Coronary artery disease最新文献

{"title":"Optical coherence tomography versus angiography alone for guidance of percutaneous coronary intervention of calcified coronary lesions: a meta-analysis.","authors":"Ahmed Emara, Ahmed Mansour, Mohamed Doma, Khaldoon Alaswad, Emmanouil S Brilakis, Michael Megaly","doi":"10.1097/MCA.0000000000001656","DOIUrl":"10.1097/MCA.0000000000001656","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"485-487"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143013","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":"Evaluating the benefits of high-dose statin preloading in ST-segment elevation myocardial infarction management: insights from a systematic review and meta-analysis.","authors":"Bernardo Resende, Emídio Mata, Tomás Carlos, João Português, Sílvia Ribeiro, João Gameiro, António Lourenço, Lino Gonçalves","doi":"10.1097/MCA.0000000000001629","DOIUrl":"10.1097/MCA.0000000000001629","url":null,"abstract":"<p><strong>Introduction: </strong>ST-segment elevation myocardial infarction (STEMI) is a life-threatening condition needing urgent reperfusion, with better outcomes linked to optimal myocardial perfusion. Statins may reduce ischemia-reperfusion injury through pleiotropic effects. While the 2019 European Society of Cardiology (ESC) Dislipidemia Guidelines recommended high-intensity statins before percutaneous coronary intervention (PCI), this was not included in the 2023 ESC or 2025 ACC/AHA/ACEP/NAEMSP/SCAI ACS Guidelines.</p><p><strong>Objective: </strong>To evaluate the effect of high-dose statin loading before primary PCI in improving coronary reperfusion and clinical outcomes in STEMI patients through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>On June 2025, CENTRAL, EMBASE, and PubMed were searched for RCTs comparing high-dose statin preloading with placebo or no statin in STEMI patients undergoing primary PCI. The primary outcome was post-PCI thrombolysis in myocardial infarction (TIMI) flow grade 3. Secondary outcomes included all-cause mortality and greater than or equal to 50% ST-segment resolution. Data were pooled using random-effects models, reporting odds ratios (OR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Nine RCTs with 1862 patients were included. High-dose statin preloading significantly increased the likelihood of achieving post-PCI TIMI flow grade 3 (OR: 1.52, 95% CI: 1.06-2.20). It was also associated with a reduction in all-cause mortality (OR: 0.59, 95% CI: 0.36-0.98). No significant difference was observed in greater than or equal to 50% ST-segment resolution (OR: 1.04, 95% CI: 0.71-1.50).</p><p><strong>Conclusion: </strong>High-dose statin loading before primary PCI in STEMI patients seems to be associated with improved coronary reperfusion and reduced all-cause mortality. These findings offer timely and clinically relevant insight, reminding the cardiovascular community of the potential value of this therapeutic.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"439-448"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376336","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":"Surgical versus percutaneous revascularization in multivessel non-ST-elevation acute coronary syndrome: a meta-analysis of 77 989 patients.","authors":"Mohammed A Elbahloul, Ahmed Elbataa, Momen Hajali, Ahmed Wahdan Kasem, Samer O Alalalmeh, Mohamed El-Moslemani, Mohamed Ahmed Zanaty, Ahmed Shawky, Ahmed K Awad, Andrea Amabile, Massimo Baudo, Gianluca Torregrossa, Sameer Hirji","doi":"10.1097/MCA.0000000000001642","DOIUrl":"10.1097/MCA.0000000000001642","url":null,"abstract":"<p><p>Multivessel coronary artery disease (MVD) significantly complicates the management of patients with non-ST-elevation acute coronary syndrome, worsening their clinical and angiographic outcomes. However, the optimal revascularization strategy in this subset of patients is still controversial. Our systematic review and meta-analysis aimed to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with MVD and non-ST-elevation acute coronary syndrome . We performed a comprehensive search of four electronic databases (PubMed, Scopus, WOS, and Cochrane) from inception till 15 December 2024. The outcomes were reported as a relative risk (RR) and 95% confidence interval (CI) in the random-effect model. Our primary outcome was all-cause mortality, while the secondary outcomes were major adverse cardiovascular events (MACCE), myocardial infarction (MI), cardiac death, repeated revascularization, and stroke. Fourteen studies, comprising 77 989 patients, were included. CABG was associated with lower risk of all-cause mortality (RR: 0.80, 95% CI: 0.68-0.93), MACCE (RR: 0.70, 95% CI: 0.59-0.83), MI (RR: 0.53, 95% CI: 0.42-0.67), cardiac death (RR: 0.77, 95% CI: 0.68-0.89), and repeated revascularization (RR: 0.41, 95% CI: 0.33-0.51) in long-term follow-up. However, stroke incidence was higher with CABG in long-term follow-up (RR: 1.36, 95% CI: 1.07-1.73). CABG and PCI showed no significant difference in clinical outcomes at 30-day follow-up. This meta-analysis showed that CABG was associated with favorable long-term outcomes compared to PCI, including lower mortality, MACCE, MI, and repeated revascularization. Time-dependent hazard ratio showed that CABG was associated with better survival over a 16-year follow-up period. perioperative outcomes were comparable in both CABG and PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"470-484"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765016","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":"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 (maxLCBI 4 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 maxLCBI 4 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":"461-469"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","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":"Radiation burden in chronic total occlusion percutaneous coronary intervention is driven more by lesion complexity and planned strategy than by the target vessel.","authors":"Sefa Sural, Semi Ozturk, Ahmet Seyfeddin Gurbuz, Sevket Gorgulu","doi":"10.1097/MCA.0000000000001672","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001672","url":null,"abstract":"<p><strong>Background: </strong>Radiation exposure is an important safety issue in chronic total occlusion percutaneous coronary intervention (CTO PCI). Right coronary artery (RCA) CTO PCI is often associated with a higher radiation burden, but it remains unclear whether this reflects the target-vessel location itself or differences in lesion complexity and strategy selection.</p><p><strong>Methods and results: </strong>We analyzed 1800 consecutive CTO PCI procedures performed between January 2020 and June 2025 at three participating CTO PCI centers (RCA n = 1013; left anterior descending coronary artery n = 540; left circumflex coronary artery n = 247). High radiation exposure was defined as a dose-area product (DAP) greater than the 90th percentile among available DAP values (>35 400 cGy·cm2). DAP was available in 1321 procedures (73.4%). RCA cases had longer fluoroscopy time and higher median DAP in unadjusted analyses. In the center-adjusted primary model, planned retrograde/hybrid strategy (adjusted odds ratio: 2.23, 95% confidence interval: 1.42-3.51) and higher J-CTO score (adjusted odds ratio: 1.70, 95% confidence interval: 1.39-2.09) were the strongest predictors of high DAP, whereas target vessel was not independently associated with excess radiation after adjustment. A Firth penalized center-adjusted sensitivity analysis yielded the same interpretation. Secondary analyses using continuous DAP and clinically relevant air kerma thresholds supported the same overall pattern.</p><p><strong>Conclusion: </strong>In CTO PCI, the higher radiation observed in RCA cases was mainly associated with lesion complexity and anticipated retrograde/hybrid strategy rather than with target-vessel location alone. These findings support strategy-based radiation risk assessment and careful donor-vessel protection when retrograde or hybrid crossing is expected.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825721","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":"Interpreting the link between obstructive sleep apnea-related hypoxemia, endothelial progenitor cells, and coronary disease severity.","authors":"Güney Sarioğlu","doi":"10.1097/MCA.0000000000001668","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001668","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825677","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":"Interpreting the interplay between lipoprotein(a) and high-density lipoprotein cholesterol on mortality: causal inference, interaction testing, and selection bias.","authors":"Shankar Biswas, Yashasvi Srivastava, Maliha Sahreen Hossain","doi":"10.1097/MCA.0000000000001671","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001671","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825694","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":"Optical coherence tomography-guided stent-less procedure using cutting balloon and drug-coated balloon for highly porous recanalized coronary thrombus.","authors":"Takashi Mabuchi, Jun Shiraishi, Hiroaki Kawakami, Yuki Nagae, Miki Nio, Shota Fujii, Takashi Kajihara, Rikuya Ukawa, Masahiro Koide, Keiji Inoue","doi":"10.1097/MCA.0000000000001669","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001669","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807930","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":"Exertional syncope and chest pain in an adolescent with anomalous origin of the left coronary artery from the right sinus of Valsalva.","authors":"Xuefeng Wang, Jixia Feng, Ji Li","doi":"10.1097/MCA.0000000000001666","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001666","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788663","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":"Combined triglyceride-glucose index and systemic inflammation for long-term risk stratification in major adverse cardiovascular events: a 10-year prospective study.","authors":"Zhao Ma, Pei Zhu, Jingjing Xu, Yang Yang, Yan Chen, Lin Jiang, Sida Jia, Queyun Sun, Jiayu Zhang, Lijian Gao, Lei Song, Jinqing Yuan, Ying Song","doi":"10.1097/MCA.0000000000001665","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001665","url":null,"abstract":"<p><strong>Background and aims: </strong>Insulin resistance and systemic inflammation are key drivers of atherosclerosis but are typically evaluated separately. This study aimed to determine whether integrating the triglyceride-glucose (TyG) index with inflammatory markers improves long-term risk stratification for major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD).</p><p><strong>Methods and results: </strong>In this prospective cohort study, 9316 CAD patients were followed for 10 years. Cox regression models were used to assess associations between the TyG index and inflammatory markers with MACE. Incremental predictive value was evaluated using net reclassification improvement (NRI) and integrated discrimination improvement. The combined TyG-inflammation models were significantly associated with an increased risk of 10-year MACE, corresponding to a 19.1% relative increase in hazard. Among the evaluated models, the TyG + systemic inflammation response index (SIRI) combination demonstrated the most consistent performance, primarily through improving risk reclassification rather than discrimination. The model achieved an NRI of 5.5% for overall MACE and 15.4% for cardiac death, indicating improved identification of high-risk patients who would not be detected by the TyG index alone.</p><p><strong>Conclusion: </strong>Integrating systemic inflammation, particularly SIRI, with the TyG index significantly enhances long-term cardiovascular risk reclassification in CAD patients. This simple and cost-effective approach based on routine laboratory parameters may improve risk stratification and support more targeted secondary prevention.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788717","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}