Coronary artery disease最新文献

{"title":"Side-branch rescue through balloon deflection technique.","authors":"Dimitrios Karelas, Konstantinos Manousopoulos, Konstantinos Filippou, Panagiotis Varelas, Ioannis Papadopoulos, Ioannis Tsiafoutis","doi":"10.1097/MCA.0000000000001638","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001638","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670874","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":"Postpercutaneous coronary intervention right atrioventricular groove hematoma causing transient mild tricuspid inflow stenosis.","authors":"Anastasios Apostolos, Mohammad Almajali, Dhanuka Perera, Mohammed Majid Akhtar, Vasileios Panoulas","doi":"10.1097/MCA.0000000000001640","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001640","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670944","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":"Plaque regression and stabilization by proprotein convertase subtilisin/kexin type 9 inhibitors: a meta-analysis of intravascular imaging studies.","authors":"Ryu Umezono, Shingo Kato, Naofumi Yasuda, Shungo Sawamura, Yoshinobu Ishiwata, Nobuyuki Horita, Daisuke Utsunomiya","doi":"10.1097/MCA.0000000000001639","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001639","url":null,"abstract":"<p><strong>Background and aims: </strong>Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are potent lipid-lowering agents that may also influence the structural and compositional features of coronary atherosclerotic plaques. Although individual intravascular imaging modalities have demonstrated beneficial effects, an integrated evaluation across modalities remains limited.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of studies evaluating the impact of PCSK9 inhibitors on coronary plaque using intravascular ultrasound, near-infrared spectroscopy, and optical coherence tomography. PubMed, Web of Science, and the Cochrane Library were searched up to June 2025. The primary outcomes were changes in percent atheroma volume (PAV), fibrous cap thickness (FCT), and maximum lipid core burden index within 4 mm (maxLCBI4 mm). A random-effects model was used to pool results.</p><p><strong>Results: </strong>Ten studies with a total of 1642 patients (PCSK9 inhibitor group: 816; control group: 826) were included. PCSK9 inhibitors significantly reduced PAV compared with control [mean difference: -1.03%; 95% confidence interval (CI): -1.46 to -0.60; P < 0.00001; I2 = 27%]. Minimum FCT showed an increase (mean difference: 28.44 μm; 95% CI: 6.10-50.77; P = 0.01; I2 = 82%). Furthermore, PCSK9 inhibitors reduced maxLCBI4 mm (mean difference: -39.73; 95% CI: -65.49 to -13.98; P = 0.002).</p><p><strong>Conclusion: </strong>This comprehensive intravascular imaging meta-analysis demonstrates that PCSK9 inhibitors are associated with both regression and stabilization of coronary plaques, as evidenced by reductions in PAV and lipid content and increases in fibrous cap thickness. These imaging-based structural changes may underlie the cardiovascular benefits observed in major outcome trials.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626639","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":"Intra-aortic balloon support for myocardial infarction with cardiogenic shock: insights from the Swedish Coronary Angiography and Angioplasty Registry.","authors":"Sebastian Völz, Pétur Pétursson, Björn Redfors, Truls Råmunddal, Dimitrios Venetsanos, Antros Louca, Araz Rawshani, Jacob Odenstedt, Inger Valeljung, Oskar Angerås, Dan Ioanes, Anna Myredal, Christian Dworeck, Charlotta Ljungman, Entela Bollano, Giovanna Sarno, Sasha Koul, Tomas Jernberg, Robin Hofmann, Joakim Alfredsson, Ole Fröbert, David Erlinge, Elmir Omerovic","doi":"10.1097/MCA.0000000000001634","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001634","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock remains the leading cause of in-hospital death in patients with acute myocardial infarction (MI). The intra-aortic balloon pump (IABP), once widely used, was downgraded in European guidelines after a major randomized trial showed no mortality benefit. This prospective observational study evaluated the impact of IABP on 30-day mortality and in-hospital complications in real-world patients with MI complicated by cardiogenic shock.</p><p><strong>Methods: </strong>Data were obtained from the Swedish Coronary Angiography and Angioplasty Registry, including all percutaneous coronary intervention procedures performed across 31 hospitals in Sweden between 2005 and 2018. A total of 2991 patients with cardiogenic shock were included, of whom 737 (25%) received IABP. To account for baseline differences, instrumental variable analysis was applied using hospital treatment preference as the instrument.</p><p><strong>Results: </strong>At 30 days, 52% of patients had died, and by 1 year, mortality reached 63.2%. In-hospital complications occurred in 13.4% of patients. IABP treatment was not associated with reduced mortality at 30 days [risk reduction: -1.1%, 95% confidence interval (CI): -15.7 to 13.5; P = 0.881] or at 1 year (risk reduction: -0.8%, 95% CI: -23.2 to 0.06; P = 0.258). However, IABP use was associated with a significantly higher risk of in-hospital complications (increase of 26.1%, 95% CI: 15.2-36.8; P < 0.001).</p><p><strong>Conclusion: </strong>IABP did not improve short- or long-term survival in patients with MI-related cardiogenic shock but was linked to increased complications, supporting current guideline recommendations against its routine use.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615964","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":"Association of serum fibroblast growth factor 21 levels with coronary artery calcification and coronary intervention in patients with chronic total occlusion.","authors":"Cong Wang, Jinghua Liu","doi":"10.1097/MCA.0000000000001636","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001636","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between serum fibroblast growth factor 21 (FGF21) levels and the severity of coronary artery calcification (CAC) in patients with chronic total occlusion (CTO), as well as the complexity and outcomes of percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We enrolled 128 CTO patients who underwent PCI and preprocedural coronary computed tomography angiography, dividing them into severe CAC (n = 48) and nonsevere CAC (n = 80) groups according to an Agatston score of greater than or equal to 400.</p><p><strong>Results: </strong>Serum FGF21 levels were significantly lower in patients with severe CAC, negatively correlated with CAC scores, and independently associated with severe CAC after multivariable adjustment [odds ratio (OR) per 1-SD increase: 0.481, 95% confidence interval (CI): 0.244-0.947; P < 0.05]. Patients with low FGF21 levels had significantly higher complexity scores, increased use of guidewires, longer procedural times, and lower procedural success rates (all P < 0.05). Receiver operating characteristic analysis identified 226.13 pg/ml as the optimal cut-off value of serum FGF21 for predicting procedural success. The area under the curve was 0.664 (95% CI: 0.527-0.802; P = 0.029).</p><p><strong>Conclusion: </strong>Serum FGF21 levels were negatively correlated with CAC severity and independently predicted severe CAC in patients with CTO. Serum FGF21 was associated with procedural difficulty and had a diagnostic value for procedural success.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615996","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)-associated thrombus formation and plaque healing in acute coronary syndromes: insights from optical coherence tomography.","authors":"Yusaku Shibata, Osamu Kurihara, Nobuaki Kobayashi, Fumitaka Okajima, Masamichi Takano, Kuniya Asai","doi":"10.1097/MCA.0000000000001637","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001637","url":null,"abstract":"<p><strong>Background: </strong>Elevated lipoprotein(a) levels are associated with myocardial infarction; however, in-vivo evidence linking lipoprotein(a) to intracoronary thrombosis remains limited. We evaluated phase-specific lipoprotein(a) levels during the hyperacute, acute, and stable phases of acute coronary syndrome and their associations with angiographic and optical coherence tomography findings.</p><p><strong>Methods: </strong>We analyzed 142 patients with acute coronary syndrome who underwent optical coherence tomography during percutaneous coronary intervention and for whom lipoprotein(a) was measured in the hyperacute (n = 58), acute (n = 125), or stable (n = 51) phases.</p><p><strong>Results: </strong>Baseline demographics, laboratory data, angiographic findings, and optical coherence tomography characteristics were similar across phases. Patients with intracoronary thrombus had significantly higher hyperacute-phase lipoprotein(a) levels than did those without [10.2 (interquartile range: 5.4-18.8) vs. 3.7 (3.0-10.3) mg/dl; P = 0.033]. In addition, a greater increase in lipoprotein(a) from the hyperacute to the acute phase was associated with thrombus presence [12.1 (4.0-18.4) vs. 2.35 (0.0-7.1) mg/dl; P = 0.027]. Conversely, patients with layered plaque on acute-phase optical coherence tomography demonstrated significantly lower stable-phase lipoprotein(a) levels than did those without [4.1 (3.0-7.1) vs. 13.0 (5.7-21.3) mg/dl; P = 0.014]. No significant associations were observed for acute-phase lipoprotein(a) levels.</p><p><strong>Conclusion: </strong>Elevated hyperacute-phase lipoprotein(a) levels were associated with intracoronary thrombus, whereas low stable-phase lipoprotein(a) levels were associated with layered plaque. These phase-specific relationships suggest that lipoprotein(a) influences thrombosis and plaque healing in acute coronary syndrome, and that stable-phase lipoprotein(a) levels may better reflect baseline biology and help identify prior subocclusive events.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616019","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 coronary-pulmonary artery fistulae demonstrated by coronary computed tomography angiography.","authors":"Ramazan Orkun Onder, Merve Nur Tasdemir, Serdar Aslan","doi":"10.1097/MCA.0000000000001635","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001635","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616040","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":"https://doi.org/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":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-26","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":"Back to the flow: a comprehensive systematic review and meta-analysis of epinephrine in the treatment of no-reflow.","authors":"Leonardo Dexheimer da Silva, Leonardo Cadorin de Araújo, Eduarda Dexheimer da Silva, Kauã Gabriel Oliveira, Ricardo Fonseca Oliveira Suruagy-Motta, Miguel Rodrigues Moreira, Gabriel Rezende Neves, Carlos Alexandre Farias, Leonardo Galvão de Oliveira Oldra, Pedro Antonio Machado Gomes de Sousa, Pedro Augusto Bento de Sousa, Felipe da Silva Ribeiro, Guilherme Sobreira Spina, Kalgi Modi","doi":"10.1097/MCA.0000000000001632","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001632","url":null,"abstract":"<p><strong>Purpose: </strong>The no-reflow phenomenon is defined as inadequate microvascular reperfusion despite successful epicardial coronary recanalization, associated with multiple adverse outcomes, occurring in up to 7% of primary PCI. Its multifactorial pathophysiology includes endothelial injury, distal embolization, and vasospasm. Thus, intracoronary epinephrine has shown promising results due to its vascular regulation. Then, this meta-analysis evaluates the role of epinephrine to treat and prevent the no-reflow phenomenon.</p><p><strong>Methods: </strong>Following Preferred reporting Items for Systematic Reviews and Meta-Analysis standards, we systematically searched MEDLINE, Scopus, Embase, Cochrane, and Web of Science for studies comparing epinephrine with conventional therapy or other drugs. The primary outcome was thrombolysis in myocardial infarction (TIMI) flow. Secondary outcomes included major adverse cardiovascular events (MACE), heart failure, mortality, left ventricular ejection fraction, and myocardial blush grade.</p><p><strong>Results: </strong>Eleven studies (700 epinephrine, 298 control) were included. TIMI flow was assessed using single-arm meta-analyses, stratified into refractory and primary no-reflow. TIMI 3 flow was achieved in 63% of refractory and 86% of primary. Myocardial blush grade 3 was achieved in 47.4% of cases. MACE incidence was 14% in refractory and 18% in primary no-reflow. Compared with conventional treatment, epinephrine reduced MACE risk (risk ratio 0.45; 95% confidence interval: 0.23-0.87; P = 0.01; I2 = 0%) but showed no difference versus adenosine. Heart failure incidence was 11% in controls and 5% in adenosine, without significant comparative differences.</p><p><strong>Conclusion: </strong>Therefore, intracoronary epinephrine was associated with encouraging but exploratory findings, and the higher success rate in primary no-reflow may reflect earlier intervention and less severe microvascular damage. Its modest advantage over adenosine suggests potential therapeutic value, though evidence remains limited and heterogeneous.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497844","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 evolution of a 5-cm giant right coronary artery-to-left ventricular fistula: a 6-year clinical follow-up.","authors":"Zhenzhen Xiao, Xiaojing Ma, Li Zhu","doi":"10.1097/MCA.0000000000001633","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001633","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497764","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}