Coronary artery disease最新文献

{"title":"Prior percutaneous coronary intervention versus deferral in patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis of randomized controlled trials.","authors":"Emídio Mata, Carla Barbosa, Inês Morais, Sílvia Ribeiro, José Alberto Rodrigues, António Lourenço, Ricardo Fontes-Carvalho","doi":"10.1097/MCA.0000000000001678","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001678","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is highly prevalent among patients undergoing transcatheter aortic valve implantation (TAVI), yet the optimal management of concomitant coronary lesions remains uncertain. While routine percutaneous coronary intervention (PCI) prior to TAVI may reduce ischemic complications, it may also increase bleeding risk and procedural burden.</p><p><strong>Methods: </strong>We systematically searched Cochrane Central Register of Controlled Trials, Scopus, and PubMed for randomized controlled trials (RCTs) comparing routine PCI versus PCI deferral in patients undergoing TAVI with CAD. Primary outcomes were all-cause mortality and myocardial infarction. Secondary outcomes included major bleeding, any bleeding, stroke, hospitalizations, and cardiovascular mortality. Random-effects meta-analysis was performed using hazard ratios with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Three multicenter RCTs (2021-2026), including 1132 patients (563 PCI deferral, 569 routine PCI), were analyzed. Routine PCI was not associated with differences in all-cause mortality (hazard ratio = 0.88; 95% CI = 0.67-1.17) or myocardial infarction (hazard ratio = 0.84; 95% CI = 0.44-1.58). Similarly, no significant differences were observed in stroke, hospitalizations, or cardiovascular mortality. However, routine PCI was associated with a higher risk of major bleeding (hazard ratio = 1.61; 95% CI = 1.05-2.49) and any bleeding (hazard ratio = 1.96; 95% CI = 1.28-3.00).</p><p><strong>Conclusion: </strong>In patients undergoing TAVI with concomitant CAD, PCI deferral appears safe and is associated with a significantly lower bleeding risk, without increasing ischemic events. These findings support a deferral approach to coronary revascularization rather than routine PCI prior to TAVI. However, longer-term follow-up is warranted to better define the impact of this strategy on late ischemic outcomes, particularly as TAVI is increasingly performed in younger patients with longer life expectancy.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016021","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":"Inflammatory ratios and in-stent restenosis after bioresorbable scaffold implantation.","authors":"Ogulcan Ozdemir","doi":"10.1097/MCA.0000000000001675","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001675","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988516","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 outcome between two different revascularization strategies for patients with left main coronary artery disease and concomitant chronic total occlusion of right coronary artery disease.","authors":"Chuan-Tsai Tsai, Wei-Chieh Huang, Shao-Sung Huang, Yi-Lin Tsai, Tse-Min Lu","doi":"10.1097/MCA.0000000000001670","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001670","url":null,"abstract":"<p><strong>Objectives: </strong>Percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) disease is technically demanding if there is a concomitant chronic total occlusion (CTO) of the right coronary artery (RCA). Which vessel to be revascularized in first attempt was not evaluated before.</p><p><strong>Methods: </strong>We included 32 845 patients who received coronary angiography in Taipei Veterans General Hospital between January 2011 and December 2020. A total of 135 patients had both LMCA disease and RCA CTO. We compared two revascularization strategies of recanalization: one that revascularized the RCA CTO first and one that received LMCA PCI first.</p><p><strong>Results: </strong>A total of 107 patients received revascularization of the LMCA first, and 28 patients received RCA CTO PCI first. There was no difference in periprocedural (cardiogenic shock and cardiac tamponade) (18 vs. 20%; P = 1.000 and 0 vs. 2%; P = 1.000, respectively) and in-hospital complications (acute kidney injury, acute respiratory failure, and in-hospital mortality) (7 vs. 7%; P = 1.000, 0 vs. 6%; P = 0.343, and 7 vs. 7%; P = 1.000, respectively). Three-year major adverse cardiocerebrovascular event (MACE) was not statistically different between the two groups (18 vs. 25%; P = 0.197). Three-year MACE was statistically significantly lower in the complete revascularization group (both LMCA PCI and successful RCA CTO PCI) than in the partial revascularization group (LMCA PCI only) (16 vs. 28%; P = 0.017).</p><p><strong>Conclusion: </strong>In patients with LMCA disease and concomitant RCA CTO, LMCA PCI did not differ from RCA CTO PCI in the first attempt in terms of periprocedural, in-hospital, 3-year all-cause mortality, and 3-year MACE.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911079","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 perforation triad as a recognition-and-response pattern for balloon- or stent-related Ellis II-III coronary artery perforation during percutaneous coronary intervention.","authors":"Emrah Acar, Melike Acar, İbrahim Dönmez, Servet İzci, Yilmaz Güneş, İbrahim Akin İzgi, Cevat Kirma","doi":"10.1097/MCA.0000000000001673","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001673","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery perforation (CAP) is a rare but potentially catastrophic complication of percutaneous coronary intervention (PCI). We describe a prespecified candidate recognition pattern - the perforation triad - that may help operators identify an evolving perforation during inflation.</p><p><strong>Methods: </strong>In this single-center retrospective matched case-control study, 9865 PCI procedures performed between 2020 and 2025 were screened. Forty-one balloon- or stent-related Ellis II-III CAP cases (0.42%) were matched 1: 1 by age, sex, American College of Cardiology/American Heart Association lesion class, and rotational atherectomy use with uncomplicated PCI controls, each contributing one stage-matched index inflation. The triad - chest or back pain during inflation, abrupt balloon-waist disappearance without balloon rupture, and ventricular extrasystole temporally linked to inflation - was prespecified before data abstraction and adjudication. Prespecified descriptive analyses covered the three components, their pairwise combinations, and component-count thresholds; no threshold optimization was undertaken.</p><p><strong>Results: </strong>Among CAP cases, components were present in 78.0, 85.4, and 73.2%, respectively; the complete triad in 28 of 41 cases (68.3%; 95% confidence interval: 51.9-81.9) and in 0 of 41 selected control inflations. Control inflations meeting the pattern fell as more components were required (≥1, 20 of 41; ≥2, 10 of 41; triad, 0 of 41), with case-level sensitivity of 87.8, 80.5, and 68.3%. Tamponade requiring drainage occurred in 29.3%, and in-hospital mortality was 7.3%.</p><p><strong>Conclusion: </strong>The perforation triad is a plausible recognition pattern for balloon- or stent-related Ellis II-III CAP. Because of retrospective sampling, selected controls, and incorporation bias, it should not be interpreted as a validated diagnostic rule or as evidence of real-world specificity; prospective inflation-level validation is required.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872837","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":"Lipoprotein(a) as a predictor of major adverse cardiovascular events in patients with very premature (≤40 years) acute coronary syndrome: long-term follow-up of the STudy of eArly Myocardial INfArction.","authors":"Loukianos S Rallidis, Sofia-Panagiota Giannakopoulou, Christos Kotakos, Stylianos Armylagos, Stylianos L Rallidis, Eleni P Stathopoulou, Konstantinos A Papathanasiou, Demosthenes Panagiotakos","doi":"10.1097/MCA.0000000000001627","DOIUrl":"10.1097/MCA.0000000000001627","url":null,"abstract":"<p><strong>Background: </strong>Lipoprotein(a) [Lp(a)] is a causal risk factor for cardiovascular disease, and it is particularly associated with premature acute coronary syndrome (ACS). We investigated whether elevated Lp(a) can predict recurrent cardiovascular events in patients who experienced their first ACS less than or equal to 40 years of age.</p><p><strong>Methods: </strong>Within the STudy of eArly Myocardial INfArction registry, we recruited 405 consecutive patients who survived their first ACS less than or equal to 40 years of age; of them 378 had complete follow-up data. Clinical endpoint was the development of major adverse cardiovascular events (MACE; i.e. cardiac death, readmission for ACS or malignant ventricular arrhythmias, ischemic stroke, or coronary revascularization due to clinical deterioration). Multi-adjusted Cox regression was used to assess the association between Lp(a) and first recurrent MACE risk.</p><p><strong>Results: </strong>Of the 378 ACS survivors (33.7 ± 4.3 years), 139 (36.8%) experienced a MACE over a median 8-year (5.2-12.5 years) follow-up. Elevated Lp(a) showed a borderline independent association with higher recurrent MACE [hazard ratio per 1 mg/dl: 1.004, 95% confidence interval (CI): 0.999-1.009, P  = 0.051]. Moreover, patients with baseline Lp(a) levels greater than or equal to 50 mg/dl had 82.6% higher risk of MACE as compared with those below (hazard ratio 1.826, 95% CI: 1.141-2.925, P  = 0.012); similarly, patients with Lp(a) ≥ 70 mg/dl had 118% higher risk as compared with those below (hazard ratio 2.180, 95% CI: 1.330-3.573, P  = 0.002).</p><p><strong>Conclusion: </strong>Elevated Lp(a) concentrations demonstrate an independent association with recurrent MACE among very young ACS survivors. Until targeted Lp(a)-lowering treatments become clinically available, an aggressive lipid-lowering approach may be warranted to partially attenuate Lp(a)-related residual cardiovascular risk.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"432-438"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376277","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 volume and Agatston scoring for aortic valve calcification on non-ECG-gated computed tomography in severe aortic stenosis.","authors":"Kotaro Ouchi, Toru Sakuma, Shu Okubo, Ayumi Nojiri, Hiroya Ojiri","doi":"10.1097/MCA.0000000000001623","DOIUrl":"10.1097/MCA.0000000000001623","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether non-ECG-gated computed tomography (CT) reliably quantifies aortic valve calcification (AVC) for diagnosing severe aortic stenosis and to compare the agreement and diagnostic performance of Agatston versus volume scoring.</p><p><strong>Methods: </strong>In this retrospective single-centre study, 129 consecutive patients with echocardiographically confirmed severe aortic stenosis (mean age, 83.1 ± 6.3 years; 46 men, 83 women) underwent same-session ECG-gated (3 mm) and Non-ECG-gated (5 mm) non-contrast CT between 21 March 2020 and 16 April 2025. AVC was quantified using Agatston and volume methods. Agreement between non-gated and gated scores was assessed by Pearson correlation, Bland-Altman analysis, and Deming regression. Diagnostic performance for sex-specific Agatston thresholds (≥2000 units men, ≥1300 units women) was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Volume scores on non-ECG-gated CT correlated more strongly with ECG-gated CT scores than Agatston scores ( r  = 0.95 vs. 0.69, P  < 0.001). Bland-Altman analysis demonstrated substantial negative bias and proportional error for Agatston scores (mean difference, -921.1 units; limits of agreement, -2900.8 to +1058.6), while volume scores showed minimal bias and no proportional error (+16.5 mm 3 ; -648.5 to +681.4). Deming regression confirmed closer agreement for volume scores (slope, 1.02; R2  = 0.90). ROC analysis showed higher area under the curve values for volume scores (0.976 for men, 0.975 for women) than for Agatston scores (0.946 and 0.967, respectively).</p><p><strong>Conclusion: </strong>Non-ECG-gated CT enables reliable quantification of aortic valve calcium in severe aortic stenosis. Volume scoring demonstrates superior agreement and diagnostic performance compared with Agatston scoring, supporting its use as a robust, density-independent metric for opportunistic assessment of AVC on routine chest CT.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"409-417"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218957","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 importance of early recognition of the de Winter ECG pattern.","authors":"Konstantinos C Theodoropoulos, Angelos Raditsis, Charalampos Kakderis, George Kassimis, Antonios Ziakas","doi":"10.1097/MCA.0000000000001605","DOIUrl":"10.1097/MCA.0000000000001605","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"488-489"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767387","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":"Predictive value of preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and haemoglobin levels for in-stent restenosis after bioresorbable scaffold implantation in patients with lower-extremity arterial occlusive disease.","authors":"Lizhao Wang, Jingran Min, Qiang Dong, Yan Gu","doi":"10.1097/MCA.0000000000001626","DOIUrl":"10.1097/MCA.0000000000001626","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of preoperative neutrophil-to-lymphocyte ratios (NLRs), platelet-to-lymphocyte ratios (PLRs) and haemoglobin (HGB) levels for in-stent restenosis (ISR) after bioresorbable scaffold (BRS) implantation in patients with lower-extremity arteriosclerosis obliterans (LEASO).</p><p><strong>Methods: </strong>A total of 53 patients with superficial femoral artery stenosis or occlusion admitted to multiple hospitals in one city between January 2023 and June 2024 were enrolled in this retrospective study. After screening the participants based on the inclusion and exclusion criteria, with a follow-up period extending to 1 year postoperatively, they were divided into an ISR group ( n  = 37) and a non-ISR group ( n  = 13) according to the occurrence of ISR. Comparative analyses were performed using t -tests and chi-squared ( χ2 ) tests to evaluate patients' medical histories, stent implantation characteristics, complete blood count parameters and blood biochemical indicators, followed by logistic regression analysis to identify independent influencing factors.</p><p><strong>Results: </strong>Patients in the ISR group had significantly longer recorded stent lengths and exhibited higher NLRs and PLRs - but lower HGB levels - than patients in the non-ISR group. Logistic regression analysis identified NLRs and PLRs as independent risk factors for postoperative ISR in patients with LEASO. Receiver operating characteristic curve analysis revealed an area under the curve (AUC) of 0.740 for HGB, 0.843 for NLR and 0.794 for PLR. The combined predictive model achieved an AUC of 0.915.</p><p><strong>Conclusion: </strong>Elevated preoperative NLRs and PLRs, alongside decreased HGB levels, are associated with an increased risk of ISR following BRS implantation in patients with LEASO and show promising predictive value.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"426-431"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510075","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 association between the Controlling Nutritional Status Score and the severity of coronary artery disease in patients with stable angina pectoris.","authors":"Damla Yalcinkaya Oner, Oguz Kilic, Kadir Karacali, Gunduzalp Saydam, Ahmet Karakurt, Fatma Karadeniz Ozpamuk, Serdal Bay","doi":"10.1097/MCA.0000000000001625","DOIUrl":"10.1097/MCA.0000000000001625","url":null,"abstract":"<p><strong>Background: </strong>The Synergy between Percutaneous Coronary Intervention with Taxus (SYNTAX) Score quantifies the complexity of coronary artery disease. The Controlling Nutritional Status (CONUT) score is a nutritional index linked to cardiovascular outcomes. This study investigates the correlation between SYNTAX Score and CONUT scores in stable angina pectoris (SAP).</p><p><strong>Methods: </strong>This single-center, retrospective study included 259 patients with a first-time diagnosis of SAP who underwent coronary angiography. Patients were divided into low SYNTAX Score (≤22, n = 192) and high SYNTAX Score (>22, n = 67) groups. The CONUT score, derived from serum albumin, total lymphocyte count, and total cholesterol, was calculated for all patients.</p><p><strong>Results: </strong>The median CONUT score was significantly higher in the high SYNTAX Score group (3 vs. 1; P < 0.001). Impaired nutritional status (CONUT ≥ 2) was more prevalent in the high SYNTAX Score group (71.6 vs. 37.5%; P < 0.001). A significant positive correlation was found between SYNTAX Score and CONUT score ( P < 0.001). A CONUT score more than 1.5 predicted high SYNTAX Score with 71.6% sensitivity and 62.5% specificity [area under the curve = 0.746, 95% confidence interval (CI): 0.672-0.820, P < 0.001]. In multivariable analysis, diabetes mellitus [odds ratio (OR): 2.47, 95% CI: 1.27-4.83, P = 0.008] and CONUT score (OR: 1.60, 95% CI: 1.32-1.95, P < 0.001) were independent predictors of high SS.</p><p><strong>Conclusion: </strong>A significant positive correlation exists between SYNTAX Score and CONUT score in SAP patients, indicating that worse nutritional status is associated with more complex disease. Nutritional assessment should be integrated into risk evaluation.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"418-425"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303221","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":"Influence of left main-left circumflex artery angle on long-term outcomes in crossover stenting for ostial left circumflex artery lesions: insights from the Multicenter CROSS-LCX Registry.","authors":"Ezgi Gültekin Güner, Ebru Serin, Muhammed Furkan Deniz, Sezer Markirt, Mehmet Erdoğan, Kurtuluş Karaüzüm, Semih Kalkan, Ali Nazmi Çalik, Serkan Asil, Veysel Ozan Tanik, Ahmet Anil Başkurt, Fatih Levent, Faruk Kara, Enes Arslan, Cemalettin Akman, Ahmet Yaşar Çizgici, Özge Çebi, Uygar Çağdaş Yüksel, İbrahim Faruk Aktürk, Kudret Keskin, İrfan Şahin, Ahmet Güner, Fatih Uzun","doi":"10.1097/MCA.0000000000001631","DOIUrl":"10.1097/MCA.0000000000001631","url":null,"abstract":"<p><strong>Background: </strong>The influence of left main bifurcation angles on cardiovascular outcomes following crossover stent implantation (CSI) in patients with ostial left circumflex artery (LCX) lesions has not been well established. This investigation sought to determine the relationship between left main bifurcation angles and poor cardiovascular outcomes in patients who underwent CSI of ostial LCX lesions.</p><p><strong>Methods: </strong>This large-scale, multicenter ( n  = 14) observational, retrospective study included 267 patients [men: 192 (71.9%), mean age: 66.30 ± 10.93 years] who underwent percutaneous coronary intervention with CSI for ostial LCX lesions. The primary outcome was major adverse cardiac events (MACE), including cardiac death, target vessel revascularization, and target vessel myocardial infarction. Patients were categorized into two groups as MACE (+) and MACE (-).</p><p><strong>Results: </strong>At least one MACE occurred in 49 patients (18.3%) in the study cohort. The left main-LCX angle (108.44 ± 17.93° vs. 115.89 ± 14.760°, P  = 0.041) was significantly lower in the MACE (+) group compared to the MACE (-) group. In multivariate Cox regression analysis, increased left main-LCX angle was identified as one of the independent predictors of MACE (hazard ratios: 0.968, P  = 0.005). In the receiver operating characteristic curve analysis, a left main-LCX angle lower than 99° predicted the presence of MACE with a sensitivity of 64% and a specificity of 75% (area under the curve: 0.721, 95% confidence interval: 0.663-0.774, P  < 0.001). The prevalence of MACE was notably higher in patients with left main-LCX angle <99° as compared to others (53.3 vs. 11.3%, P  < 0.001).</p><p><strong>Conclusions: </strong>This multicenter study shows that a narrow left main-LCX angle (99°) value may be associated with poor cardiovascular events in patients who underwent CSI for ostial LCX disease.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"449-460"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462775","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}