Coronary artery disease最新文献

{"title":"Double-barrel coronary sinus: a rare anomaly unveiled during cardiac resynchronization therapy.","authors":"Aziz Inan Celik, Tahir Bezgin, Burcu Kodal, Ali Cevat Tanalp, Metin Cagdas","doi":"10.1097/MCA.0000000000001434","DOIUrl":"10.1097/MCA.0000000000001434","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"271"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892682","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":"https://doi.org/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":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","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":"Characteristics and outcomes of patients with acute coronary syndrome who present with atypical symptoms: a systematic review, pooled analysis and meta-analysis.","authors":"Chun Shing Kwok, Sadie Bennett, Eric Holroyd, Duwarakan Satchithananda, Josip A Borovac, Maximilian Will, Konstantin Schwarz, Gregory Y H Lip","doi":"10.1097/MCA.0000000000001462","DOIUrl":"10.1097/MCA.0000000000001462","url":null,"abstract":"<p><p>How frequent and whether outcomes are worse for patients with atypical presentation in acute coronary syndrome (ACS) across the literature is not known. We conducted a systematic review of the literature on patients with ACS or acute myocardial infarction who reported whether their symptoms were atypical or typical. We determined the proportion of patients with atypical or no chest pain and used meta-analysis to evaluate predictors of atypical presentation and mortality associated with atypical presentation. A total of 43 studies were included with 1 691 401 patients (mean age: 65.4 years, 63.8% male). The proportion of patients with atypical presentation ranged from 4.6 to 74.2% while for those with no chest pain it ranged from 1.4 to 35.5%. Atypical presentation occurred in 11.6% of patients (28 studies) and no chest pain occurred in 33.6% of patients (16 studies). The three strongest factors associated with increased odds of atypical presentation or no chest pain presentation were non-ST-elevation myocardial infarction [odds ratio (OR): 2.38, 95% confidence interval (CI): 1.55-3.64], greater Killip class (OR: 2.22, 95% CI: 1.84-2.67), and prior heart failure (OR: 1.79, 95% CI: 1.76-1.82). There is a two-fold increase in odds of mortality with atypical or no chest pain presentation in ACS compared with the typical presentation (OR: 2.07, 95% CI: 1.71-2.50, I2  = 99%). Atypical presentation occurs in approximately 1 in 10 patients with ACS but can be as high as 1 in 3 in some populations. Patients who present atypically are at two-fold increased risk of mortality.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"240-251"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709134","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":"Cooling the forearm puncture site following transradial cardiac catheterization or percutaneous coronary intervention: the hemostatic 'Cryoband' pilot study.","authors":"Guy F A Prado, Alexandre A Aquino, Fabio Conejo, Sandro M Faig, Alexandre Sposito, Diego Garcia, Pedro Gabriel Melo de Barros E Silva, Flavio L Ribichini, Expedito E Ribeiro, Henrique B Ribeiro","doi":"10.1097/MCA.0000000000001530","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001530","url":null,"abstract":"<p><strong>Background: </strong>The transradial approach in percutaneous coronary procedures has become the primary vascular access worldwide. Cryotherapy is frequently used to promote analgesia and vasoconstriction. This study aimed to evaluate the safety of forearm puncture site cooling using the novel hemostatic Cryoband protocol.</p><p><strong>Methods: </strong>The proposed protocol modifies pneumatic wristband devices by incorporating a cooling plate of frozen gel on the forearm, situated beneath the air cuff. This is a pilot, prospective, single-arm study involving 100 patients. The primary endpoints were device success and time to hemostasis. The safety secondary endpoints included (a) hematomas [early discharge after transradial stenting of coronary arteries (EASY)] and bleeding (Bleeding Academic Research Consortium); (b) radial artery patency predischarge; (c) numerical rating scale for pain; and (d) frostbite burns.</p><p><strong>Results: </strong>The study involved 106 procedures (84 for diagnosis and 22 for interventions) and demonstrated a 100% success rate for the device. The median time to hemostasis was 95 min (IQR: 90-110 min) for diagnostic procedures and 180 min (IQR: 160-210 min) for interventions. In-hospital outcomes indicated no hematomas exceeding EASY grade II, a 2% incidence of radial artery occlusion, a pain score of zero in 90% of cases, and no instances of frostbite burns. After a median follow-up of 9 days, no adverse clinical events were reported, and most patients (91.5%) did not experience bleeding.</p><p><strong>Conclusion: </strong>Cooling the forearm puncture site with the novel Cryoband protocol was safe and effective. Further randomized studies are warranted to assess its potential clinical benefit over the standard technique.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955436","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":"Feasibility of biodegradable polymer everolimus-eluting stent overexpansion: the SYNOVER study.","authors":"Seung Hun Lee, Yong-Kyu Lee, Joon Ho Ahn, Yongcheol Kim, Seongho Park, Donghyeon Joo, Kyung Hoo Cho, Min Chul Kim, Doo Sun Sim, Ju Han Kim, Youngkeun Ahn, Young Joon Hong","doi":"10.1097/MCA.0000000000001529","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001529","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in percutaneous coronary intervention (PCI), stent-related complications continue to occur, emphasizing the necessity for stent optimization. This study employed optical coherence tomography (OCT) to investigate the safety and efficacy of overexpanding the biodegradable polymer everolimus-eluting stent (SYNERGY; Boston Scientific, Marlborough, Massachusetts, USA) stent in large coronary arteries.</p><p><strong>Methods: </strong>This single-center observational study enrolled patients with ischemic heart disease requiring stent placement in large coronary arteries (≥4.5 mm). The patients underwent PCI guided by OCT using SYNERGY stents, incorporating postdilation techniques to enhance expansion. Stent parameters were evaluated through OCT imaging. The primary endpoints focused on the maximum stent diameter and the maximum percentage of overexpansion. Secondary clinical outcomes, including death, myocardial infarction (MI), revascularization, stent thrombosis, cerebrovascular accidents (CVAs), and heart failure readmissions, were monitored with follow-ups at 1, 6, and 12 months, as well as annually thereafter.</p><p><strong>Results: </strong>A total of 12 patients (8427 struts) were analyzed after successful PCI. OCT imaging showed adequate stent expansion, maximum stent diameter was 4.5 ± 0.2 mm, with a maximum expansion of 113.2 ± 4.1%), with no definite stent fractures or major edge dissections. During follow-up, one patient experienced an MI, but no stent thrombosis, target lesion revascularization, CVA, or death were reported.</p><p><strong>Conclusion: </strong>Application of OCT-guided PCI with SYNERGY stents is safe and effective for treating large coronary arteries. It facilitates optimal stent expansion and yields favorable long-term outcomes. These results advocate for an expanded application of OCT-guided PCI in complex anatomical situations, showcasing the performance of SYNERGY stents in cases of excess expansion.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962689","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":"Optical coherence tomography assessment of retrograde wire in chronic total occlusion percutaneous coronary intervention.","authors":"Yanbing Jiang, Li Xie, Lorenzo Azzalinilini, Xiaohui Zhao","doi":"10.1097/MCA.0000000000001528","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001528","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981515","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":"Sex differences in the impact of marital status on coronary artery disease outcomes in Korea.","authors":"Ha Jeong Lim, Lee Bom, Seung-Yul Lee, Jae Youn Moon, Sang-Hoon Kim, Jung-Hoon Sung, In Jai Kim, Sang-Wook Lim, Dong-Hun Cha, Se Hun Kang","doi":"10.1097/MCA.0000000000001527","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001527","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) outcomes are influenced by social determinants, including marital status. However, research on the sex-specific effects of marital status on CAD outcomes is limited. This study aimed to evaluate the relationship between marital status and clinical outcomes of patients with CAD stratified according to sex in Korea.</p><p><strong>Methods: </strong>A total of 3476 patients with CAD who underwent percutaneous coronary intervention (PCI) were enrolled in this retrospective observational study. Patients were categorized into married and nonmarried groups based on demographic data at the time of admission. The primary endpoint was all-cause mortality.</p><p><strong>Results: </strong>Among the study population, 20.7% of women and 11.5% of men who underwent PCI for CAD were nonmarried. For 87.1% of nonmarried women, the cause of being nonmarried was the death of a spouse, whereas for 48.3% of unmarried men, the most common cause was being unmarried. During a median follow-up of 53.3 months, in analysis using the Cox proportional hazard regression model, nonmarried status was associated with higher all-cause [adjusted hazard ratio (HR): 2.24, 95% confidence interval (CI): 1.22-4.09, P = 0.009] and cardiovascular (adjusted HR: 2.63, 95% CI: 19.91-5.80, P = 0.017) deaths in men but not in women.</p><p><strong>Conclusion: </strong>Marital status independently predicted the adverse outcomes in men with CAD but not in women, highlighting the importance of sex-specific approaches to the assessment of social determinants in cardiovascular care. Future studies should explore broader social and economic factors to inform targeted interventions.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991723","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":"Enhancing the diagnostic specificity of exercise ECG testing in obstructive coronary artery disease: the role of the Selvester QRS score.","authors":"Ilke Erbay, Pelin Aladag, Naile Eris Gudul, Ugur Kokturk, Melisa Begum Kisa, Ahmet Avci","doi":"10.1097/MCA.0000000000001525","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001525","url":null,"abstract":"<p><strong>Background: </strong>Exercise ECG testing is a widely used, noninvasive tool for detecting obstructive coronary artery disease (OCAD). However, its diagnostic performance is often limited by low specificity, leading to false-positive results and unnecessary invasive procedures.</p><p><strong>Objective: </strong>This study aims to assess the potential of combining the Selvester QRS score with exercise ECG to enhance diagnostic specificity for OCAD in patients with suspected stable angina.</p><p><strong>Methods: </strong>This retrospective study included 203 patients who presented with chest pain, underwent exercise ECG and were assessed for OCAD by coronary angiography or computed tomography angiography. Receiver operating characteristic analysis identified the optimal Selvester QRS score cutoff and assessed the diagnostic performance of exercise ECG and the combined model. Multivariable logistic regression was performed in the exercise ECG positive and negative groups.</p><p><strong>Results: </strong>Of the 203 patients, 116 were diagnosed with OCAD. The optimal Selvester QRS score cutoff was ≥3, with a sensitivity of 83.6% and a specificity of 93.1%. The combination of a positive exercise ECG and a Selvester QRS score ≥3 achieved the highest specificity (98.9%). Regression analyses showed that Selvester QRS score ≥3 was an independent predictor of OCAD, even in patients with negative exercise ECG results (adjusted odds ratio: 7.018; P < 0.001).</p><p><strong>Conclusion: </strong>The Selvester QRS score can improve the specificity of the exercise ECG in detecting OCAD in patients with suspected stable angina. This approach has the potential to reduce false positives and unnecessary invasive procedures by improving risk stratification.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771704","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":"Eclipsed mitral regurgitation only during percutaneous coronary intervention.","authors":"Nao Oda, Hiroki Matsuzoe, Ryo Takeshige, Hiroshi Takaishi","doi":"10.1097/MCA.0000000000001522","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001522","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751504","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":"Spontaneous formation of an arteriovenous fistula: an unusual decompression pathway for septal collateral perforation and hematoma.","authors":"Minggang Zhou, Li Chen","doi":"10.1097/MCA.0000000000001526","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001526","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751508","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}