Coronary artery disease最新文献

{"title":"Deciphering the incidence of heart failure following drug-eluting stent use in patients with high bleeding risk: a population-based cohort study.","authors":"Li-Nien Chien, Yan-Jun Chen, Ya-Hui Chang, Chao-Feng Lin","doi":"10.1097/MCA.0000000000001588","DOIUrl":"10.1097/MCA.0000000000001588","url":null,"abstract":"<p><strong>Objective: </strong>Features of high bleeding risk (HBR) determined by the Academic Research Consortium (ARC) are linked to an enhanced risk of bleeding events among patients undergoing percutaneous coronary intervention. This population-based study investigated whether patients with ARC-HBR are at an increased risk of hospitalization for heart failure (HHF) following drug-eluting stent (DES) implantation by analyzing a large-scale national healthcare database.</p><p><strong>Methods: </strong>A total of 124 891 patients undergoing DES implantation between 1 January 2007 and 31 December 2019 were identified and divided into two groups: the ARC-HBR group and the non-ARC-HBR group. The incidence rates of HHF of patients were observed. The risk of HHF following DES implantation associated with ARC-HBR features was analyzed using a multivariable Cox proportional hazards model.</p><p><strong>Results: </strong>The incidence rates (per 1000 person-year) of HHF were 86.9 [95% confidence interval (CI): 84.3-89.6] for ARC-HBR patients and 28.8 (95% CI: 28.3-29.3) for non-ARC-HBR patients during a mean follow-up of 4.6 ± 2.9 years. After adjustment for clinical variables, ARC-HBR patients exhibited an increased risk of HHF [adjusted hazard ratio (aHR): 1.13, 95% CI: 1.08-1.19, P  < 0.001], particularly among patients without a prior history of HHF (aHR: 1.31, 95% CI: 1.24-1.39, P  < 0.001). These results remained consistent for patients who adhered to greater than or equal to 6 months of dual antiplatelet therapy.</p><p><strong>Conclusion: </strong>ARC-HBR patients exhibited a higher risk of HHF following DES implantation than non-ARC-HBR patients. These results highlight that the ARC-HBR feature is of clinical importance in identifying individuals at a heightened risk of developing HHF following DES implantation.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"249-257"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480660","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":"IVUS-guided percutaneous coronary intervention to the extrinsic left main coronary artery compressive stenosis due to pulmonary artery dilatation in a very young pulmonary arterial hypertension patient presenting with recurrent exertional syncope.","authors":"Kaan Hanci, Didar Mirzamidinov, Kurtulus Karauzum, Mehmet Ali Anik, Ebrar Gencer, Beyza Kalas, Irem Yilmaz, Tayfun Sahin","doi":"10.1097/MCA.0000000000001650","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001650","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027635","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":"Inferobasal myocardial infarction.","authors":"Chan-Hee Lee, Young-Sang Jeong, Melvin M Scheinman","doi":"10.1097/MCA.0000000000001651","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001651","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027633","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":"Beyond traditional risk models: an inflammatory-cardiometabolic framework for coronary artery disease in sub-Saharan Africa.","authors":"Miguel Bernardino Antunes Vicente, Afonso Kapenda, Valdirene Gonçalves, Luis Mariano, Tomás Peralta","doi":"10.1097/MCA.0000000000001653","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001653","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027592","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":"Efficacy and safety of intralesional versus intracoronary administration of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention for acute coronary syndromes: a meta-analysis of randomized controlled trials.","authors":"Jawad Basit, Mushood Ahmed, Muhammad Burhan, Areeba Ahsan, Rubab Zahra, Mohammad Hamza, Muhammad Usman, Raheel Ahmed, Akram Kawsara, Ramesh Daggubati, Yasar Sattar, Vikrant Jagadeesan, M Chadi Alraies","doi":"10.1097/MCA.0000000000001649","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001649","url":null,"abstract":"<p><strong>Background: </strong>Intracoronary glycoprotein IIb/IIIa inhibitors (GPIs) after percutaneous coronary intervention (PCI) have shown better outcomes than intravenous administration. However, limited data exist comparing intracoronary versus intralesional GPI delivery during PCI for acute coronary syndromes (ACS).</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials comparing intralesional and intracoronary GPI administration in ACS patients undergoing PCI. Odds ratios (ORs) and mean differences were used to combine dichotomous and continuous outcomes, respectively, using a random-effects model. Analyses were conducted in RevMan 5.4 and CRAN-R.</p><p><strong>Results: </strong>Nine randomized controlled trials comparing the intralesional (n = 509) with intracoronary route (n = 486) were included. In the primary analysis, the intralesional route demonstrated significantly better postprocedural thrombolysis in myocardial infarction (TIMI) grade 3 flow [OR = 2.38, 95% confidence interval (CI) = 1.52-3.72, P = 0.0001], corrected TIMI frame count (mean difference = -4.63, 95% CI = -8.83 to -0.43, P = 0.03), myocardial blush grade 3 (OR = 2.60, 95% CI = 1.51-4.49, P = 0.0006), and complete ST-segment resolution (OR = 1.64, 95% CI = 1.16-2.33, P = 0.005). After Hartung-Knapp restricted maximum likelihood adjustment, only TIMI grade 3 flow remained significant (OR = 2.38, 95% CI = 1.36-4.15, P = 0.009). No significant differences were observed in major adverse cardiovascular events, bleeding, or thrombocytopenia (P > 0.05).</p><p><strong>Conclusion: </strong>During PCI for ACS, intralesional GPI administration improves postprocedural TIMI grade 3 flow, with no significant differences in corrected TIMI frame count, complete ST-segment resolution, or hard clinical outcomes.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027624","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 aspiration catheter size on thrombus removal and slow-flow/no-reflow in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Phutharet Chaturonrutsamee, Panuwat Lertlaksameewilai, Numchai Numkiatsakul","doi":"10.1097/MCA.0000000000001580","DOIUrl":"10.1097/MCA.0000000000001580","url":null,"abstract":"<p><strong>Background: </strong>Thrombus aspiration during primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients with a high thrombus burden remains an important clinical consideration. This study aimed to evaluate the impact of aspiration catheter size on thrombus removal and the slow-flow/no-reflow phenomenon.</p><p><strong>Methods: </strong>This retrospective study included 208 STEMI patients presenting within 12 h of symptom onset with high thrombus burden. All underwent primary PCI with thrombus aspiration. Patients were divided based on catheter size: 7-French ( n = 85) and 6-French ( n = 123). Clinical characteristics, procedural outcomes, and angiographic results were compared. Multivariate logistic regression identified independent predictors of slow-flow/no-reflow.</p><p><strong>Results: </strong>Patients treated with a 7-French catheter had a lower incidence of slow-flow/no-reflow after stent deployment (14.0 vs. 36.6%; P < 0.001) and postdilatation (25.0 vs. 55.2%; P = 0.003). Final thrombolysis in myocardial infarction 3 flow was more frequently achieved in the 7-French group (100 vs. 90.2%; P = 0.032). History of stroke or transient ischemic attack [odds ratio (OR): 5.16; P = 0.021] and ischemic time greater than 330 min (OR: 2.13; P = 0.032) were predictors of no-reflow, while use of a 7-French catheter was protective (OR: 0.26; P < 0.001).</p><p><strong>Conclusion: </strong>In STEMI patients with high thrombus burden, using a 7-French aspiration catheter was associated with higher procedural success and lower incidence of slow-flow/no-reflow. Larger-caliber catheters may offer a clinical advantage in selected patients undergoing primary PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"222-228"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426640","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 effects of delays at each stage of care on mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.","authors":"Omid Rafizadeh, Saghar Erfani, Sobhan Zarbafti, Sahel Erfani","doi":"10.1097/MCA.0000000000001578","DOIUrl":"10.1097/MCA.0000000000001578","url":null,"abstract":"<p><strong>Background: </strong>Timely restoration of blood flow is critical for ST-segment elevation myocardial infarction (STEMI) management. We evaluate the effects of time intervals - total ischemic time, time from symptom onset to first medical contact, delay within the healthcare system, and time from hospital arrival to balloon inflation and from arrival at the catheterization laboratory to balloon inflation - on in-hospital mortality among patients with STEMI undergoing primary percutaneous coronary intervention.</p><p><strong>Methods: </strong>We analyzed data from 315 patients with STEMI who underwent primary percutaneous coronary intervention in a hospital between 2020 and 2021. A random forest model was used to assess the predictive importance of time delay components for in-hospital mortality.</p><p><strong>Results: </strong>Of the total sample, 35 patients died. The median (interquartile range) for total ischemic time was 310.0 (215.0-547.5) min. Univariate analysis showed significant differences between the two groups in time to first medical contact [120.0 (60.0-245.0) vs. 210.0 (120.0-272.5); P  = 0.007] and total ischemic time [300.0 (210.0-531.2) vs. 370.0 (320.0-720.0); P = 0.001]; however, the multivariable model (accuracy = 0.971, sensitivity = 0.800, specificity = 0.999, and an area under the curve = 0.93) identified total ischemic time as the most important time-based predictor of mortality, followed by system delay, time from hospital arrival to balloon inflation, from symptom onset to first medical contact, and from arrival at the catheterization laboratory to balloon inflation.</p><p><strong>Conclusion: </strong>Each delay component in STEMI management carries distinct clinical consequences that necessitate targeted intervention.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"179-186"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353783","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 perivascular adipose tissue fat attenuation index in patients with ischemia with no obstructive coronary arteries and coronary microvascular dysfunction.","authors":"Nathaniel R Smilowitz, Barbara Jerome, David W Rhee, Robert Donnino, Jill E Jacobs, Anaïs Hausvater, Amanda Joa, Claudia Serrano-Gomez, Lindsay Elbaum, Ayman Farid, Judith S Hochman, Jeffrey S Berger, Harmony R Reynolds","doi":"10.1097/MCA.0000000000001583","DOIUrl":"10.1097/MCA.0000000000001583","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) is present in approximately 40% of patients with ischemia with no obstructive coronary arteries (INOCA) and has been associated with inflammation. We investigated associations between measures of inflammation of the coronary perivascular adipose tissue assessed by coronary computed tomography angiography (CCTA) and results of invasive coronary function testing (CFT) to diagnose CMD.</p><p><strong>Methods: </strong>Adults referred for clinically indicated invasive coronary angiography who had less than 50% stenosis in all epicardial arteries were prospectively enrolled. CMD was defined as a coronary flow reserve (CFR) less than 2.5 or index of microvascular resistance (IMR) greater than or equal to 25 using bolus thermodilution in the left anterior descending (LAD) coronary artery. Coronary perivascular fat attenuation index was assessed by CCTA in the right coronary artery (RCA) and LAD. T tests were used to evaluate differences in perivascular FAI by CMD status.</p><p><strong>Results: </strong>A total of 31 participants underwent CFT and CCTA. The mean age was 58 ± 11.7 years, 77% were female, and 61% were white. CMD was present in 15 participants (48%). No differences in perivascular FAI were observed in patients with and without CMD, either in the RCA [-74.2 ± 9.8 vs. -69.9 ± 10.3 Hounsfield units (HU), P  = 0.24] or LAD (-76.4 ± 10.2 vs. -74.8 ± 12.7 HU, P  = 0.69). Perivascular FAI was not correlated with CFR or IMR measurements in the RCA or LAD.</p><p><strong>Conclusion: </strong>There were no associations between CMD diagnosed by invasive CFT and perivascular FAI by CCTA in patients with INOCA. Further research is needed to understand the relationship between vascular inflammation and CMD in INOCA.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"187-194"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430384","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":"'Septal-to-septal' retrograde LAD CTO intervention: an alternative approach to a demanding case.","authors":"Konstantinos Filippou, Konstantinos A Manousopoulos, Panagiotis N Varelas, Dimitrios F Karelas, Ioannis S Papadopoulos, Ioannis P Nenekidis, Ioannis N Tsiafoutis","doi":"10.1097/MCA.0000000000001621","DOIUrl":"10.1097/MCA.0000000000001621","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"241-243"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140861","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":"Optimizing duration of renin-angiotensin system inhibition after ST-elevation myocardial infarction with drug-eluting stent-percutaneous coronary intervention: Real-World Landmark Evidence from the Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry.","authors":"Byoung Geol Choi, Hae Don Kim, Seung-Woon Rha, Seung Uk Lee, Soohyung Park, Manda Satria Chesario, Melly Susanti, Cheol Won Choi, Cheol Ung Choi, Myung Ho Jeong, Dong Joo Oh","doi":"10.1097/MCA.0000000000001622","DOIUrl":"10.1097/MCA.0000000000001622","url":null,"abstract":"<p><strong>Background: </strong>Renin-angiotensin system inhibitors (RASi), including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, improve outcomes after acute myocardial infarction. However, in the drug-eluting stent (DES) era with routine percutaneous coronary intervention (PCI), the duration and timing of benefit after ST-elevation myocardial infarction (STEMI) remain uncertain.</p><p><strong>Methods: </strong>Using the nationwide prospective Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry, we identified STEMI patients who underwent successful DES-PCI and survived to discharge ( n = 5017). RASi exposure was defined at discharge for analyses from 0 to 12 months and reassigned at a 12-month landmark for analyses from 12 to 36 months, reflecting real-world switching or discontinuation. The primary outcome was all-cause mortality. Confounding was addressed using 1 : 1 propensity-score matching (851 pairs) and Cox proportional hazards models.</p><p><strong>Results: </strong>At discharge, 4093 patients received RASi and 924 did not. At 12 months, all-cause mortality was lower with RASi in the overall cohort [2.1 vs. 4.5%, hazard ratio: 0.45, 95% confidence interval (CI): 0.31-0.66, P < 0.001] and matched cohort (3.0 vs. 4.9%, hazard ratio: 0.61, 95% CI: 0.37-1.00, P = 0.050), driven by fewer cardiac deaths. Over 36 months, RASi was associated with lower mortality overall and after matching. From 12 to 36 months, landmark analyses showed neutral associations. First-year left ventricular ejection fraction and blood pressure improved more with RASi (both P < 0.01).</p><p><strong>Conclusion: </strong>In STEMI treated with DES-PCI, RASi at discharge offers a survival benefit concentrated within the first year. After 12 months, associations were neutral among event-free survivors, supporting early initiation and maintenance of RAS inhibition with individualized reassessment beyond 1 year.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"167-178"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141455","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}