Coronary artery disease最新文献

{"title":"Rescue primary percutaneous coronary intervention and left main bifurcation stenting via the arteria lusoria.","authors":"Konstantinos C Theodoropoulos, Evdoxia Stavropoulou, Matthaios Didagelos, Charalambos Kakderis, Alexandra Liakopoulou, Antonios Kouparanis, Vasileios Rafailidis, Antonios Ziakas","doi":"10.1097/MCA.0000000000001443","DOIUrl":"10.1097/MCA.0000000000001443","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"e70-e71"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521240","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":"Heart's hidden link: intercoronary communication in a geriatric patient.","authors":"Ana Rita Teixeira, Bárbara Lacerda Teixeira, Pedro Garcia Brás, Tiago Mendonça, Rui Cruz Ferreira","doi":"10.1097/MCA.0000000000001453","DOIUrl":"10.1097/MCA.0000000000001453","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"543-544"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581747","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":"Predicting severe multivessel coronary artery disease to guide access strategy in patients undergoing invasive coronary angiography.","authors":"Garry W Hamilton, David Chye, Hannah Johns, Jefferson Ko, Edmond Wong, Leonid Churilov, Jaishankar Raman, David J Clark, Omar Farouque","doi":"10.1097/MCA.0000000000001490","DOIUrl":"10.1097/MCA.0000000000001490","url":null,"abstract":"<p><strong>Introduction: </strong>Given radial artery conduits are increasingly utilized for coronary artery bypass grafting (CABG), avoiding transradial access (TRA) for invasive coronary angiography (ICA) may benefit patients who ultimately undergo CABG. We sought to predict the likelihood of severe multivessel disease (MVD) before ICA to guide this decision.</p><p><strong>Methods: </strong>This was a single-center study of 1485 patients with stable symptoms who underwent ICA. A model to predict severe MVD was developed. Relative importance analyses were performed to identify clinical characteristics most associated with the presence or absence of severe MVD.</p><p><strong>Results: </strong>When predicting severe MVD, the model had a sensitivity of 70.3% and specificity of 71.8% (area under the curve = 0.7105). With a prevalence of 12.5% in our cohort, the model had a strong negative predictive value of 94.4%. Relative importance analyses showed factors most associated with the presence of severe MVD were a history of abnormal noninvasive tests, typical chest pain, aspirin use, insulin-dependent diabetes, increasing age, and a family history of coronary artery disease. Conversely, the absence of severe MVD was most associated with female sex, undergoing ICA as workup for either noncardiac or valve surgery, lung disease, atypical chest pain, and increased BMI.</p><p><strong>Conclusion: </strong>Clinical information available before ICA can risk stratify the likelihood of severe MVD and therefore aid in identifying patients that may need CABG and could stand to benefit from TRA avoidance. The potential benefits of maximizing radial artery conduit availability by avoiding TRA must be balanced against the risks of alternative access on an individual patient basis.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"e12-e18"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845945","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 quantitative flow ratio with in-stent restenosis in patients with unstable angina undergoing percutaneous coronary intervention.","authors":"Dongchao Liu, Zheng Xue, Jingxian Qi, Liang Yin, Bing Duan, Bulang Gao, Jie Mi","doi":"10.1097/MCA.0000000000001494","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001494","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) with in-stent restenosis (ISR) in patients with unstable angina.</p><p><strong>Materials and methods: </strong>Patients treated with PCI and follow-up for ISR were divided into a poor QFR group (QFR < 0.91) and a good QFR group with (QFR ≥ 0.91). All clinical data were analyzed.</p><p><strong>Results: </strong>Among 143 patients enrolled, 57 (39.9%) patients were in the poor QFR group and 86 (60.1%) in the good QFR group. After stenting, the stenosis was decreased to 0 from ≥80% before PCI. At 10-month follow-up, the incidence of ISR in the good QFR group was 6.9%, significantly lower than 33.9% in the poor QFR group (P < 0.05). QFR < 0.91 was a significant (P = 0.002) risk factor for ISR, 4.25 times that of patients with QFR ≥ 0.91. After adjusting for age and sex, the risk of developing ISR in patients with poor QFR was 4.51 times that in patients with good QFR [95% confidence interval (CI): 1.76-11.54, P = 0.002], and QFR < 0.91 (adjusted risk ratio: 6.57, 95% CI: 2.45-17.60, P < 0.001) and diabetes (adjusted risk ratio: 7.23, 95% CI: 2.81-18.60, P < 0.001) were two independent risk factors for ISR.</p><p><strong>Conclusion: </strong>A positive linear relationship exists between QFR and ISR after adjusting for age and sex, and poor QFR < 0.91 after PCI is a significant independent risk factor for ISR among unstable angina patients undergoing PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 6","pages":"482-487"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774840","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 fate of coronary artery bypass grafting in the elderly: treat and forget.","authors":"Elisa Gastino, Fabio Barili, Stefano Rosato, Francesco Pollari, Giovanni Baglio, Matteo Scarpanti, Gabriella Badoni, Giorgia Duranti, Francesco Donatelli, Alessandro Parolari, Paola D'Errigo","doi":"10.1097/MCA.0000000000001552","DOIUrl":"10.1097/MCA.0000000000001552","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery bypass grafting (CABG) is offered to a growing population of octogenarians, considering the constant rise of life expectancy. However, the mid-term benefit of surgical revascularization is still unclear. The aim of this study is to highlight the 10-year outcomes after isolated CABG in the elderly included in the Italian nationwide PRIORITY cohort.</p><p><strong>Methods: </strong>Patients younger and older than 80 years were identified within the PRIORITY project. Baseline differences between the study groups were balanced with propensity score matching and inverse probability of treatment. Time to events was analyzed using Cox regression and competing risk analysis.</p><p><strong>Results: </strong>The cohort consisted of 10 989 patients who underwent isolated CABG (7.9% OPCAB). The median follow-up time was 7.9 years. Octogenarians showed poorer 10-year survival [hazard ratio (HR) 3.09, 95% confidence interval (CI) 2.93-3.25, P  < 0.001] and major adverse cardiac and cerebrovascular events (HR 2.13, 95% CI 2.04-2.22, P  < 0.001). Interestingly, although presenting higher incidence of myocardial infarction (MI) at 10 years (HR 1.39, 95% CI 1.29-1.50, P  < 0.001), octogenarians demonstrated a reduced incidence of 10-year myocardial revascularization (HR 0.53, 95% CI 0.48-0.59, P  < 0.001), corroborating the hypothesis of undertreatment for elderly.</p><p><strong>Conclusions: </strong>With the increasing incidence of octogenarians undergoing CABG, undertreatment after surgery appears a critical issue. The higher incidence of 10-year MI, together with the opposite rate of myocardial revascularization, suggests a tendency for conservative approaches, opening a debate on the choice of treating the elderly with CABG without guaranteeing a clinical assistance comparable to younger patients.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"474-481"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574977","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":"Prognostic value of systemic immune-inflammation index in older patients with acute coronary syndrome.","authors":"Ahmet Gürdal, Ebru Serin, Mert Sarilar, Mutlu Çağan Sümerkan, Erol Kalender, Hasan Değirmenci, Sinan Şahin, Kudret Keskin","doi":"10.1097/MCA.0000000000001496","DOIUrl":"10.1097/MCA.0000000000001496","url":null,"abstract":"<p><strong>Objectives: </strong>Contemporary studies assessing the importance of the systemic immune-inflammation index (SII) in older patients presenting with acute coronary syndrome (ACS) are scarce. This study investigated the impact and prognostic value of the SII regarding long-term mortality in older patients with ACS.</p><p><strong>Methods: </strong>The study included 401 older patients aged 75 years and above admitted with ACS between May 2015 and December 2022. Predictors of mortality were determined using multivariate Cox regression analysis. Survival curves were generated using the Kaplan-Meier method.</p><p><strong>Results: </strong>The patients' median age was 81 (77-85) years, and 197 (49.1%) were male. The median follow-up was 23 months (Q1-Q3 : 4-43, maximum: 102). All short- and long-term deaths, including in-hospital deaths, were significantly high in patients with high SII ( P  = 0.001). Inflammatory variables, including C-reactive protein, SII, the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio, were positively correlated with the SYNTAX score (for SII; R  = 0.492, P  = 0.001). Multivariate Cox regression analysis revealed that age [hazard ratio (HR): 1.082, 95% confidence interval (CI): 1.051-1.114, P  = 0.001], estimated glomerular filtration rate (HR: 0.988, 95% CI: 0.982-0.994, P  = 0.001), SII (HR: 1.004, 95% CI: 1.001-1.006, P  = 0.001), and left ventricular ejection fraction (HR: 0.959, 95% CI: 0.947-0.97, P  = 0.001) were independent predictors of mortality in older patients with ACS. Kaplan-Meier analysis also showed that patients with high SII had a significantly higher mortality rate ( P  = 0.001).</p><p><strong>Conclusion: </strong>A high SII is an independent predictor of long-term mortality in older patients with ACS.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"e45-e52"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001212","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 management of giant coronary artery aneurysms.","authors":"Zaid Abood, Andrew Lin, Tanvir Bajwa, Suhail Q Allaqaband, M Fuad Jan","doi":"10.1097/MCA.0000000000001439","DOIUrl":"10.1097/MCA.0000000000001439","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"534-535"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521241","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":"Comparative clinical and echocardiographic outcomes of coronary artery bypass grafting for nonfilling and filling chronic total occlusion in the left anterior descending artery.","authors":"Takeshi Kinoshita, Ryoma Oda, Daisuke Endo, Taira Yamamoto, Minoru Tabata","doi":"10.1097/MCA.0000000000001531","DOIUrl":"10.1097/MCA.0000000000001531","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the clinical and echocardiographic outcomes of multivessel coronary artery bypass grafting (CABG) for nonfilling vs. filling chronic total occlusion (CTO) in the left anterior descending artery (LAD).</p><p><strong>Methods: </strong>A retrospective analysis included 257 from 2778 patients undergoing multivessel CABG at Juntendo University between 2002 and 2020. CTO lesions were assessed using coronary angiography, and collateral circulation was graded using the Rentrop classification. Nonfilling CTO was defined as grades 0 and 1 while filling CTO was defined as grades 2 and 3.</p><p><strong>Results: </strong>LAD revascularization with internal thoracic artery (ITA) grafts showed higher graft dysfunction in nonfilling CTO patients. Transit-time flow measurement revealed lower mean graft flow (23 ± 12 ml/min vs. 36 ± 13 ml/min, P  = 0.01) and higher pulsatile index (4.0 ± 1.5 vs. 3.0 ± 1.4, P  = 0.02) in nonfilling CTO patients. Postoperative computed tomography in the ITA grafts indicated string signs in 13.7% of nonfilling CTO and 6.1% of filling CTO patients ( P  = 0.04), with graft occlusion rates of 5.9 and 1.8%, respectively ( P  = 0.03). Although long-term survival rates showed no significant difference ( P  = 0.19), filling CTO patients had significant improvements in left ventricular ejection fraction (LVEF) from 39 to 47% ( P  = 0.01) and wall motion score index (WMSI) from 1.5 to 1.1 ( P  = 0.02). In contrast, nonfilling CTO patients did not show significant improvements in LVEF ( P  = 0.76) or WMSI ( P  = 0.64).</p><p><strong>Conclusion: </strong>CABG for LAD nonfilling CTO does not significantly impact long-term survival but is associated with lower graft flow, higher occlusion rates, and less improvement in cardiac function compared to filling CTO.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"459-466"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989550","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 bifurcation angle on clinical outcomes in patients who underwent nano-crush technique: the insight from the multicenter EVOLUTE-CRUSH V study.","authors":"Ahmet Yaşar Çizgici, Ahmet Güner, Elnur Alizade, İlyas Çetin, Ebru Serin, Abdullah Doğan, Kaan Gökçe, Berkay Serter, Koray Çiloğlu, İbrahim Faruk Aktürk, Hande Uysal, Ezgi Gültekin Güner, Cemalettin Akman, Aybüke Şimşek, Fatih Furkan Bedir, Veysel Ozan Tanik, Kudret Keskin, Hamdi Püşüroğlu, Merve Aydin, Emre Aydin, Büşra Çörekçioğlu, Mehmet Köseoğlu, Fatih Uzun","doi":"10.1097/MCA.0000000000001507","DOIUrl":"10.1097/MCA.0000000000001507","url":null,"abstract":"<p><strong>Background: </strong>This multicenter study aimed to retrospectively assess the relationship between bifurcation angle (BA) and major cardiovascular events (MACEs) in patients undergoing nano-crush technique (NCT) for complex bifurcation lesions (CBLs).</p><p><strong>Methods: </strong>A total of 122 consecutive patients [male: 85 (69.6%), mean age: 61.53 ± 9.03 years] who underwent NCT between January 2019 and January 2024 were included. The primary endpoint was a combined endpoint (MACE) including cardiac death, target vessel myocardial infarction (TVMI), or clinically driven target lesion revascularization (TLR). Patients were classified into two groups: MACE-positive and MACE-negative patients.</p><p><strong>Results: </strong>Among the study population, 22 patients (18%) had at least one MACE. The BA (46.89 ± 14.65° vs. 65.23 ± 10.40°, P  = 0.001) was notably lower in the MACE-positive group than the MACE-negative group. In multivariable regression analysis, decreased BA was identified as one of the independent predictors of MACE (odds ratio = 0.908; 95% confidence interval: 0.852-0.969; P  < 0.001). We divided the study cohort into two subgroups based on historical narrow and wide BAs (<70 vs. ≥70°). The incidence of MACE (25.3 vs. 6.4%, P  = 0.008), clinically driven TLR (22.7 vs. 4.3%, P  = 0.009), and TVMI (18.7 vs. 0%, P  = 0.001) were notably higher in the BA <70° group than in the BA ≥70° group. Kaplan-Meier analysis also revealed that MACE-free survival was significantly lower in the BA <70° group than in the BA ≥70° group under mid-term follow-up (log-rank P  = 0.009).</p><p><strong>Conclusion: </strong>This observational multicenter study showed that the BA significantly affects mid-term outcomes in patients who underwent NCT. In addition, our findings suggest that NCT may not be a viable option in patients with narrow-angle (<70°) CBLs.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"e53-e61"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001343","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":"'Open umbrella' technique with a distal protection filter for foreign body retrieval.","authors":"Te-Ming Lin, Chia-Hung Wu, Jung-Hsuan Chen, Feng-Chi Chang","doi":"10.1097/MCA.0000000000001569","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001569","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945643","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}