Coronary artery disease最新文献

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Deconditioning in coronary artery disease: an underrecognized problem with contemporary clinical relevance. 冠状动脉疾病的去适应:一个与当代临床相关的未被充分认识的问题。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-17 DOI: 10.1097/MCA.0000000000001667
Chun Shing Kwok, Jonathan Hinton, Gregory Y H Lip, Adnan I Qureshi, Josip Andelo Borovac
{"title":"Deconditioning in coronary artery disease: an underrecognized problem with contemporary clinical relevance.","authors":"Chun Shing Kwok, Jonathan Hinton, Gregory Y H Lip, Adnan I Qureshi, Josip Andelo Borovac","doi":"10.1097/MCA.0000000000001667","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001667","url":null,"abstract":"<p><p>Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Beyond recurrent ischemic events, many patients experience a sustained and gradual reduction in physical activity and functional capacity after diagnosis, hospitalization, and treatment. Deconditioning is a complex process that encompasses physiological and behavioral decline driven by inactivity, symptoms, fear-avoidance behaviors, and treatment-related factors. It provides a unifying condition through which these deficits can be understood and targeted. Although exercise-based cardiac rehabilitation is a cornerstone of secondary prevention, deconditioning is rarely measured explicitly in clinical practice or treated as a reportable outcome in CAD studies and clinical pathways. In this narrative review, we aim to refine the contemporary definition of deconditioning as it applies to CAD, and we summarize drivers of deconditioning across the CAD continuum (stable angina, acute coronary syndromes, and postrevascularization care). Furthermore, we discuss clinical consequences, including impaired quality of life, hospital readmission risk, and reduced participation, in evidence-based therapies. Finally, this review proposes a pragmatic research and implementation agenda to incorporate objective activity/functional endpoints and early patient mobilization strategies into routine CAD care. Treating deconditioning as a modifiable, patient-oriented outcome may improve recovery after adverse coronary events and might offer a platform that aligns coronary revascularization and pharmacotherapy decisions with what matters to patients the most. This includes the absence of ischemic symptoms, recovery of functional capacity, and return to usual leisure and work activities.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758462","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}
引用次数: 0
Intravascular lithotripsy versus rotational atherectomy in calcified coronary artery disease: a systematic review and meta-analysis. 钙化冠状动脉疾病的血管内碎石术与旋转动脉粥样硬化切除术:系统回顾和荟萃分析。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-13 DOI: 10.1097/MCA.0000000000001611
Basma Badrawy Khalefa, Abdelrahman M Elettreby, Moumen Arnaout, Basel F Alqeeq, Alshayma Alalawneh, Shahd Alqato, Naif Fawaz Aljamlan, Mohammad Tanashat, Wafaa Shehada, Almothana Manasrah, Malik Allahham, Bassel Gaballah, Ahmad Jabri, Pedro Villablanca
{"title":"Intravascular lithotripsy versus rotational atherectomy in calcified coronary artery disease: a systematic review and meta-analysis.","authors":"Basma Badrawy Khalefa, Abdelrahman M Elettreby, Moumen Arnaout, Basel F Alqeeq, Alshayma Alalawneh, Shahd Alqato, Naif Fawaz Aljamlan, Mohammad Tanashat, Wafaa Shehada, Almothana Manasrah, Malik Allahham, Bassel Gaballah, Ahmad Jabri, Pedro Villablanca","doi":"10.1097/MCA.0000000000001611","DOIUrl":"10.1097/MCA.0000000000001611","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary stenosis with severe calcification is a serious challenge for percutaneous coronary intervention. Coronary artery calcification interferes with stent expansion and catheter passage and leads to higher complications, such as target lesion failure, stent thrombosis, and cardiac mortality. There are multiple proposed modalities for calcium modification, such as intravascular lithotripsy (IVL) and rotational atherectomy. We aim to compare both techniques for calcified coronary artery disease.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, Cochrane, and Web of Science from inception to January 2025. To estimate the effect size, dichotomous outcomes were pooled as odds ratio (OR), and continuous outcome was pooled as mean difference with their respective 95% confidence interval (CI). The prespecified primary endpoint was major adverse cardiovascular events (MACE; in‑hospital and longest reported follow‑up). Procedural success was a prespecified key secondary endpoint.</p><p><strong>Results: </strong>Fifteen studies were included (rotational atherectomy: n  = 1406; IVL: n  = 1088). There was no difference in MACE in‑hospital (OR = 1.43, 95% CI: 0.63-3.22) or at longest follow‑up (OR = 0.93, 95% CI: 0.44-2.00). Procedural success favored IVL (OR = 0.57, 95% CI: 0.36-0.89). Safety endpoints favored IVL: rotational atherectomy was associated with more coronary perforation (OR = 2.67, 95% CI: 1.58-4.49) and slow flow/no‑reflow (OR = 2.49, 95% CI: 1.03-6.03). There were no differences in mortality (in‑hospital or long‑term), myocardial infarction (in‑hospital or long‑term), target vessel revascularization, or stent thrombosis. Procedure duration was shorter with IVL (mean difference: 13.79 min, 95% CI: 4.09-23.49).</p><p><strong>Conclusion: </strong>IVL and rotational atherectomy are excellent options to be utilized in the plaque modification of calcified coronary artery lesions before drug-eluting stents implantation with comparable clinical safety and efficacy outcomes. Rotational atherectomy and IVL yielded comparable clinical outcomes for MACE. IVL was associated with higher procedural success, fewer periprocedural complications (perforation, slow flow/no‑reflow), and shorter procedures. However, the higher costs incurred by IVL represent a major drawback that limits the use and the standardization of such a technique in clinical practice.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"366-376"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965443","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}
引用次数: 0
Long-term impact of a left upper limb arteriovenous fistula on coronary artery bypass surgery with left internal thoracic artery to left anterior descending artery anastomosis. 左上肢动静脉瘘对左胸内动脉与左前降支吻合冠状动脉搭桥手术的远期影响。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-07 DOI: 10.1097/MCA.0000000000001607
Ryoma Oda, Takeshi Kinoshita, Daisuke Endo, Kan Kajimoto, Taira Yamamoto, Atsushi Amano, Minoru Tabata
{"title":"Long-term impact of a left upper limb arteriovenous fistula on coronary artery bypass surgery with left internal thoracic artery to left anterior descending artery anastomosis.","authors":"Ryoma Oda, Takeshi Kinoshita, Daisuke Endo, Kan Kajimoto, Taira Yamamoto, Atsushi Amano, Minoru Tabata","doi":"10.1097/MCA.0000000000001607","DOIUrl":"10.1097/MCA.0000000000001607","url":null,"abstract":"<p><strong>Background: </strong>The left internal thoracic artery (LITA) to left anterior descending artery (LAD) anastomosis is standard in coronary artery bypass grafting (CABG) owing to its long-term patency. However, in hemodialysis patients with an ipsilateral upper-limb arteriovenous fistula (AVF), in-situ LITA grafting may raise concern for coronary steal syndrome (CSS). We assessed whether AVF laterality influences outcomes after CABG with LITA-LAD in hemodialysis patients.</p><p><strong>Methods: </strong>We retrospectively reviewed hemodialysis patients who underwent isolated primary CABG with in-situ LITA-LAD between 2002 and 2020. Patients were classified by AVF side (ipsilateral vs. contralateral). The primary endpoint was all-cause mortality; secondary endpoints were cardiac death, major adverse cardiac events (MACEs), and in-hospital mortality. Propensity score matching (2 : 1), time-to-event analyses, and competing-risk analyses were performed.</p><p><strong>Results: </strong>Of 206 patients (169 ipsilateral and 37 contralateral), 99 (66 ipsilateral and 33 contralateral) were matched, achieving covariate balance. All-cause mortality was similar in the overall and matched cohorts (log-rank P = 0.89 and P = 0.34), and AVF laterality was not associated with mortality (hazard ratio: 0.98, 95% confidence interval: 0.57-1.69, P = 0.94). Cardiac death, MACEs, and in-hospital mortality did not differ significantly; all four in-hospital deaths occurred in the ipsilateral group (three due to cardiac causes).</p><p><strong>Conclusion: </strong>In hemodialysis patients undergoing CABG with in-situ LITA-LAD, an ipsilateral AVF was not associated with worse survival or cardiovascular outcomes, supporting the safety of in-situ LITA grafting even when ipsilateral to an AVF. Future studies should identify CSS high-risk subgroups (e.g. subclavian artery stenosis, forearm vs. upper-arm AVF).</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"336-343"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932705","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}
引用次数: 0
Imaging coronary atherosclerotic precursors of acute myocardial infarction from baseline coronary computed tomography angiography to follow-up optical coherence tomography. 从基线冠状动脉计算机断层血管成像到后续光学相干断层成像,急性心肌梗死的冠状动脉粥样硬化前体成像。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-29 DOI: 10.1097/MCA.0000000000001616
Sarah Malik, Evan Shlofmitz, Kathleen Rapelje, Susan Thomas, Omar K Khalique, Allen Jeremias, Ziad Ali, Richard Shlofmitz, Jie Jane Cao
{"title":"Imaging coronary atherosclerotic precursors of acute myocardial infarction from baseline coronary computed tomography angiography to follow-up optical coherence tomography.","authors":"Sarah Malik, Evan Shlofmitz, Kathleen Rapelje, Susan Thomas, Omar K Khalique, Allen Jeremias, Ziad Ali, Richard Shlofmitz, Jie Jane Cao","doi":"10.1097/MCA.0000000000001616","DOIUrl":"10.1097/MCA.0000000000001616","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"403-405"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060606","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}
引用次数: 0
Balloon-expandable versus self-expanding valves in severe aortic stenosis with small aortic annulus: an updated meta-analysis. 球囊扩张与自扩张瓣膜治疗严重主动脉狭窄伴小主动脉环:一项最新荟萃分析。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-02-04 DOI: 10.1097/MCA.0000000000001618
Igor Antonio Tolentino Narciso, Mrinal Murali Krishna, Meghna Joseph, Luis Rene Puglla Sanchez, Chidubem Ezenna, Ayesha Ayesha, Vinicius Pereira, Paweł Łajczak, Bárbara Samira Mendes, Michele Schincariol
{"title":"Balloon-expandable versus self-expanding valves in severe aortic stenosis with small aortic annulus: an updated meta-analysis.","authors":"Igor Antonio Tolentino Narciso, Mrinal Murali Krishna, Meghna Joseph, Luis Rene Puglla Sanchez, Chidubem Ezenna, Ayesha Ayesha, Vinicius Pereira, Paweł Łajczak, Bárbara Samira Mendes, Michele Schincariol","doi":"10.1097/MCA.0000000000001618","DOIUrl":"10.1097/MCA.0000000000001618","url":null,"abstract":"<p><strong>Background: </strong>Balloon-expandable valve (BEV) and self-expanding valve (SEV) are used in transcatheter aortic valve replacement (TAVR). Patients with a small aortic annulus (SAA) make up to one-third of the cases and face higher risks of prosthesis-patient mismatch and high valvular gradients.</p><p><strong>Objectives: </strong>This meta-analysis aimed to compare balloon-expandable and self-expanding valves used in TAVR in patients with a SAA, focusing on hemodynamic and clinical outcomes.</p><p><strong>Methods: </strong>We systematically searched Cochrane Central, PubMed, and EMBASE for studies comparing balloon-expandable and self-expanding valves in patients with SAA undergoing TAVR. Random effects models were applied to generate odds ratios (ORs) and mean differences with 95% confidence interval (CI).</p><p><strong>Results: </strong>Fifteen studies (two randomized controlled trials and 13 propensity-matched studies) with 5149 patients (48.4% balloon-expandable valves) were identified. BEVs were associated with a lower indexed effective orifice area (mean difference: -0.18, 95% CI: -0.25 to -0.10; P  < 0.00001) and higher transvalvular mean pressure gradient (mean difference: 4.32, 95% CI: 3.39-5.24; P  < 0.00001) and peak pressure gradients (mean difference: 4.87, 95% CI: 1.23-8.51; P  = 0.009). Permanent pacemaker implantation (OR: 0.57, 95% CI: 0.44-0.73; P  < 0.0001) and major bleeding (OR: 0.67, 95% CI: 0.47-0.96; P  = 0.03) were lower in balloon-expandable valves. BEVs increased the odds of any prosthesis-patient mismatch (OR: 2.28, 95% CI: 1.61-3.22; P  < 0.00001) and severe prosthesis-patient mismatch (OR: 3.16, 95% CI: 2.19-4.58; P  < 0.00001).</p><p><strong>Conclusion: </strong>In patients with SAA undergoing TAVR, SEVs offer superior hemodynamic performance, whereas BEVs are associated with fewer conduction disturbances and bleeding events. Both valve platforms yielded similar clinical outcomes, underscoring the need for individualized device selection.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"394-402"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112610","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}
引用次数: 0
Impact of cancer history on coronary calcification and clinical outcomes in intravascular ultrasound-guided percutaneous coronary intervention. 超声引导下经皮冠状动脉介入治疗中癌症病史对冠状动脉钙化及临床结果的影响。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-07 DOI: 10.1097/MCA.0000000000001609
Daisuke Kanda, Akihiro Tokushige, Kenta Ohmure, Hirokazu Shimono, Hiroyuki Tabata, Nobuhiro Ito, Takuro Kubozono, Mitsuru Ohishi
{"title":"Impact of cancer history on coronary calcification and clinical outcomes in intravascular ultrasound-guided percutaneous coronary intervention.","authors":"Daisuke Kanda, Akihiro Tokushige, Kenta Ohmure, Hirokazu Shimono, Hiroyuki Tabata, Nobuhiro Ito, Takuro Kubozono, Mitsuru Ohishi","doi":"10.1097/MCA.0000000000001609","DOIUrl":"10.1097/MCA.0000000000001609","url":null,"abstract":"<p><strong>Background: </strong>Cancer survivors have an elevated cardiovascular disease burden, yet the influence of cancer history on coronary calcification and outcomes following percutaneous coronary intervention (PCI) is not well characterized. This study investigated the association between cancer history and coronary calcification assessed by intravascular ultrasound (IVUS), and examined outcomes after IVUS-guided PCI.</p><p><strong>Methods: </strong>We retrospectively evaluated 450 patients with stable angina who underwent IVUS-guided PCI between January 2020 and March 2024 and stratified them into cancer ( n  = 110) and non-cancer ( n  = 340) groups. Coronary calcification was graded using an IVUS-derived calcium score. Major adverse cardiac and cerebrovascular events (MACCEs) were assessed during follow-up. Multivariate logistic and Cox regression analyses identified predictors of severe calcification (IVUS-calcium score ≥2) and MACCEs excluding cancer-related deaths. Furthermore, outcomes of rotational atherectomy for severely calcified lesions were examined.</p><p><strong>Results: </strong>Patients with a history of cancer had a high prevalence of moderate-to-severe calcification. Cancer history was independently associated with severe calcification (adjusted odds ratio: 2.32; 95% confidence interval: 1.43-3.77; P  < 0.001), but not with MACCEs excluding cancer-related deaths. An IVUS-calcium score ≥2 and impaired renal function were independently associated with MACCEs excluding cancer-related deaths. Among patients undergoing rotational atherectomy, clinical outcomes including MACCEs and target lesion revascularization were comparable between groups.</p><p><strong>Conclusion: </strong>Cancer history was associated with a greater coronary calcification burden; however, clinical outcomes following IVUS-guided PCI showed no significant difference between patients with and without cancer. These findings suggest that appropriate IVUS-guided lesion assessment enable safe revascularization in this high-risk population.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"355-365"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932743","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}
引用次数: 0
The pan-immune-inflammation value associated with in-hospital heart failure in elderly patients with acute myocardial infarction. 老年急性心肌梗死患者院内心力衰竭的泛免疫炎症价值
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2025-12-16 DOI: 10.1097/MCA.0000000000001606
Yi Ma, Jing Han, Jianhui Wang, Haojun An, Xuebin Geng, Ning Shang, Shuyu Li
{"title":"The pan-immune-inflammation value associated with in-hospital heart failure in elderly patients with acute myocardial infarction.","authors":"Yi Ma, Jing Han, Jianhui Wang, Haojun An, Xuebin Geng, Ning Shang, Shuyu Li","doi":"10.1097/MCA.0000000000001606","DOIUrl":"10.1097/MCA.0000000000001606","url":null,"abstract":"<p><strong>Background: </strong>Few studies have focused on the association between pan-immune-inflammation value (PIV) and in-hospital heart failure postcoronary angioplasty in elderly patients with acute myocardial infarction (AMI).</p><p><strong>Objectives: </strong>This prospective study aimed to confirm the relationship between PIV, the severity of coronary artery disease, and in-hospital heart failure in elderly patients with AMI after coronary angioplasty.</p><p><strong>Methods: </strong>A total of 799 patients with AMI aged greater than or equal to 60 years were enrolled and divided into two groups according to whether they presented heart failure during hospitalization. They all received coronary angiography and underwent successful percutaneous coronary intervention. The degree of stenosis of the coronary artery was assessed with the Gensini score.</p><p><strong>Results: </strong>PIV was significantly greater in the heart failure group than in the control group (1250 ± 975 vs. 674 ± 406; P < 0.001). The multivariate Cox proportional hazards model analyses found that PIV (hazard ratio: 1.029, 95% confidence interval: 1.015-1.045, P < 0.001) was an independent risk factor of in-hospital heart failure. Receiver-operating characteristic curve analyses showed that the optimal cutoff value of the PIV for pridicting in- hospital heart failure was 693, with a sensitivity of 68% and a specificity of 69%. In addition, the multivariate logistic regression analysis revealed that PIV was an independent predictor of the severity of coronary artery disease ( P < 0.05).</p><p><strong>Conclusion: </strong>PIV was an independent predictor of the severity of coronary artery disease and in-hospital heart failure in elderly patients with AMI after coronary angioplasty.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"329-335"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767328","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}
引用次数: 0
Reduction in circulating endothelial progenitor cells caused by obstructive sleep apnea-related hypoxemia and its association with the severity of coronary artery disease. 阻塞性睡眠呼吸暂停相关低氧血症引起的循环内皮祖细胞减少及其与冠状动脉疾病严重程度的关系
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-22 DOI: 10.1097/MCA.0000000000001615
Hehe Zhang, Jing Zhang, Yun Lin, Yuanni Jiao, Shuang Li, Hao Wu, Xin Xi, Jiang Xie
{"title":"Reduction in circulating endothelial progenitor cells caused by obstructive sleep apnea-related hypoxemia and its association with the severity of coronary artery disease.","authors":"Hehe Zhang, Jing Zhang, Yun Lin, Yuanni Jiao, Shuang Li, Hao Wu, Xin Xi, Jiang Xie","doi":"10.1097/MCA.0000000000001615","DOIUrl":"10.1097/MCA.0000000000001615","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a risk factor for coronary artery disease (CAD), while endothelial progenitor cells (EPCs) are critical for vascular repair. This study investigated the associations among OSA-related hypoxemia, circulating EPC, and CAD severity.</p><p><strong>Methods: </strong>This prospective study enrolled patients with unstable angina undergoing coronary angiography. All participants underwent overnight polysomnography to determine the apnea-hypopnea index (AHI) and the sleep apnea-specific hypoxic burden (SASHB). Circulating EPCs were quantified using flow cytometry. CAD severity was assessed via angiography, with a Gensini score greater than or equal to 22 defining severe CAD and the presence of greater than or equal to 2 major vessels with greater than or equal to 50% diameter stenosis defining multivessel CAD.</p><p><strong>Results: </strong>Among 80 included patients [median age 59 years; 53 (66.3%) male], 42 (52.5%) had OSA (AHI ≥ 15 events/h). Patients with high SASHB exhibited more severe coronary artery lesions than those with low SASHB (Gensini: 33.0 vs. 19.5; P  = 0.040). Multivariable linear regression confirmed log10-transformed SASHB as an independent predictor of reduced circulating EPC levels (count: standardized β = -0.37, P  = 0.002; percentage: standardized β = -0.40, P  < 0.001). Multivariable logistic regression analysis revealed low EPC count [odds ratio (OR) = 3.41, 95% confidence interval (CI): 1.21-9.58, P  = 0.020] and low EPC percentage (OR = 2.94, 95% CI: 1.00-8.78, P  = 0.049) as independent risk factors for multivessel CAD.</p><p><strong>Conclusion: </strong>OSA may promote CAD progression by depleting EPCs and hindering vascular repair. Incorporating hypoxemia metrics and EPC levels into risk assessment could help identify patients with OSA-related CAD.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"385-393"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008727","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}
引用次数: 0
Long-term outcomes of premature acute myocardial infarction: impact of multivessel disease. 早发急性心肌梗死的长期预后:多血管疾病的影响
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-20 DOI: 10.1097/MCA.0000000000001613
Sang Hyun Kim, Wonjae Lee, Eun Ho Choo, Kwan Yong Lee, Byung-Hee Hwang, Ik Jun Choi, Jong-Min Lee, Ki-Dong Yoo, Mahn-Won Park, Chul Soo Park, Hee-Yeol Kim, Min Chul Kim, Youngkeun Ahn, Kiyuk Chang
{"title":"Long-term outcomes of premature acute myocardial infarction: impact of multivessel disease.","authors":"Sang Hyun Kim, Wonjae Lee, Eun Ho Choo, Kwan Yong Lee, Byung-Hee Hwang, Ik Jun Choi, Jong-Min Lee, Ki-Dong Yoo, Mahn-Won Park, Chul Soo Park, Hee-Yeol Kim, Min Chul Kim, Youngkeun Ahn, Kiyuk Chang","doi":"10.1097/MCA.0000000000001613","DOIUrl":"10.1097/MCA.0000000000001613","url":null,"abstract":"<p><strong>Background: </strong>Premature acute myocardial infarction (AMI) is increasingly prevalent yet underrepresented in trials. We aimed to evaluate the prognosis of premature AMI and the prognostic impact of multivessel coronary artery disease.</p><p><strong>Methods: </strong>We analyzed consecutive AMI patients undergoing percutaneous coronary intervention in the multicenter Cardiovascular Risk and Identification of Potential High-Risk Population in AMI registry between April 2001 and April 2015, with follow-up through October 2019. Patients with premature AMI (age ≤ 45 years) were analyzed, and those who experienced in-hospital death were excluded. The primary outcome was major adverse cardiovascular events (MACE, a composite of recurrent myocardial infarction (MI), stroke, or repeat revascularization). Risks of ischemic outcomes were evaluated using multivariable Fine-Gray subdistribution hazard models. Sensitivity analyses included cause-specific Cox regression and multiple-imputation Cox models, accounting for competing risks.</p><p><strong>Results: </strong>Of the 10 144 AMI patients, 907 (8.9%) had premature AMI (mean 40.4 years; 94.3% male). Compared with older patients, premature AMI was not associated with lower risk of MACE [adjusted subdistribution hazard ratio (sHR) 1.01, 95% confidence interval (CI): 0.84-1.21], recurrent MI (adjusted sHR 1.49, CI: 1.07-2.06), and repeat revascularization (adjusted sHR 1.16, 95% CI: 0.95-1.44), despite fewer comorbidities. Findings were consistent across sensitivity analyses. In premature AMI, 34.3% had multivessel disease, which independently predicted higher risks of MACE (sHR 2.46), recurrent MI (sHR 3.34), and repeat revascularization (sHR 2.46) compared with older patients (sHR 1.47, 1.22, 1.61, respectively) with significant age-by-multivessel interactions.</p><p><strong>Conclusion: </strong>Premature AMI exhibited sustained long-term ischemic risk despite favorable baseline profiles. Multivessel disease conferred a greater prognostic impact in younger patients, highlighting the need for intensified secondary prevention strategies. Given the extended inclusion period encompassing major therapeutic advances, these findings should be interpreted with caution and warrant validation in contemporary clinical practice.Registration: https://www.clinicaltrials.gov ; unique identifier: NCT02806102.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"377-384"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003098","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}
引用次数: 0
Iatrogenic coronary pseudoaneurysm diagnosed by three-dimensional transesophageal echocardiography. 经食道三维超声心动图诊断医源性冠状动脉假性动脉瘤。
IF 2.2 4区 医学
Coronary artery disease Pub Date : 2026-08-01 Epub Date: 2026-01-13 DOI: 10.1097/MCA.0000000000001612
Hatice Tolunay, Yunus Oz, Mehmet Can Ozalevli, Ozgur Ulas Ozcan, Mustafa Mucahit Balci
{"title":"Iatrogenic coronary pseudoaneurysm diagnosed by three-dimensional transesophageal echocardiography.","authors":"Hatice Tolunay, Yunus Oz, Mehmet Can Ozalevli, Ozgur Ulas Ozcan, Mustafa Mucahit Balci","doi":"10.1097/MCA.0000000000001612","DOIUrl":"10.1097/MCA.0000000000001612","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"406-407"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965431","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}
引用次数: 0
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