Coronary artery disease最新文献

{"title":"Predictive value of residual vessel fractional flow reserve for optimizing coronary physiology postrevascularization.","authors":"Wei-Ting Sung, Ya-Wen Lu, Ming-Ju Chuang, Dan-Ying Lee, Ding-Jun Jaun, Ruey-Hsing Chou, Hsin Lin Chou, Hsin-I Teng, Chun-Chin Chang, Po-Hsun Huang","doi":"10.1097/MCA.0000000000001571","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001571","url":null,"abstract":"<p><strong>Background: </strong>Vessel fractional flow reserve (vFFR) is an angiography-based assessment for coronary physiology. vFFR can be measured at baseline and after percutaneous coronary intervention (PCI). Residual vFFR, a feature designed to predict post-PCI vFFR following stent implantation, can be utilized for PCI planning. This study aimed to investigate the correlation between residual vFFR and post-PCI vFFR, and to identify factors associated with achieving post-PCI vFFR greater than or equal to 0.90.</p><p><strong>Methods: </strong>Between July 2017 to December 2022, 143 chronic coronary syndrome patients (222 vessels) undergoing image-guided PCI using second-generation drug-eluting stents were analyzed retrospectively. Pre-PCI vFFR, residual vFFR, and post-PCI vFFR were calculated using coronary angiograms obtained before and after PCI.</p><p><strong>Results: </strong>Residual vFFR showed a moderate correlation with post-PCI vFFR (r = 0.65, P < 0.001) and had a good predictive value for post-PCI vFFR greater than or equal to 0.90 (area under the curve: 0.83, 95% confidence interval: 0.76-0.90). Multivariable logistic regression analysis indicated non-left anterior descending (LAD) lesions (odds ratio: 4.30, 95% confidence interval: 1.76-10.49; P = 0.001) and stent size greater than or equal to 3.0 mm (odds ratio: 4.23, 95% confidence interval: 1.83-9.74; P < 0.001) were associated with optimal post-PCI vFFR.</p><p><strong>Conclusion: </strong>Residual vFFR demonstrated a strong predictive value for achieving post-PCI vFFR greater than or equal to 0.90. Non-LAD lesions and stent sizes greater than or equal to 3 mm were associated with achieving optimal physiological outcomes after PCI.</p>","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":"144945637","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-induced coronary artery calcification in breast cancer: insights from a systematic review and meta-analysis.","authors":"Nima Rahimi Petrudi, Shiva Rahimi Petroudi, Mohammad Reza Rajabi, Hossein Farshidi, Jalal Hassanshahi","doi":"10.1097/MCA.0000000000001570","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001570","url":null,"abstract":"<p><p>Radiation therapy for breast cancer increases the risk of coronary artery disease by promoting atherosclerotic plaques. However, the extent of changes in coronary artery calcification (CAC) scores postradiation and the influencing factors remain unclear. This systematic review and meta-analysis evaluated studies investigating changes in CAC scores following breast cancer radiation therapy. Data abstraction was independently performed by two unblinded reviewers using structured collection forms, with no divergences in data collection. The nine-star Newcastle-Ottawa Scale scoring system assessed methodological quality. Statistical analysis was conducted using Comprehensive Meta-Analysis software. Among eight studies (1972 patients), radiation doses ranged from 47 to 60 Grays. The overall rate of CAC score increase or new appearance postradiation was 25.8% [95% confidence interval (CI), 21.3-30.8%]. The rate was significantly higher after left-sided radiation at 32.3% (95% CI, 25.7-39.6%) compared to 16.1% (95% CI, 5.8-37.3%) for right-sided radiation. CAC score development occurs in approximately one-quarter of breast cancer patients after radiation therapy, with a significantly higher risk following left-sided radiation. These findings underscore the need for tailored monitoring strategies to mitigate cardiovascular risks in this population.</p>","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":"144945649","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":"Temporal trends in the treatment with beta-blocker and the effect on outcome of patients with acute myocardial infarction.","authors":"Ela Giladi, Ilya Losin, Ziad Arow, Ranin Hilu, Oded Sabah, Rami Barashi, Alexander Omelchenko, Yoav Arnson, Abid Assali, David Pereg","doi":"10.1097/MCA.0000000000001568","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001568","url":null,"abstract":"<p><strong>Background: </strong>Early beta-blocker treatment has long been recommended for patients with acute myocardial infarction (AMI), particularly when left ventricular ejection fraction (LVEF) is reduced; however, whether beta-blocker therapy improves outcomes in patients with AMI receiving contemporary treatment remains uncertain. This study aimed to investigate temporal trends in the effect of beta-blocker therapy on outcomes of patients with AMI in a large, nationwide cohort.</p><p><strong>Methods: </strong>Patients with AMI enrolled in the Acute Coronary Syndromes Israeli Survey from 2000 to 2021 were included. They were categorized into three periods: early (2000-2004), mid (2006-2016), and late (2018-2021). Each period group was further divided into two subgroups based on LVEF (>40 and ≤40%) and then stratified by beta-blocker treatment status.</p><p><strong>Results: </strong>The cohort consisted of 11 569 patients. Among patients with LVEF less than 40%, beta-blocker treatment was associated with improved 1-year survival rates in the early (9.1 vs. 20.4%; P < 0.001) and mid (10 vs. 20.6%; P < 0.001) periods only. Among patients with LVEF greater than or equal to 40%, beta-blocker treatment was linked to enhanced 1-year survival in patients enrolled in the early period (3.4 vs. 7.6%; P < 0.001), but not in the mid and late periods.</p><p><strong>Conclusion: </strong>The association between beta-blocker treatment and improved survival in patients with AMI has diminished over recent decades, regardless of LVEF. These findings are likely attributed to the advancements in contemporary medical and revascularization therapy. As such, our results may challenge current recommendations regarding beta-blocker therapy in AMI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945634","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":"Mechanistic insights into lumen reduction after implantation of a drug-eluting bioresorbable metallic scaffold assessed with serial intracoronary imaging: from the OPTIMIS trial.","authors":"Kirstine Nørregaard Hansen, Akiko Maehara, Jens Trøan, Manijeh Noori, Mikkel Hougaard, Julia Ellert-Gregersen, Karsten Tange Veien, Anders Junker, Henrik Steen Hansen, Jens Flensted Lassen, Lisette Okkels Jensen","doi":"10.1097/MCA.0000000000001561","DOIUrl":"10.1097/MCA.0000000000001561","url":null,"abstract":"<p><strong>Background: </strong>The mechanisms behind lumen reduction after percutaneous coronary intervention with a sirolimus-eluting Magmaris bioresorbable scaffold (MgBRS) are unclear.</p><p><strong>Objectives: </strong>To identify mechanisms and risk factors for lumen reduction after MgBRS implantation.</p><p><strong>Methods: </strong>In the OPTIMIS-trial, patients were randomized to predilatation with a scoring balloon or a standard noncompliant balloon before MgBRS implantation. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) were performed. Patients were divided into two groups according to minimal lumen area (MLA) at 6-month follow-up: MLA less than or equal to 4 mm2 and MLA greater than 4 mm2 assessed with OCT. Matched-framed analysis identified MLA at the lesion site and corresponding sites postprocedure and at follow-up. Vessel injury was defined as an intrascaffold dissection flap greater than or equal to 200 µm. Logistic regression predicted MLA less than or equal to 4 mm2.</p><p><strong>Results: </strong>Preprocedural, postprocedural, and 6-month follow-up IVUS and OCT were analyzable in 73 lesions (MLA ≤ 4 mm2, n = 28, and MLA > 4 mm2, n=45). In the MLA less than or equal to 4 mm2 group, lumen area (7.7 ± 1.8-6.4 ± 2.6 mm2, P = 0.002) and vessel area (15.5 ± 3.8-14.1 ± 4.4 mm2; P = 0.03) were reduced from postprocedure to follow-up, whereas lumen and vessel area did not differ significantly in the MLA less than or equal to 4 mm2 group. Vessel injury [odds ratio (OR): 5.1, 95% confidence interval (CI): 1.4-18.8] and predilatation with a standard noncompliant balloon (OR: 4.0, 95% CI: 1.1-14.4) were independent predictors of MLA less than or equal to 4 mm2.</p><p><strong>Conclusion: </strong>Vessel shrinkage was associated with lumen reduction at the lesion site. Vessel injury and lesion preparation with a standard noncompliant balloon were associated with MLA less than or equal to 4 mm2.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882379","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":"Relationship between C-reactive protein and uric acid to albumin ratio and coronary collateral circulation in patients with chronic total occlusion.","authors":"Kadir Karacali, Tugba Kapansahin, Damla Yalcinkaya Oner, Bilal Canberk Ilhan, Anil Salman, Mikail Yarlioglu","doi":"10.1097/MCA.0000000000001564","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001564","url":null,"abstract":"<p><strong>Objective: </strong>C-reactive protein and uric acid to albumin ratio (CUAR) is a recent inflammatory marker associated with cardiovascular disease. We aim to investigate the relationship between CUAR and coronary collateral circulation (CCC) in patients with stable coronary artery disease and chronic total occlusion (CTO).</p><p><strong>Methods: </strong>The patients were divided into two groups; 267 patients with poor CCC formation group and 133 patients with well CCC formation group. CUARlog was calculated using the 'log10 (CRP × UA/Albumin)' formula.</p><p><strong>Results: </strong>CUARlog levels were significantly higher in patients with poor CCC formation (P < 0.001). CUARlog levels above 1.45 predicted poor CCC with a higher sensitivity of 70% and specificity of 67% than uric acid to albumin ratio (UAR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) (P < 0.001). In the comparison of the AUC values, there was a significant difference between the CUARlog and UAR (P = 0.047), NLR (P = 0.001), and PLR (P < 0.001). In multivariate regression analysis, CUARlog above 1.45 (P < 0.001) was associated independently with poor CCC occurrence.</p><p><strong>Conclusion: </strong>Our results suggested that CUARlog is a more potent and independent marker than other inflammatory markers to predict poor CCC occurrence in CTO patients. It may be useful to identify high-risk patients with poor CCC occurrence.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871829","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":"Artificial intelligence in ECG interpretation: promise, pitfalls, and the peril of cognitive debt.","authors":"Artur Dziewierz","doi":"10.1097/MCA.0000000000001567","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001567","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844826","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":"Urgent percutaneous revascularization of the left main spontaneous coronary artery dissection.","authors":"Uygur Simsek, Kurtulus Karauzum, Didar Mirzamidinov","doi":"10.1097/MCA.0000000000001562","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001562","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844828","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":"Coronary computed tomography angiography/computed tomography perfusion guided percutaneous coronary intervention for recurrent ischemia following coronary artery bypass grafting.","authors":"Han Zhang, Zhao Na, Lei Song","doi":"10.1097/MCA.0000000000001566","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001566","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820758","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":"Intravascular ultrasound-guided covered stent implantation under dummy wire usage for iatrogenic aortocoronary dissection.","authors":"Takashi Kajihara, Jun Shiraishi, Shota Fujii, Tomomi Oda, Rikuya Ukawa, Takashi Mabuchi, Masao Takigami, Masahiro Koide, Keiji Inoue","doi":"10.1097/MCA.0000000000001565","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001565","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820760","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":"A novel algorithm to identify high risk non-ST-elevation acute coronary syndrome patients.","authors":"Georgios Chalikias, Dimitrios Stakos, Anna Dagre, Georgios Triantis, George Kassimis, Ioannis Tsiafoutis, Juan Carlos Kaski, Dimitrios Tziakas","doi":"10.1097/MCA.0000000000001563","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001563","url":null,"abstract":"<p><strong>Background: </strong>Timing of invasive coronary angiography in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains controversial. Angiographic risk and, hence, myocardium at risk are not necessarily considered in currently used non-ST elevation myocardial infarction management algorithms. The aim of this study was to assess the diagnostic performance of the SAVE score in NSTE-ACS patients to noninvasively identify patients with high-risk angiographic risk who might benefit from an early invasive strategy.</p><p><strong>Methods: </strong>We prospectively assessed 950 consecutive patients admitted to five different hospitals with a diagnosis of NSTE-ACS, 598 (491 male, mean age 63 ± 12 years) of whom were risk-stratified according to the SAVE risk score. The primary endpoint was the identification of high-risk angiographic features.</p><p><strong>Results: </strong>High-risk angiographic features were observed in 347 (58%) (292 male/55 female). SAVE score was significantly higher in patients in the high-risk angiography group compared with patients without high-risk features [6 (4.5-8) ± vs. 4 (2-5.5); P < 0.001]. Using the proposed risk score, 79% (275 out of 347 patients) were correctly identified as having a high angiographic risk, and 58% (145 out of 251 patients with low-risk angiographic features) were also correctly identified by the SAVE score.</p><p><strong>Conclusions: </strong>The SAVE score adequately identified patients with high angiographic risk who may benefit from early invasive management strategies.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820724","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}