Coronary artery disease最新文献

{"title":"Myocardial infarction with nonobstructive coronary arteries: a single-center retrospective study by sex and race.","authors":"Christine Hsueh, Ghenekaro Esin, Thomas Breen, Mauro Gitto, Miriam Katz, Martha Gulati, Quinn Capers Iv, Harmony R Reynolds, Annabelle S Volgman, Nanette Wenger, S Elissa Altin","doi":"10.1097/MCA.0000000000001402","DOIUrl":"10.1097/MCA.0000000000001402","url":null,"abstract":"<p><strong>Background: </strong>In myocardial infarction with nonobstructive coronary arteries (MINOCA), there are limited patient-level data on outcomes by sex and race.</p><p><strong>Objective: </strong>The aim of this study was to assess baseline demographics and 3-year outcomes by sex and race for MINOCA patients.</p><p><strong>Methods: </strong>Patients admitted to a single center with acute myocardial infarction (MI) between 1 January 2012 and 31 December 2018, were identified by chart and angiographic review. The primary outcome was nonfatal MI with secondary outcomes including nonfatal cerebrovascular accident (CVA), chest pain readmission, and repeat coronary angiography.</p><p><strong>Results: </strong>During the study period, 304 patients were admitted with MINOCA. The cohort was predominantly female (66.4%), and women were significantly older (64.6 vs. 59.2). One-sixth of the total population were Black patients, and nearly half of Black patients (47.2%) were male. Prior CVA (19.7%) and comorbid anxiety, depression, or post-traumatic stress disorder (41.1%) were common. Rates of nonfatal MI were 6.3% without difference by sex or race. For secondary outcomes, rates of CVA were 1.7%, chest pain readmission was 22.4%, and repeat angiography was 8.9%. Men were significantly more likely to have repeat angiography (13.7 vs. 6.4%), and Black patients were more likely to be readmitted for angina (34.0 vs. 19.1%). Over one-quarter of patients underwent repeat stress testing, with 8.9% ultimately undergoing repeat angiograms and low numbers (0.7%) undergoing revascularization. Men were more likely to be referred for a repeat angiogram (13.7 vs. 6.4%, P  = 0.035). In multivariate analysis, Black race [odds ratio (OR), 2.31; 95% confidence interval (CI), 1.06-5.03] was associated with an increased risk of readmission for angina, while female sex was associated with decreased odds of repeat angiography (OR, 0.36; 95% CI, 0.14-0.90) and current smoking was associated with increased odds of repeat angiography (OR, 4.07; 95% CI, 1.02-16.29)] along with hyperlipidemia (OR, 4.65; 95% CI, 1.22-17.7).</p><p><strong>Conclusion: </strong>White women presented more frequently with MINOCA than White men, however, Black men are equally as affected as Black women. Rates of nonfatal MI were low without statistical differences by sex or race.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"684-691"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579217","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":"Thrombus aspiration in ST elevation myocardial infarction: are we done?","authors":"Rachel Wang, Nick Ossei-Gerning, Ashish H Shah","doi":"10.1097/MCA.0000000000001372","DOIUrl":"10.1097/MCA.0000000000001372","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"35 8","pages":"701-702"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544227","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":"Importance of provoked spasms at the sites of nonobstructive stenosis as well as at the sites of obstructive stenosis in patients with obstructive coronary arteries and coronary spasm.","authors":"Shozo Sueda, Yutaka Hayashi","doi":"10.1097/MCA.0000000000001398","DOIUrl":"10.1097/MCA.0000000000001398","url":null,"abstract":"<p><strong>Objectives: </strong>There are few reports regarding the prognosis in patients with obstructive coronary artery disease (OCAD) and vasospastic angina (VSA). This study investigated the clinical characteristics and clinical outcomes in patients with VSA and OCAD, especially regarding provoked spasm phenotypes and sites.</p><p><strong>Methods: </strong>This was a retrospective, observational, single-center study of 403 patients with typical or atypical angina-like chest pain undergoing acetylcholine (ACH) spasm provocation testing and OCAD. An obstructed coronary artery was defined as ≥50% luminal narrowing. We defined positive epicardial spasm as ≥90% transient stenosis and usual chest symptoms or ischemic ECG changes.</p><p><strong>Results: </strong>Among these 403 patients with OCAD, positive spasm by intracoronary ACH testing was observed in 196 patients (49%), whereas negative spasm was found in the remaining 207 patients (51%). The clinical outcomes in the patients with OCAD and provoked spasm were not different according to the provoked-spasm phenotypes. Furthermore, the clinical outcomes were unsatisfactory in the patients with spasm at the site of nonobstructive lesion alone compared with those with spasm at the site of obstructive and nonobstructive lesions.</p><p><strong>Conclusion: </strong>We should precisely diagnose patients with OCAD who have provoked spasm by using intracoronary ACH testing and medicate the nonobstructive vessels in patients with OCAD and VSA under optimal coronary vasodilators.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"650-658"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198626","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":"Trends in the incidence, mortality and clinical outcomes in patients with ventricular septal rupture following an ST-elevation myocardial infarction.","authors":"Emily Hiltner, Marc Sandhaus, Ashish Awasthi, Abdul Hakeem, John Kassotis, Manabu Takebe, Mark Russo, Ankur Sethi","doi":"10.1097/MCA.0000000000001401","DOIUrl":"10.1097/MCA.0000000000001401","url":null,"abstract":"<p><strong>Background: </strong>Despite improvements in outcomes of ST elevation myocardial infarction (STEMI), ventricular septal rupture (VSR) remains a known complication, carrying high mortality. The contemporary incidence, mortality, and management of post-STEMI VSR remains unclear.</p><p><strong>Methods: </strong>The National Inpatient Sample database (2009-2020) was used to study trends in admissions and outcomes of post-STEMI VSR over time. Survey estimation commands were used to determine weighted national estimates.</p><p><strong>Results: </strong>There were 2 315 186 ± 22 888 visits for STEMI with 0.194 ± 0.01% experiencing VSR during 2009-2020 in the USA. Patients with VSR were more often older, white, female, and presented with an anterior STEMI; there was no difference in the rates of fibrinolysis. In-hospital mortality was 73.6 ± 1.8%, but only 29.2 ± 1.9 and 10 ± 1.2% received surgical repair and transcatheter repair (TCR), respectively. TCR was associated with higher and surgical repair with lower mortality. Days to surgery were longer for those who survived (5.9 ± 2.75) compared with those who died (2.44 ± 1). In a multivariable analysis, surgical repair at greater than or equal to day 4 was associated with lower in-hospital mortality (odds ratio = 0.39, 95% confidence interval: 0.17-0.88).</p><p><strong>Conclusion: </strong>Mortality in post-STEMI VSR remains high with no improvement over time. Most patients are managed conservatively, and the frequency of surgical repair has decreased, while TCR has increased over the study period. Despite design limitations and survival bias, surgical repair at greater than or equal to 4 days was associated with a lower mortality.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"675-683"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300261","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":"Computed tomography angiography and coronary artery disease-reporting and data system and a 5-year prognostic major adverse cardiovascular and cerebral event outcome study in a symptomatic Southeast Asian population.","authors":"Kan Witoonchart, Witoonchart Wannit, Chintanavilas Kumpol","doi":"10.1097/MCA.0000000000001403","DOIUrl":"10.1097/MCA.0000000000001403","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the relationship between coronary artery disease-reporting and data system (CAD-RADS) for coronary computed tomography angiogram (CCTA) and major adverse cardiovascular and cerebral event (MACE) in a symptomatic Southeast Asian, Thai population over a 5-year period.</p><p><strong>Methods: </strong>A retrospective cohort study of Thai patients without known CAD who underwent CCTA for CAD symptoms. CCTA images and 5-year health data were reviewed for CAD-RADS and MACE. MACE consists of all-cause mortality, cardiovascular death, acute coronary syndrome, heart failure hospitalization, and stroke.</p><p><strong>Results: </strong>In total 336 patients were evaluated. The median follow-up period was 6.4 years. The overall MACE incidence was 63 cases (18.8%). The MACE event rate was progressively increased with higher CAD-RADS categories; CAD-RADS 3 [hazard ratio (HR), 3.62; P  = 0.015], CAD-RADS 4a (HR, 3.50; P  = 0.024), CAD-RADS 4b & 5 (HR, 7.56; P  = 0.001). The risk of MACE increased significantly in the moderate to severe CAD burden group (HR, 5.58; P  = 0.01). Kaplan-Meier curve showed a significant rise in MACE with higher CAD-RADS categories ( P  = 0.01).</p><p><strong>Conclusion: </strong>CAD-RADS classification has a significant prognostic value in Southeast Asian, Thai population with cardiac symptoms.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"692-698"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466770","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":"Higher inpatient mortality following percutaneous coronary intervention in patients with advanced chronic kidney disease.","authors":"Mohammad Reza Movahed, Sina Aghdasi, Madhan Shanmugasundaram, Mehrtash Hashemzadeh","doi":"10.1097/MCA.0000000000001379","DOIUrl":"10.1097/MCA.0000000000001379","url":null,"abstract":"<p><strong>Background: </strong>Advanced chronic kidney disease (ACKD) is common in patients undergoing percutaneous coronary intervention (PCI) and is associated with adverse outcomes. These patients are often excluded from revascularization studies. The goal of this study was to evaluate the impact of ACKD in patients undergoing PCI.</p><p><strong>Methods: </strong>We analyzed the national inpatient sample database to compare the inpatient mortality rate for ACKD patients [chronic kidney disease (CKD) stage 3 and above] who underwent PCI between 2006 and 2011 to patients without ACKD. Specific ICD-9 CM codes were used to identify these patients.</p><p><strong>Results: </strong>A total of 1 826 536 PCIs were performed during the study period, of which 113 018 (6.2%) were patients with advanced CKD. The age-adjusted inpatient mortality rates were significantly higher in the ACKD group in all years studied compared to the no CKD group. For the first year studied in 2006, the age-adjusted mortality rate for patients undergoing PCI was 149 per 100 000 vs. 48 per 100 000 in patients without ACKD ( P  < 0001). In the last year studied in 2011, age-adjusted mortality was 124.1 per 100 000 vs. 40.4 per 100 000 in patients with no ACKD, ( P  < 0.0001). The presence of ACKD remained independently associated with higher mortality despite multivariate adjustment (odds ratio: 1.32, confidence interval: 1.27-1.36, P  < 0.001).</p><p><strong>Conclusion: </strong>ACKD is independently associated with higher mortality in patients undergoing PCI. Therefore, PCI in these patients should be performed with more caution.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"629-632"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426546","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 between hyperuricemia and chronic total coronary occlusion in non-chronic kidney disease populations: a cross-sectional study.","authors":"Jianping Wang, Xiaoli Chen, Zhongwei He, Lian Xiao, Kaiyong Xiao, Lin Zhao, Qiang Yu, Yulin Hou, Qingrui Li, Lei He, Hui Feng, Xiaowen Luo","doi":"10.1097/MCA.0000000000001400","DOIUrl":"10.1097/MCA.0000000000001400","url":null,"abstract":"<p><strong>Background: </strong>Chronic total coronary occlusion (CTO) is an extremely hazardous condition that leads to various clinical phenomena and complications and results in social and economic burdens. Hyperuricemia (HU) is often associated with atherosclerosis. Few studies, however, have investigated the risk of CTO in individuals with HU and the role of traditional cardiovascular risk factors in this setting.</p><p><strong>Methods: </strong>A cohort of 1245 individuals without chronic kidney disease from southwest China who underwent coronary angiography between February 2018 and June 2021 were enrolled. CTO was defined as a total occlusion of any coronary artery or arteries for more than 3 months. HU was defined as a serum uric acid level of ≥420 µmol/L in men and ≥360 µmol/L in women. Univariate and multivariate logistic regression models and subgroup analyses were applied to assess the relationship between HU and CTO.</p><p><strong>Results: </strong>After adjustment, HU was noted to be associated with a 1.47-fold increase in the risk of CTO [odds ratio (OR), 1.47; 95% confidence interval (CI), 1.06-2.58; P  = 0.026]. As a continuous variable, uric acid was an independent predictor of CTO (OR, 1.002; 95% CI, 1.001-1.004; P  = 0.047). Subgroup analyses showed that the risk of CTO was higher among individuals under 65 years of age (OR, 2.77; 95% CI, 1.3-5.89), nonobese individuals (OR, 1.9; 95% CI, 1.16-3.1), and those with dyslipidemia (OR, 1.8; 95% CI, 1.04-3.11), while sex, smoking, hypertension, and diabetes did not show similar effects. Interaction analyses revealed no interaction among subgroups.</p><p><strong>Conclusion: </strong>Among individuals residing in southwest China, HU was associated with an increased risk of CTO in non-CKD individuals, especially those under 65 years of age and nonobese and dyslipidemic individuals.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"668-674"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199847","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 dynamic nomogram for predicting in-hospital major adverse cardiovascular and cerebrovascular events in patients with both coronary artery disease and atrial fibrillation: a multicenter retrospective study.","authors":"Jie Jian, Lingqin Zhang, Yang Zhang, Chang Jian, Tingting Wang, Mingxuan Xie, Wenjuan Wu, Bo Liang, Xingliang Xiong","doi":"10.1097/MCA.0000000000001399","DOIUrl":"10.1097/MCA.0000000000001399","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients with both coronary artery disease (CAD) and atrial fibrillation (AF) are at a high risk of major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization. Accurate prediction of MACCE can help identify high-risk patients and guide treatment decisions. This study was to elaborate and validate a dynamic nomogram for predicting the occurrence of MACCE during hospitalization in Patients with CAD combined with AF.</p><p><strong>Methods: </strong>A total of 3550 patients with AF and CAD were collected. They were randomly assigned to a training group and a validation group in a ratio of 7 : 3. Univariate and multivariate analyses were utilized to identify risk factors ( P  < 0.05). To avoid multicollinearity and overfit of the model, the least absolute shrinkage and selection operator was conducted to further screen the risk factors. Calibration curves, receiver operating characteristic curves, and decision curve analyses are employed to assess the nomogram. For external validation, a cohort consisting of 249 patients was utilized from the Medical Information Mart for Intensive Care IV Clinical Database, version 2.2.</p><p><strong>Results: </strong>Eight indicators with statistical differences were screened by univariate analysis, multivariate analysis, and the least absolute shrinkage and selection operator method ( P  < 0.05). The prediction model based on eight risk factors demonstrated good prediction performance in the training group, with an area under the curve (AUC) of 0.838. This performance was also maintained in the internal validation group (AUC = 0.835) and the external validation group (AUC = 0.806). Meanwhile, the calibration curve indicates that the nomogram was well-calibrated, and decision curve analysis revealed that the nomogram exhibited good clinical utility.</p><p><strong>Conclusion: </strong>The nomogram we constructed may aid in stratifying the risk and predicting the prognosis for patients with CAD and AF.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"659-667"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247974","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":"Unveiling the silent threat of a left ventricular pseudoaneurysm.","authors":"Argyro Kalompatsou, Eirini Beneki, Konstantinos Tsioufis, Constantina Aggeli","doi":"10.1097/MCA.0000000000001422","DOIUrl":"10.1097/MCA.0000000000001422","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"707-708"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281590","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":"Prevalence and location of coronary artery disease in anomalous aortic origin of coronary arteries.","authors":"Sandra Zendjebil, Athanasios Koutsoukis, Thomas Rodier, Fabien Hyafil, Xavier Halna du Fretay, Patrick Dupouy, Jean-Michel Juliard, Reza Farnoud, Phalla Ou, Jean-Pierre Laissy, Camille Couffignal, Pierre Aubry","doi":"10.1097/MCA.0000000000001385","DOIUrl":"10.1097/MCA.0000000000001385","url":null,"abstract":"<p><strong>Background: </strong>The prevalence and location of coronary artery disease (CAD) in anomalous aortic origin of a coronary artery (AAOCA) remain poorly documented in adults. We sought to assess the presence of CAD in proximal (or ectopic) and distal (or nonectopic) segments of AAOCA. We hypothesized that the representation of CAD may differ among the different courses of AAOCA.</p><p><strong>Methods: </strong>The presence of CAD was analyzed on coronary angiography and/or coronary computed tomography angiography in 390 patients (median age 64 years; 73% male) with AAOCA included in the anomalous coronary arteries multicentric registry.</p><p><strong>Results: </strong>AAOCA mainly involved circumflex artery (54.4%) and right coronary artery (RCA) (31.3%). All circumflex arteries had a retroaortic course; RCA mostly an interarterial course (98.4%). No CAD was found in the proximal segment of interarterial AAOCA, whereas 43.8% of retroaortic AAOCA, 28% of prepulmonic AAOCA and 20.8% subpulmonic AAOCA had CAD in their proximal segments ( P  < 0.001). CAD was more prevalent in proximal than in distal segments of retroaortic AAOCA (OR: 3.1, 95% CI: 1.8-5.4, P  < 0.001). On multivariate analysis, a retroaortic course was associated with an increased prevalence of CAD in the proximal segment (adjusted OR 3.4, 95% CI: 1.3-10.7, P  = 0.022).</p><p><strong>Conclusion: </strong>Increased prevalence of CAD was found in the proximal segment of retroaortic AAOCA compared to the proximal segments of other AAOCA, whereas no CAD was observed in the proximal segment of interarterial AAOCA. The mechanisms underlying these differences are not yet clearly identified.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"633-640"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921692","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}