Coronary artery disease最新文献

{"title":"Long-term (12 months) vs. short-term (<12 months) dual antiplatelet therapy post-percutaneous coronary intervention with drug-eluting stents: a critical appraisal and systematic review.","authors":"Kolten Abbott, Nicholas Seton, Gurjeevan Kaur, Jilai Zhao, Mark Jones, Kuljit Singh","doi":"10.1097/MCA.0000000000001483","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001483","url":null,"abstract":"<p><strong>Background: </strong>A growing body of evidence supports short-term DAPT as safe and efficacious following PCI with DES. However, methodological criticism of RCTs has led to caution when translating results into clinical practice. This study aimed to critically appraise the methodological rigour of included studies and consolidate the evidence on the safety and efficacy of short-term DAPT.</p><p><strong>Methods: </strong>Medline, Cochrane Library and Embase were searched from inception until August 2022. The primary outcome was the methodological quality of published primary studies. Risk of bias was assessed using RoB 2.0 and the CASP tool. Evidence was rated for quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) score approach. Other endpoints were all-cause mortality and major bleeding.</p><p><strong>Results: </strong>Eighteen RCTs were included. Based on GRADE score, there was a moderate level of certainty that the reported results for both outcomes are probably close to the true effect. A total of 78% (14/18) of RCTs had a low risk of bias when assessing all-cause mortality and 61% (11/18) when assessing major bleeding. The CASP tool confirmed methodological rigour; however, only 33% (6/18) of studies were applicable beyond the studied populations. Compared with 12 months of DAPT, short-term DAPT was associated with a reduced risk of major bleeding [relative risk (RR): 0.69, 95% CI: 0.54-0.88, P = 0.003, I2 = 45%] and trended towards a reduced risk in all-cause mortality (RR: 0.90, 95% CI: 0.79-1.01, P = 0.08, I2 = 0%).</p><p><strong>Conclusion: </strong>With moderate certainty evidence, short-term DAPT appears safe and efficacious post-PCI with DES in the studied populations.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 4","pages":"312-325"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981398","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":"Body surface area or sex for stent sizing in proximal coronary arteries.","authors":"James Nguyen, Evan Shlofmitz, Doosup Shin, Sarah Malik, Susan V Thomas, Craig Porter, Koshiro Sakai, Jeffrey W Moses, Akiko Maehara, David J Cohen, Ziad A Ali, Richard A Shlofmitz, Allen Jeremias","doi":"10.1097/MCA.0000000000001463","DOIUrl":"10.1097/MCA.0000000000001463","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"333-334"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784342","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":"Triggering type and long-term survival following ST segment elevation-myocardial infarction treated with primary percutaneous coronary intervention.","authors":"Moaad Slieman, Inbal Greenberg, Zach Rozenbaum, Yoav Granot, Yacov Shacham, David Zahler, Maayan Konigstein, Amir Halkin, Shmuel Banai, Jeremy Ben-Shoshan","doi":"10.1097/MCA.0000000000001455","DOIUrl":"10.1097/MCA.0000000000001455","url":null,"abstract":"<p><strong>Background: </strong>Physical and emotional stress are recognized triggers of acute coronary syndromes, including ST segment elevation-myocardial infarction (STEMI). We have previously shown that identifiable triggers precede symptoms in over one-third of STEMI patients and inversely correlate with the extent of coronary artery disease (CAD). This study aims to investigate the association between trigger type (physical vs. emotional) and long-term mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This retrospective, single-center observational study included all patients admitted with an STEMI diagnosis from January 2008 to December 2013. Physical and emotional triggers were identified retrospectively from patient records. Mortality data were obtained from the Israeli Ministry of Health.</p><p><strong>Results: </strong>Of 1345 consecutive STEMI patients treated with primary PCI, mortality data were available for 1267 patients (median age: 61 years). A trigger preceding symptoms onset was identified in 36.5% of patients, with 85% experiencing physical stress and 15% emotional stress. Triggered STEMI patients tended to be younger with fewer comorbidities and lower incidence of multiple vessel CAD compared with nontriggered patients. Notably, emotionally triggered STEMI patients exhibited improved long-term survival compared with those without emotional triggers or with physical triggers. Emotional triggering was identified as an independent predictor of enhanced long-term survival post-PCI compared with physical triggering.</p><p><strong>Conclusion: </strong>Patients with emotionally triggered STEMI showed less extensive CAD and improved long-term survival following PCI compared with those with physically triggered STEMI. These findings highlight the importance of considering both the presence and type of trigger in the management of STEMI patients and their long-term prognosis.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"281-286"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581865","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 perceived stress on the prognosis in patients undergoing percutaneous coronary intervention.","authors":"Qiuyin Shi, Xuefei Wang, Dongxia Zhao, Weihong Tang, Yongzhen Mo","doi":"10.1097/MCA.0000000000001478","DOIUrl":"10.1097/MCA.0000000000001478","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of perceived stress levels in patients undergoing percutaneous coronary intervention (PCI) on the occurrence of major adverse cardiovascular events (MACEs) within a 6-month follow-up period postprocedure.</p><p><strong>Methods: </strong>A cohort of 339 hospitalized patients with coronary heart disease undergoing initial PCI was prospectively enrolled in the Department of Cardiology at two branches of Zhongda Hospital Affiliated to Southeast University between January 2022 and July 2022. Baseline data including demographic and clinical characteristics, along with the Chinese Perceived Stress Scale (CPSS), were collected. The occurrence of MACE was evaluated at 3 and 6 months post-PCI. Kaplan-Meier survival analysis and Cox regression models were engaged to analyze the relationship between perceived stress and MACE within 6 months after PCI.</p><p><strong>Results: </strong>MACE occurred in 16.22% (55/339) of patients during the 6 following months. High CPSS at baseline was significantly associated with an increasing risk of short-term MACE occurrence (HR: 6.48, 95% confidence interval: 2.98-14.11, P < 0.05).</p><p><strong>Conclusion: </strong>High perceived stress during the baseline period after PCI was significantly correlated with increased incidence of MACE within 6 months postprocedure. The perceived stress level could help to identify patients undergoing PCI at heightened risk of short-term MACE.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"303-311"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845907","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":"Predictors of in-hospital mortality in patients with acute coronary syndrome.","authors":"Cihan Aydin, Mesut Engin, Aykut Demirkiran","doi":"10.1097/MCA.0000000000001497","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001497","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 4","pages":"350"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962662","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":"Aslanger pattern: please do not waste time.","authors":"Miguel Vicente, Bernardo Resende, Domingos Ramos, Lino Gonçalves","doi":"10.1097/MCA.0000000000001471","DOIUrl":"10.1097/MCA.0000000000001471","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"355-357"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845917","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":"Bilateral large conus artery to main pulmonary artery fistulas.","authors":"Jixia Feng, Danping Zhang, Wei Yan, Xuefeng Wang","doi":"10.1097/MCA.0000000000001425","DOIUrl":"10.1097/MCA.0000000000001425","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"353-354"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343086","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 HALP score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention.","authors":"Huiliang Liu, Feifei Zhang, Yingxiao Li, Litian Liu, Xuelian Song, Jiaqi Wang, Yi Dang, Xiaoyong Qi","doi":"10.1097/MCA.0000000000001446","DOIUrl":"10.1097/MCA.0000000000001446","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Despite recent advances in the management of ST-segment elevation myocardial infarction (STEMI), the clinical outcome of some patients is still unsatisfactory. Therefore, early evaluation to identify high-risk individuals in STEMI patients is essential. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, as a new indicator that can reflect both nutritional status and inflammatory state of the body, can provide prognostic information. In this context, the present study was designed to investigate the relationship between HALP scores assessed at admission and no-reflow as well as long-term outcomes in patients with STEMI.</p><p><strong>Material and methods: </strong>A total of 1040 consecutive STEMI patients undergoing primary PCI were enrolled in this retrospective study. According to the best cutoff value of HALP score of 40.11, the study samples were divided into two groups. The long-term prognosis was followed up by telephone.</p><p><strong>Results: </strong>Long-term mortality was significantly higher in patients with HALP scores lower than 40.11 than in those higher than 40.11. The optimal cutoff value of HALP score for predicting no-reflow was 41.38, the area under the curve (AUC) was 0.727. The best cutoff value of HALP score for predicting major adverse cardiovascular events (MACE) was 40.11, the AUC was 0.763. The incidence of MACE and all-cause mortality was higher in the HALP score <40.11 group.</p><p><strong>Conclusion: </strong>HALP score can independently predict the development of no-reflow and long-term mortality in STEMI patients undergoing PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"273-280"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567953","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":"Artificial or not?: spontaneous and acetylcholine-induced coronary spasm during coronary angiography.","authors":"Valeria Martínez Pereyra, Andreas Seitz, Peter Ong","doi":"10.1097/MCA.0000000000001441","DOIUrl":"10.1097/MCA.0000000000001441","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"362-364"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521238","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":"Obesity paradox in coronary artery disease: national inpatient sample analysis.","authors":"Ali Salman, Muhammad Saad, Ruqiat Masooma Batool, Zainab Siddiqua Ibrahim, Saad Ahmed Waqas, Syed Zaeem Ahmed, Syed Ibad Ahsan, Eliza Aisha, Haiqa Aamer, Muhammad Umer Sohail, Ifrah Ansari, Muhammad Khalid Afridi, Fatima Aman Makda, Jazza Aamir","doi":"10.1097/MCA.0000000000001479","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001479","url":null,"abstract":"<p><strong>Background: </strong>Although existing literature highlights obesity as a significant predictor for coronary artery disease (CAD), the impact of BMI on hospital outcomes among CAD patients remains unclear.</p><p><strong>Methods: </strong>We extracted data from the National Inpatient Sample database for adult patients with CAD from 2018 to 2020. The study cohort was stratified into six BMI categories: underweight, normal weight, overweight, class I obesity, class II obesity, and class III obesity. Using multivariable logistic and linear regression, we assessed the impact of BMI on in-hospital mortality, length of stay (LOS), and inflation-adjusted total charges.</p><p><strong>Results: </strong>We identified a total of 3 693 570 hospitalizations (mean age: 69 ± 12 years). Underweight individuals had the highest in-hospital mortality rate (6.8%), followed by normal weight (5.2%), overweight (3.2%), class III obese (2.5%), class I obese (1.9%), and class II obese (1.8%) individuals. After adjusting for covariates, underweight patients had higher odds of in-hospital mortality compared to normal-weight individuals [odds ratio (OR), 1.38; 95% confidence interval (CI), 1.31-1.45; P < 0.001], while overweight or obese individuals had lower odds: overweight (OR, 0.75; 95% CI, 0.70-0.79; P < 0.001), obese class I: (OR, 0.54; 95% CI, 0.51-0.57; P < 0.001), obese class II: (OR, 0.56; 95% CI, 0.53-0.59; P < 0.001), obese class III: (OR, 0.78; 95% CI, 0.74-0.82; P < 0.001). Normal weight and underweight patients had the longest median LOS [5 days (3.0-9.0)]. Overweight patients incurred the highest total charges [$53 730 (28 587-105 184)].</p><p><strong>Conclusion: </strong>Underweight patients experienced higher, while overweight and obese patients experienced lower in-hospital mortality than normal-weight patients, suggesting a protective effect of higher BMI against mortality in CAD.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 4","pages":"294-302"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971673","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}