Coronary artery disease最新文献

{"title":"Stent thrombosis in the setting of ST-segment elevation acute myocardial infarction in the contemporary practice: results from the TOTAL randomized trial.","authors":"Raúl Moreno, Vladimír Džavík, John Cairns, Kumar Balasubramanian, Ricardo Martínez, Warren J Cantor, Sasko Kedev, Goran Stankovic, Olivier Bertrand, Natalia Pinilla, Matthew Sibbald, Elie Akl, Sanjit S Jolly","doi":"10.1097/MCA.0000000000001456","DOIUrl":"10.1097/MCA.0000000000001456","url":null,"abstract":"<p><p>The aim was to know the risk and predictive factors of stent thrombosis (ST) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) in the contemporary practice. The TOTAL [ThrOmbecTomy with percutaneous coronary intervention (PCI) versus PCI ALone] randomized trial, being the largest trial performed in the setting of STEMI with a general application of the recent recommendations, represents a unique opportunity to know the current real-world incidence of ST as well as its associated factors. A total of 10 064 patients that received ≥1 coronary stent in the TOTAL trial comprise the study population. The risk, predictive factors, and clinical implications of ST was studied. During 1-year follow-up, 155 patients (1.54%) suffered definitive or probable ST (59 acute, 67 subacute, and 29 late). Previous infarction, the number of stents, the previous use of clopidogrel, and the use of diuretics at discharge were independent predictors for ST, whereas the use of upfront glycoprotein IIb/IIIa inhibitors, radial access, and treatment with statins at discharge were independent protective factors. The number of stents, stent diameter, upfront treatment with IIb/IIIa inhibitors, previous treatment with clopidogrel, and treatment with statins at discharge were independently associated with the risk of early ST. Only previous infarction was associated with the risk of late ST. In the contemporary practice, ST still constitutes a frequent complication of primary PCI for STEMI, occurring in 1.5% of patients. Independent predictors are different depending on the time of ST.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"126-138"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590363","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 value of fractional flow reserve based on coronary computed tomography angiography with low-dose contrast agent in noninvasive diagnosis of coronary artery disease.","authors":"Zengkun Wang, Xiaomei Luan, Qian Zhang, Chu Chu, Xiaodie Xu, Huijing Chai, Peiji Song","doi":"10.1097/MCA.0000000000001448","DOIUrl":"10.1097/MCA.0000000000001448","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed, using invasive coronary angiography (ICA) as the gold standard, to investigate the noninvasive diagnostic value of flow reserve fraction derived from coronary computed tomography angiography (CCTA) with low-dose contrast agent in coronary artery disease (CAD).</p><p><strong>Methods: </strong>A total of 163 patients with clinical symptoms related to CAD were enrolled between 1 January 2022 and 30 January 2023. The patients received CCTA with a low dose of contrast agent to rule out CAD. If significant (CCTA ≥ 50%) stenosis is suspected, ICA is performed to further evaluate the CCTA for coronary lesions. CT-FFR is calculated from the CCTA dataset using a machine learning-based algorithm. Compared with ICA as a reference standard, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of low-dose contrast agent CT-FFR in the diagnosis of myocardial ischemia were calculated. Coronary lesions with CT-FFR ≤0.80 were defined as hemodynamically significant.</p><p><strong>Results: </strong>Obstructive CAD was excluded by low-contrast CCTA in 87 of 163 patients (53.7%). In the remaining 75 patients (42.35%), at least one coronary artery stenosis was greater than 50%. The accuracy, sensitivity, specificity, PPV, and NPV of low-dose contrast agent CT-FFR on a patient-based evaluation in diagnosing CAD were 93.06, 93.44, 90.01, 98.28, and 71.43%, respectively (Kappa = 0.759). The accuracy, sensitivity, specificity, PPV, and NPV of low-dose contrast agent CT-FFR on a vessel-based evaluation in diagnosing CAD were 86.72, 82.76, 91.58, 92.31, and 81.31%, respectively (Kappa = 0.735). Pearson correlation analysis showed that the ICA examination had a good correlation with CT-FFR value of low-dose contrast media ( r  = 0.731, P  < 0.01). Moreover, in 81.31% of cases, additional analysis of CT-FFR correctly excluded the hemodynamic significance of stenosis.</p><p><strong>Conclusion: </strong>CT-FFR based on low-dose contrast agent CCTA is a very promising noninvasive approach to exclude hemodynamically significant coronary artery stenosis in patients with suspected coronary heart disease while reducing renal burden and helping to reduce the rate of ICA in this high-risk population.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"158-165"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767099","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":"Platelet-to-albumin ratio is an independent predictor for ventricular aneurysm formation in ST segment elevation myocardial infarction.","authors":"Haifeng Ding, Rui Chai, Yin Yin, Wenwen Li, Shijiu Jiang","doi":"10.1097/MCA.0000000000001445","DOIUrl":"10.1097/MCA.0000000000001445","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular aneurysm (LVA) is a common complication of acute myocardial infarction. We aimed to investigate the association of the platelet-to-albumin ratio (PAR) with LVA formation in patients with acute ST segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>A total of 767 consecutive patients with STEMI were prospectively enrolled. Logistic regression analysis and restricted cubic spline (RCS) were used to assess the association between PAR and LVA formation. The predictive ability of PAR and combined variable for LVA formation were assessed using receiver-operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The prevalence of LVA was 14.1%. Univariable logistic regression analysis revealed that PAR was associated with the risk of LVA at both 1 month [odds ratio (OR) = 4.42, P  < 0.001] and 6 months (OR = 4.35, P  < 0.001) of follow-up. The predictive value of PAR remained significant even after multivariate logistic regression analysis at 1 month (OR = 3.42, P  = 0.004) and 6 months (OR = 4.28, P  < 0.001). RCS analysis revealed a nonlinear association between a higher PAR and an increased risk of LVA (nonlinear P  < 0.05). In addition, the predictive abilities of PAR for LVA were 0.659. The combination of PAR, hemoglobin, left ventricular ejection fraction, and the use of angiotensin-converting enzym inhibitor/angiotensin receptor blocker significantly enhanced the ability to predict LVA formation (C statistic= 0.887).</p><p><strong>Conclusion: </strong>A higher PAR was significantly associated with an increased risk of LVA formation in patients with acute STEMI who underwent primary PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"117-125"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567948","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":"Observance of rare congenital anomaly: dual right coronary artery.","authors":"Rachelle Bishay, Jairo Aldana-Bitar, Matthew J Budoff","doi":"10.1097/MCA.0000000000001423","DOIUrl":"10.1097/MCA.0000000000001423","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"178-179"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281588","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":"Comment on: 'The triglyceride-glucose index as a new predictor of coronary artery complexity in elderly patients with non-ST-segment elevation acute coronary syndrome'.","authors":"Cihan Aydin, Mesut Engin, Aykut Demirkiran","doi":"10.1097/MCA.0000000000001482","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001482","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 2","pages":"177"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064232","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":"Timing of coronary angiography in high-risk non-ST-elevation acute coronary syndrome: results from the Portuguese Registry for Acute Coronary Syndromes (ProACS).","authors":"Catarina Ribeiro Carvalho, Marta Catarina Bernardo, Isabel Martins Moreira, Pedro Mateus, Ana Baptista, Ilídio Moreira","doi":"10.1097/MCA.0000000000001457","DOIUrl":"10.1097/MCA.0000000000001457","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend an early invasive coronary angiography (ICA) within 24 h of admission for high-risk patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Nevertheless, meta-analyses failed to demonstrate a clear advantage of this strategy in reducing hard endpoints such as death or nonfatal myocardial infarction compared to a delayed approach. Thus, the optimal timing of ICA in high-risk NSTE-ACS remains undetermined.</p><p><strong>Objective: </strong>This study aimed to determine the optimal timing for ICA in high-risk NSTE-ACS, regarding 1-year all-cause mortality and cardiovascular rehospitalizations.</p><p><strong>Methods: </strong>We conducted a national multicenter retrospective study of high-risk NSTE-ACS patients included in the Portuguese Registry for Acute Coronary Syndromes. Patients were divided into three groups according to the time of ICA: within the first 24 h, between 24 and 48 h, and between 48 and 72 h. The incidence of in-hospital complications and mortality, 1-year mortality, and cardiovascular rehospitalizations were assessed.</p><p><strong>Results: </strong>Of the 9949 patients included, 46.7% underwent early ICA. This was associated with a lower incidence of acute heart failure (8.5% vs. 11.1% vs. 11.5%, P  < 0.001) and shorter length of stay (3 vs. 4 vs. 6 days, P  = 0.012). It, however, did not reduce in-hospital complications or mortality (1.2 vs. 0.7 vs. 0.8%, P  = 0.066). We also found no significant association with the composite endpoint of 1-year mortality or cardiovascular rehospitalization (15.1 vs. 15.9 vs. 15.7%, P  = 0.887).</p><p><strong>Conclusions: </strong>Early ICA was associated with a lower incidence of acute heart failure and shorter length of stay, without a significant impact on 1-year mortality risk or cardiovascular rehospitalizations.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"166-172"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590371","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":"Impact of the fibrosis-4 index in patients with ST-elevated myocardial infarction.","authors":"Naoki Shibata, Takanori Ito, Yasuhiro Morita, Hidenori Toyoda, Yasunori Kanzaki, Naoki Watanabe, Naoki Yoshioka, Hiroyuki Miyazawa, Kazuki Shimojo, Takuma Ohi, Hiroki Goto, Hoshito Karasawa, Itsuro Morishima","doi":"10.1097/MCA.0000000000001431","DOIUrl":"10.1097/MCA.0000000000001431","url":null,"abstract":"<p><strong>Background: </strong>The fibrosis-4 (FIB4) index, a simple, noninvasive marker used for hepatic diseases, represents adverse outcomes. The aim of the present study was to evaluate whether the FIB4 index can predict adverse outcomes in patients with ST-elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>We investigated patients with STEMI who underwent primary percutaneous coronary intervention (PCI) and were alive at discharge. The cut-off FIB4 index at discharge was investigated using the survival classification and regression tree (CART) model to predict adverse outcomes. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Between January 2006 and December 2018, 1354 patients with STEMI (median age, 68 years; men, 76.1%) were investigated. The median value of the FIB4 index was 1.21 (0.84-1.78). The CART model divided the study population into low (FIB4 index <0.945; n  = 435), intermediate (0.945 ≤ FIB4 index < 2.185; n  = 692), and high (FIB4 index ≥2.185; n  = 227) groups based on the significant predictive values for all-cause death. During a median follow-up period of 4.3 years, all-cause death occurred in 208 patients (15.4%). The Kaplan-Meier analysis showed a significant increase in mortality with higher FIB4 index values (log-rank, P  < 0.001). The multivariate Cox regression model revealed that the FIB4 index was an independent risk predictor for all-cause death in patients with STEMI [low group as reference vs. intermediate group, hazard ratio: 1.975; 95% confidence interval (CI): 1.166-3.346; P  = 0.011 and vs. high group, hazard ratio: 4.633; 95% CI: 2.549-8.418; P  < 0.001].</p><p><strong>Conclusions: </strong>The FIB4 index was associated with the risk of all-cause mortality in patients with STEMI who underwent primary PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"99-107"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380239","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":"Drug-coated balloon coronary angioplasty: where are we going?","authors":"Fernando Alfonso, Islam Y Elgendy, Bernardo Cortese","doi":"10.1097/MCA.0000000000001474","DOIUrl":"10.1097/MCA.0000000000001474","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"173-176"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845872","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":"Congenital systemic and coronary-to-pulmonary artery fistulas with a coronary aneurysm rupture.","authors":"Leizhi Ku, Zheng Liu, Xiaojing Ma","doi":"10.1097/MCA.0000000000001516","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001516","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522772","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 of rotational atherectomy followed by cutting balloon for calcified coronary lesions.","authors":"Tingquan Zhou, Xian Jin, Shixin Ma, Jiming Han, Chengxing Shen","doi":"10.1097/MCA.0000000000001515","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001515","url":null,"abstract":"<p><strong>Objective: </strong>Rotational atherectomy is an effective method for treating severe coronary artery calcification; however, several challenges in its clinical application persist. This study aimed to compare the safety and effectiveness of rotational atherectomy combined with cutting balloon (RACB) versus rotational atherectomy with plain balloon (RAPB) in patients with heavily calcified coronary lesions.</p><p><strong>Methods: </strong>This retrospective observational cohort study included 326 patients who underwent rotational atherectomy at Shanghai Sixth People's Hospital from January 2016 to December 2022. Patients were divided into two groups (RACB and RAPB) on the basis of the type of balloon used. The primary outcome was the incidence of major adverse cardiovascular events (MACE) 1 year after percutaneous coronary intervention. Propensity score matching (PSM) was applied to minimize bias, and survival analyses were performed with the Cox proportional hazards model.</p><p><strong>Results: </strong>The procedural complication rates of the patients in the RACB and RAPB groups were comparable. Baseline covariates were balanced between groups after adjustment via PSM. Patients receiving RACB during their procedures had a lower MACE rate during the first postprocedural year in the unadjusted analysis (6.7% vs 16.2%, P < 0.05) and after adjustment with PSM (5.6% vs 16.1%, P < 0.01). The Kaplan-Meier survival curves revealed hazard ratios of 0.44 (95% CI: 0.23-0.82; P < 0.05) for the unadjusted model and 0.36 (95% CI: 0.17-0.76; P < 0.01) for the PSM-adjusted model.</p><p><strong>Conclusion: </strong>Performing RACB before stent implantation was demonstrated to be a safe and effective strategy for managing severely calcified coronary lesions.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467127","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}