Coronary artery disease最新文献

{"title":"Risk factors that predict for presence of clinically significant, noncalcified plaque in younger adults.","authors":"Aditya Mehta, Felix Thomas, Venkat Manubolu, April Kinninger, Matthew Budoff, Sion K Roy","doi":"10.1097/MCA.0000000000001495","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001495","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery calcium (CAC) scoring may be a useful tool for assessing cardiovascular disease in young adults, particularly in those with risk factors such as hypertension, dyslipidemia, or smoking. In this study, we aimed to address the risk factors for developing noncalcified plaque in young adults by assessing total plaque burden.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted among 1026 consecutive patients aged 18-45 years who underwent CAC scoring and coronary computed tomography (CT) angiograms for clinical indications. CAC scores and total plaque scores (TPS) were calculated using standard scoring protocols. Multiple logistic regression analysis was conducted to identify independent risk factors of significant, noncalcified plaque in subjects where CAC = 0.</p><p><strong>Results: </strong>This single-center retrospective cohort study included 1026 patients aged 18-45 years who underwent CAC scoring and coronary CT angiograms for clinical indications. The mean age of the population was 38.8 years old. Sixty-three patients had a CAC score of 0 and a TPS >0. Of the patients with noncalcified plaque burden, 15% had a stenosis >50%, and 10% had a stenosis >70%. The odds of a subject having noncalcified plaque presence and CAC absent were significantly associated with being Hispanic, having diabetes, and having hyperlipidemia.</p><p><strong>Conclusion: </strong>In young adults aged 18-45 years old, we found diabetes, hyperlipidemia, and being of Hispanic origin to be significantly associated with noncalcified plaque burden.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064207","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}

{"title":"Mechanical circulatory support devices in acute left main disease: a multicenter study.","authors":"Andreia Campinas, André Alexandre, Bruno Brochado, João Calvao, Marta Braga, João Carlos Silva, Mariana Brandão, Marisa Silva, Gustavo Pires-Morais, David Sá Couto, Mariana Santos, Catarina Gomes, Raquel Santos, André Luz, João Silveira, Severo Torres","doi":"10.1097/MCA.0000000000001510","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001510","url":null,"abstract":"","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":"143058440","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":"Double trouble: thrombosis of giant coronary aneurysm with left ventricular aneurysm in child with Kawasaki disease.","authors":"Rakesh Kumar Pilania, Abarna Thangaraj, Harsimran Bhatia, Abhishek Mallick, Arun Sharma, Sanjeev Naganur, Surjit Singh, Manphool Singhal","doi":"10.1097/MCA.0000000000001509","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001509","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022484","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":"Comparison of ticagrelor and clopidogrel in primary percutaneous coronary intervention patients: a single-center retrospective study.","authors":"Yufeng Yan, Haimei Xu, Yingying Zhao, Song Lin, Yaguo Zheng","doi":"10.1097/MCA.0000000000001506","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001506","url":null,"abstract":"<p><strong>Background: </strong>It is uncertain whether ticagrelor is more effective and safer than clopidogrel in ST-segment elevation myocardial infarction (STEMI) patients in the East Asian population in the real world. This study compared the clinical outcomes of ticagrelor and clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We retrospectively enrolled 1124 patients diagnosed with STEMI in Nanjing First Hospital from July 2011 to April 2019. Propensity score matching was used to balance baseline covariates between the ticagrelor and clopidogrel groups. The primary efficacy endpoint was all-cause death, and the primary safety endpoint was major bleeding, defined as Bleeding Academic Research Consortium type 3-5 bleeding.</p><p><strong>Results: </strong>We enrolled 1124 STEMI patients in the analysis. After propensity score matching, 420 patients were included in each group. There was a lower incidence of all-cause death in the ticagrelor group when compared with the clopidogrel group during the follow-up (8.3 vs. 17.1%; hazard ratio: 0.481; P < 0.001). Ticagrelor was also associated with reduced myocardial infarction, cardiovascular death, and stent thrombosis. However, no difference was detected in major bleeding. Multivariate Cox regression analysis showed that age, Killip classification, creatinine, low-density lipoprotein, left ventricular ejection fraction, single vessel disease, inhospital intra-aortic balloon pump implantation, β-blockers, and ticagrelor were independent predictive parameters of all-cause death.</p><p><strong>Conclusion: </strong>Compared with clopidogrel, ticagrelor reduced all-cause death but did not increase the incidence of major bleeding in primary PCI patients. Therefore, ticagrelor may be considered a viable substitute for clopidogrel.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001633","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":"Short-term effects of upstream high bolus dose of tirofiban in patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Amr E I Abouelnour, Eman Q Mohammed, Doaa A Fouad, Aly Tohamy","doi":"10.1097/MCA.0000000000001501","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001501","url":null,"abstract":"<p><strong>Background: </strong>No-reflow following primary percutaneous coronary intervention (PPCI) is challenging to treat.</p><p><strong>Objectives: </strong>The objective of this study is to evaluate the efficacy and safety of upstream high-bolus-dose tirofiban administration in ST-segment elevation myocardial infarction (STEMI) cases undergoing PPCI on top of dual antiplatelet therapy, including ticagrelor, in comparison to selective bailout administration.</p><p><strong>Methods: </strong>This hospital-based, randomized, single-blinded prospective interventional study was conducted on 150 patients at Assiut University Heart Hospital. Patients with STEMI within 12 h after symptom onset who underwent PPCI were randomized to an upstream group (n = 75) and a selective bailout group (n = 75) based on the timing of the tirofiban bolus administration (25 µg/kg intravenously over 5 min).</p><p><strong>Results: </strong>The bailout group's thrombolysis in myocardial infarction (TIMI) frame count was higher than the upstream group's, despite comparable TIMI flow and myocardial blush grade between the two groups, but only approached statistical significance [14.4 (4-36) vs 12.2 (5-55), P = 0.08]. The enzymatic infarct size tended to be lower in the upstream group. All echocardiographic findings were comparable between the two studied groups, with no significant difference (P > 0.05). There was no significant difference between the two groups regarding clinical outcomes.</p><p><strong>Conclusion: </strong>Compared to selective bailout administration, upstream high bolus dose of tirofiban in STEMI patients undergoing primary coronary intervention did not significantly affect angiographic outcomes, left ventricular remodeling, or function, despite smaller infarction size.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001325","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 and patients' perspective of fatigue following spontaneous coronary artery dissection.","authors":"Sahrai Saeed, Erlend Eriksen, Pål Aukrust, Bente Halvorsen, Kjetil Løland, Øyvind Bleie, Nigussie Bogale","doi":"10.1097/MCA.0000000000001499","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001499","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001625","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":"Thrombectomy using Penumbra aspiration system through Guideliner 7F catheter for high thrombotic burden myocardial infarction.","authors":"Francisco Barbas de Albuquerque, Tiago Mendonça, Luís Morais","doi":"10.1097/MCA.0000000000001502","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001502","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001263","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 outcomes of second-generation drug-eluting stents versus coronary artery bypass graft: a systematic review and meta-analysis of randomized trials and multivariable adjusted data.","authors":"André Luiz Carvalho Ferreira, Maria Esther Benitez Gonzalez, Ana Emanuel Coelho Pessoa Lima, Almir Alamino Lacalle, Gabriel Saad, Camila Mota Guida","doi":"10.1097/MCA.0000000000001503","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001503","url":null,"abstract":"<p><p>Long-term data are limited comparing percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (S-DES) vs coronary artery bypass grafting (CABG) in patients with complex coronary artery disease (CAD). We aimed to conduct a systematic review and meta-analysis comparing these interventions in patients with left main or multivessel CAD. We systematically reviewed PubMed, Embase, and Cochrane for studies that compared PCI with S-DES and CABG in patients with left main or multivessel CAD with a minimum mean follow-up period of 3 years. Outcomes of interest were all-cause mortality, myocardial infarction (MI), stroke, and major adverse cardiovascular events (MACE). We extracted data from observational studies as multivariable-adjusted or propensity score-matched hazard ratio to minimize confounding and pooled hazard ratios with 95% confidence intervals (CIs) using a random effects model in Review Manager 5.4.1. We included 10 studies, 3 of which were randomized controlled trials, comprising a total of 26964 patients, of whom 14928 underwent PCI. As compared with CABG, S-DES had a significantly higher risk of all-cause mortality (hazard ratio 1.35; 95% CI 1.22-1.49; P < 0.001; I2 = 0%), MACE (hazard ratio 1.27; 95% CI 1.08-1.50; P = 0.005; I2 = 67%), and MI (hazard ratio 2.43; 95% CI 1.80-3.28; P < 0.01; I2 = 0%). There was no significant difference between groups in incidence of stroke. In this meta-analysis of patients with complex CAD, PCI with S-DES was associated with an increased risk of mortality, MI, and MACE compared with CABG.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001193","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 impact of bifurcation angle on clinical outcomes in patients who underwent nano-crush technique: the insight from the multicenter EVOLUTE-CRUSH V study.","authors":"Ahmet Yaşar Çizgici, Ahmet Güner, Elnur Alizade, İlyas Çetin, Ebru Serin, Abdullah Doğan, Kaan Gökçe, Berkay Serter, Koray Çiloğlu, İbrahim Faruk Aktürk, Hande Uysal, Ezgi Gültekin Güner, Cemalettin Akman, Aybüke Şimşek, Fatih Furkan Bedir, Veysel Ozan Tanik, Kudret Keskin, Hamdi Püşüroğlu, Merve Aydin, Emre Aydin, Büşra Çörekçioğlu, Mehmet Köseoğlu, Fatih Uzun","doi":"10.1097/MCA.0000000000001507","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001507","url":null,"abstract":"<p><strong>Background: </strong>This multicenter study aimed to retrospectively assess the relationship between bifurcation angle (BA) and major cardiovascular events (MACEs) in patients undergoing nano-crush technique (NCT) for complex bifurcation lesions (CBLs).</p><p><strong>Methods: </strong>A total of 122 consecutive patients [male: 85 (69.6%), mean age: 61.53 ± 9.03 years] who underwent NCT between January 2019 and January 2024 were included. The primary endpoint was a combined endpoint (MACE) including cardiac death, target vessel myocardial infarction (TVMI), or clinically driven target lesion revascularization (TLR). Patients were classified into two groups: MACE-positive and MACE-negative patients.</p><p><strong>Results: </strong>Among the study population, 22 patients (18%) had at least one MACE. The BA (46.89 ± 14.65° vs. 65.23 ± 10.40°, P = 0.001) was notably lower in the MACE-positive group than the MACE-negative group. In multivariable regression analysis, decreased BA was identified as one of the independent predictors of MACE (odds ratio = 0.908; 95% confidence interval: 0.852-0.969; P < 0.001). We divided the study cohort into two subgroups based on historical narrow and wide BAs (<70 vs. ≥70°). The incidence of MACE (25.3 vs. 6.4%, P = 0.008), clinically driven TLR (22.7 vs. 4.3%, P = 0.009), and TVMI (18.7 vs. 0%, P = 0.001) were notably higher in the BA <70° group than in the BA ≥70° group. Kaplan-Meier analysis also revealed that MACE-free survival was significantly lower in the BA <70° group than in the BA ≥70° group under mid-term follow-up (log-rank P = 0.009).</p><p><strong>Conclusion: </strong>This observational multicenter study showed that the BA significantly affects mid-term outcomes in patients who underwent NCT. In addition, our findings suggest that NCT may not be a viable option in patients with narrow-angle (<70°) CBLs.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001343","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}