Coronary artery disease最新文献

{"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":"https://doi.org/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 = 9%). 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":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","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":"Body surface area or sex for stent sizing in proximal coronary arteries.","authors":"James Nguyen, Evan Shlofmitz, Doosup Shin, Sarah Malik, Susan V Thomas, Craig Porter, Koshiro Sakai, Jeffrey W Moses, Akiko Maehara, David J Cohen, Ziad A Ali, Richard A Shlofmitz, Allen Jeremias","doi":"10.1097/MCA.0000000000001463","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001463","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784342","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":"Challenging percutaneous coronary intervention of a 'roller coaster' left circumflex coronary artery.","authors":"Konstantinos C Theodoropoulos, Matthaios Didagelos, Charalambos Kakderis, George Kassimis, Antonios Kouparanis, Antonios Ziakas","doi":"10.1097/MCA.0000000000001465","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001465","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784347","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":"Controlled low-density lipoprotein cholesterol attenuates cardiovascular risk mediated by elevated lipoprotein(a) after percutaneous coronary intervention.","authors":"Ahmed K Mahmoud, Kamal Awad, Juan M Farina, Mohammed Tiseer Abbas, Nima Baba Ali, Hesham M Abdalla, Amro Badr, Muhammad A Elahi, Milagros Pereyra, Isabel G Scalia, Niloofar Javadi, Nadera N Bismee, Said Alsidawi, Steven J Lester, Chadi Ayoub, Reza Arsanjani","doi":"10.1097/MCA.0000000000001460","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001460","url":null,"abstract":"<p><strong>Background: </strong>Lipoprotein(a) [Lp(a)] is an independent, causal risk factor for cardiovascular disease. However, it is still unclear whether controlling low-density lipoprotein cholesterol (LDL-C) to optimal levels can attenuate cardiovascular risk mediated by elevated Lp(a), especially in the setting of secondary prevention.</p><p><strong>Methods: </strong>Adult patients with a baseline Lp(a) measurement who underwent percutaneous coronary intervention (PCI) and reached their LDL-C target levels (<70 mg/dl) at Mayo Clinic sites between 2006 and 2017 were included. Primary outcomes included major adverse cardiovascular events (MACE) and all-cause mortality. Kaplan-Meier curves were created to compare the survival probabilities among patients with Lp(a) ≥ 50 mg/dl compared with Lp(a) < 50 mg/dl. Multivariable Cox regression analyses were performed to quantify the association of elevated Lp(a) with our relevant outcomes and to control for possible confounders.</p><p><strong>Results: </strong>In total, 878 patients (median age: 68 years, and 74% males) who underwent PCI were included for analysis. Of them, 29.7% had elevated Lp(a) ≥ 50 mg/dl. Kaplan-Meier curves did not reveal any significant difference in survival probabilities for elevated Lp(a) for any outcome including MACE (P = 0.91), all-cause mortality (P = 0.26), or the separate MACE components. Similarly, the multivariable analysis showed no significant association for MACE (hazard ratio: 1.07, 95% confidence interval: 0.84-1.37) or all-cause mortality (hazard ratio: 0.98, 95% confidence interval: 0.74-1.30).</p><p><strong>Conclusion: </strong>In patients who underwent PCI and have their LDL-C controlled below 70 mg/dl, no significant association was found between elevated Lp(a) ≥ 50 mg/dl and risk for MACE or all-cause mortality.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946187","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":"Intraplaque hemorrhage and angina in a low-risk young female.","authors":"Takeshi Nishi, Yuhei Kobayashi, Matthew Jones, Manish Parikh","doi":"10.1097/MCA.0000000000001452","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001452","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784350","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":"Duration of dual antiplatelet treatment after percutaneous coronary intervention in patients with chronic kidney disease: a systematic review and meta-analysis.","authors":"Anastasios Apostolos, Maria Bozika, Kassiani-Maria Nastouli, Dimitrios-David Chlorogiannis, Kyriakos Dimitriadis, Konstantinos Toutouzas, Konstantinos Tsioufis, Periklis Davlouros, Grigorios Tsigkas","doi":"10.1097/MCA.0000000000001447","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001447","url":null,"abstract":"<p><p>Patients suffering from chronic kidney disease (CKD) have higher ischemic and bleeding risk compared with patients with normal renal function. The aim of our systematic review and meta-analysis is to compare shortened (≤3 months) dual antiplatelet therapy (DAPT) with longer DAPT in patients with CKD undergoing percutaneous coronary interventions. We systematically screened three major databases (Medline, Cochrane Central Register of Controlled Trials, and Scopus) searching for randomized-controlled trials or subanalyses of them, which compared shortened (S-DAPT) to longer (L-DAPT) regimens of DAPT in patients with CKD. The primary endpoint is the net adverse clinical events (NACE) and the secondary is major adverse cardiac events (MACE), and bleedings. Subgroup analyses included studies using only P2Y12 monotherapy, ticagrelor-based regimens, 1- and 3-month duration of DAPT. A total of 10 studies and 6688 patients were included in our analysis. No significant differences regarding NACE (RR: 0.97, 95% CI: 0.84-1.12, I2 = 0%), MACE (RR: 1.00, 95% CI: 0.85-1.117, I2 = 0%), and bleedings (RR: 0.78, 95% CI: 0.59-1.03, I2 = 25%) were observed between S-DAPT and L-DAPT in our meta-analysis. The findings from the subgroup analyses were in accordance with total findings; bleedings were significantly reduced in S-DAPT when only studies with 3-month duration of DAPT were analyzed (RR: 0.58, 95% CI: 0.40-0.85, I2 = 0%). Our systematic review and meta-analysis showed that no significant differences were observed between patients treated with S-DAPT or L-DAPT in the terms of MACE, NACE, and bleedings in patients with CKD. When it is required, S-DAPT could be considered in patients with CKD.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581797","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":"https://doi.org/10.1097/MCA.0000000000001453","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","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":"Triggering type and long-term survival following ST segment elevation-myocardial infarction treated with primary percutaneous coronary intervention.","authors":"Moaad Slieman, Inbal Greenberg, Zach Rozenbaum, Yoav Granot, Yacov Shacham, David Zahler, Maayan Konigstein, Amir Halkin, Shmuel Banai, Jeremy Ben-Shoshan","doi":"10.1097/MCA.0000000000001455","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001455","url":null,"abstract":"<p><strong>Background: </strong>Physical and emotional stress are recognized triggers of acute coronary syndromes, including ST segment elevation-myocardial infarction (STEMI). We have previously shown that identifiable triggers precede symptoms in over one-third of STEMI patients and inversely correlate with the extent of coronary artery disease (CAD). This study aims to investigate the association between trigger type (physical vs. emotional) and long-term mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This retrospective, single-center observational study included all patients admitted with an STEMI diagnosis from January 2008 to December 2013. Physical and emotional triggers were identified retrospectively from patient records. Mortality data were obtained from the Israeli Ministry of Health.</p><p><strong>Results: </strong>Of 1345 consecutive STEMI patients treated with primary PCI, mortality data were available for 1267 patients (median age: 61 years). A trigger preceding symptoms onset was identified in 36.5% of patients, with 85% experiencing physical stress and 15% emotional stress. Triggered STEMI patients tended to be younger with fewer comorbidities and lower incidence of multiple vessel CAD compared with nontriggered patients. Notably, emotionally triggered STEMI patients exhibited improved long-term survival compared with those without emotional triggers or with physical triggers. predictor of enhanced long-term survival post-PCI compared with physical triggering. Emotional triggering was identified as an independent.</p><p><strong>Conclusion: </strong>Patients with emotionally triggered STEMI showed less extensive CAD and improved long-term survival following PCI compared with those with physically triggered STEMI. These findings highlight the importance of considering both the presence and type of trigger in the management of STEMI patients and their long-term prognosis.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581865","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 HALP score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention.","authors":"Huiliang Liu, Feifei Zhang, Yingxiao Li, Litian Liu, Xuelian Song, Jiaqi Wang, Yi Dang, Xiaoyong Qi","doi":"10.1097/MCA.0000000000001446","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001446","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Despite recent advances in the management of ST-segment elevation myocardial infarction (STEMI), the clinical outcome of some patients is still unsatisfactory. Therefore, early evaluation to identify high-risk individuals in STEMI patients is essential. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, as a new indicator that can reflect both nutritional status and inflammatory state of the body, can provide prognostic information. In this context, the present study was designed to investigate the relationship between HALP scores assessed at admission and no-reflow as well as long-term outcomes in patients with STEMI.</p><p><strong>Material and methods: </strong>A total of 1040 consecutive STEMI patients undergoing primary PCI were enrolled in this retrospective study. According to the best cutoff value of HALP score of 40.11, the study samples were divided into two groups. The long-term prognosis was followed up by telephone.</p><p><strong>Results: </strong>Long-term mortality was significantly higher in patients with HALP scores lower than 40.11 than in those higher than 40.11. The optimal cutoff value of HALP score for predicting no-reflow was 41.38, the area under the curve (AUC) was 0.727. The best cutoff value of HALP score for predicting major adverse cardiovascular events (MACE) was 40.11, the AUC was 0.763. The incidence of MACE and all-cause mortality was higher in the HALP score <40.11 group.</p><p><strong>Conclusion: </strong>HALP score can independently predict the development of no-reflow and long-term mortality in STEMI patients undergoing PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567953","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":"N-terminal pro-B-type natriuretic peptide and pulmonary echography are predictors of acute heart failure needing early mechanical ventilation in acute coronary syndrome.","authors":"María J Cristo-Ropero, Juan C Garcia-Rubira, Francisco Javier Rivera-Rabanal, Tania Seoane-García, Luis Madrona-Jiménez, Álvaro Izquierdo-Bajo, Begoña Hernández-Meneses, Angel Vilches-Arenas, Rafael Hidalgo-Urbano","doi":"10.1097/MCA.0000000000001396","DOIUrl":"10.1097/MCA.0000000000001396","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to determine the best clinical predictors of acute heart failure needing mechanical ventilation (MV) in the first 48 h of evolution of patients admitted because of acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>We analyzed a cohort of patients admitted for ACS between February 2017 and February 2018. A pulmonary ultrasound was performed on admission and was considered positive (PE+) when there were three or more B-lines in two quadrants or more of each hemithorax. It was compared with N-terminal pro-B-type natriuretic peptide (NT-proBNP), peak troponin T-us value GRACE (Global Registry of Acute Coronary Events), CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology and American Heart Association guidelines - Bleeding Score), CACS (Canada Acute Coronary Syndrome risk score), and HAMIOT (Heart Failure after Acute Myocardial Infarction with Optimal Treatment score) scores, shock index, ejection fraction, chest X-ray, and Killip class at admission as predictors of MV in the first 48 h of admission.</p><p><strong>Results: </strong>A total of 119 patients were included: 54.6% with ST elevation and 45.4% without ST elevation. Twelve patients (10.1%) required MV in the first 48 h of evolution. The sensitivity of PE+ was 100% (73.5-100%), specificity 91.6% (84.6-96.1%), and area under the curve was 0.96 (0.93-0.96). The sensitivity of an NT-proBNP value more than 3647 was 88.9% (51.9-99.7%), specificity 92.1% (84.5-96.8%), and area under the curve was 0.905 (0.793-1). The κ statistic between both predictors was 0.579. All the other scores were significantly worse than PE + .</p><p><strong>Conclusion: </strong>Lung ultrasound and a high NT-proBNP (3647 ng/L in our series) on admission are the best predictors of acute heart failure needing MV in the first 48 h of ACS. The agreement between both tests was only moderate.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"556-563"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198655","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}