosis, cerebrovascular accidents (CVAs), and heart failure readmissions, were monitored with follow-ups at 1, 6, and 12 months, as well as annually thereafter.</p><p><strong>Results: </strong>A total of 12 patients (8427 struts) were analyzed after successful PCI. OCT imaging showed adequate stent expansion, maximum stent diameter was 4.5 ± 0.2 mm, with a maximum expansion of 113.2 ± 4.1%), with no definite stent fractures or major edge dissections. During follow-up, one patient experienced an MI, but no stent thrombosis, target lesion revascularization, CVA, or death were reported.</p><p><strong>Conclusion: </strong>Application of OCT-guided PCI with SYNERGY stents is safe and effective for treating large coronary arteries. It facilitates optimal stent expansion and yields favorable long-term outcomes. These results advocate for an expanded application of OCT-guided PCI in complex anatomical situations, showcasing the performance of SYNERGY stents in cases of excess expansion.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"604-609"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962689","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":"Efficacy of paclitaxel-coated versus uncoated balloon angioplasty for revascularization of coronary in-stent restenosis: a meta-analysis and metaregression.","authors":"Mrinal Murali Krishna, Meghna Joseph, Chidubem Ezenna, Vinicius Pereira, Ancy Jenil Franco, Mahmoud Ismayl, Jennifer Rymer, Andrew M Goldsweig","doi":"10.1097/MCA.0000000000001534","DOIUrl":"10.1097/MCA.0000000000001534","url":null,"abstract":"<p><strong>Background: </strong>Treatment of in-stent restenosis (ISR) accounts for 10% of percutaneous coronary interventions in the USA. Paclitaxel-coated balloons (PCBs) are an alternative to uncoated balloons (UCBs) for ISR.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, and Cochrane Central for studies comparing PCB with UCB in treating ISR. Outcomes included late lumen loss, binary restenosis, target lesion revascularization (TLR), and major adverse cardiovascular events (MACE).</p><p><strong>Results: </strong>Eight trials including 1410 patients [PCB in 865 (61%), follow-up 6 months to 10 years) were identified. Angiographic outcomes of late lumen loss [mean difference: -0.50 mm; 95% confidence interval (CI): -0.66 to -0.33; P  < 0.01] and binary restenosis [relative risk (RR): 0.22; 95% CI: 0.13-0.40; P  < 0.01] at 6-8 months were lower with PCB. TLR at 6 months (RR: 0.16; 95% CI: 0.06-0.40; P  < 0.001) and 1 year (RR: 0.45; 95% CI: 0.31-0.66; P  < 0.001), MACE at 6 months (RR: 0.25; 95% CI: 0.16-0.38; P  < 0.001), MACE at 3-5 years (RR: 0.54; 95% CI: 0.37-0.80; P  = 0.002), and TLR at 3-5 years (RR: 0.51; 95% CI: 0.29-0.90; P  = 0.021) were lower with PCB. Meta-regression revealed that ISR lesions in the left anterior descending artery were associated with lower rates of binary restenosis while the opposite was observed for left circumflex lesions.</p><p><strong>Conclusion: </strong>Revascularization of coronary ISR with PCB is associated with reduced late lumen loss, binary restenosis, TLR, CCE, and MACE. PCB may be a preferred strategy for coronary ISR.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"569-579"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982256","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":"Eight-month angiographic outcomes and in-stent restenosis in patients undergoing percutaneous coronary intervention on unprotected left main coronary artery.","authors":"Mauro Massussi, Andrea Drera, Edoardo Pancaldi, Elisa Pezzola, Luca Tagazzini, Claudia Fiorina, Luca Branca, Giuliano Chizzola, Marco Metra, Salvatore Curello, Marianna Adamo","doi":"10.1097/MCA.0000000000001557","DOIUrl":"10.1097/MCA.0000000000001557","url":null,"abstract":"<p><p>In-stent restenosis (ISR) remains a significant complication of percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) disease, with potentially severe consequences. This study aimed to evaluate the incidence and predictors of ISR and highlight the role of systematic angiographic follow-up in optimizing patient outcomes. We conducted a retrospective cohort study including 229 patients who underwent LMCA PCI between 2013 and 2023 at ASST Spedali Civili di Brescia. All patients underwent systematic angiographic follow-up at 8 months. Data on clinical, angiographic, and procedural characteristics were collected and analyzed using univariate and multivariate logistic regression to identify predictors of ISR. Kaplan-Meier survival analysis was employed to assess outcomes. ISR was identified in 24 patients (10.5%) during angiographic follow-up, with 29.2% being symptomatic. Chronic kidney disease (CKD; odds ratio: 3.84, P = 0.003) and diabetes (odds ratio: 3.18, P = 0.008) emerged as independent predictors of ISR. Multivariate analysis confirmed these associations. Survival rates were high, with 97.7% at 1 year, 92.2% at 2 years, and 81.5% at 4 years. Subanalyses showed trends toward higher mortality among patients with CKD or diabetes but no significant differences between patients with acute and chronic coronary syndromes. In conclusion, ISR remains a clinically significant challenge after LMCA PCI, with CKD and diabetes as key predictors. Systematic angiographic follow-up is essential for early ISR detection, especially in high-risk populations, as the majority of cases are asymptomatic. These findings emphasize the need for tailored surveillance strategies to improve outcomes.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844827","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":"https://doi.org/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":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-22","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":"Ticagrelor vs. clopidogrel in elderly patients following acute myocardial infarction: a multicenter international analysis.","authors":"Ramzi Ibrahim, Robert Seby, Abdullah Shaik, Malak Tahsin, Mahmoud Abdelnabi, Hoang Nhat Pham, Nada Said, Juan Farina, Mayurkumar D Bhakta, Eric H Yang, John P Sweeney, David Fortuin, Chadi Ayoub, Kwan Lee, Reza Arsanjani","doi":"10.1097/MCA.0000000000001576","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001576","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328464","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}