Coronary artery disease最新文献

{"title":"First comparison between artificial intelligence-guided coronary computed tomography angiography versus single-photon emission computed tomography testing for ischemia in clinical practice.","authors":"Geoffrey W Cho, Sammy Sayed, Zoee D'Costa, Daniel W Karlsberg, Ronald P Karlsberg","doi":"10.1097/MCA.0000000000001485","DOIUrl":"10.1097/MCA.0000000000001485","url":null,"abstract":"<p><strong>Background: </strong>Noninvasive cardiac testing with coronary computed tomography angiography (CCTA) and single-photon emission computed tomography (SPECT) are becoming alternatives to invasive angiography for the evaluation of obstructive coronary artery disease. We aimed to evaluate whether a novel artificial intelligence (AI)-assisted CCTA program is comparable to SPECT imaging for ischemic testing.</p><p><strong>Methods: </strong>CCTA images were analyzed using an artificial intelligence convolutional neural network machine-learning-based model, atherosclerosis imaging-quantitative computed tomography (AI-QCT) ISCHEMIA . A total of 183 patients (75 females and 108 males, with an average age of 60.8 years ± 12.3 years) were selected. All patients underwent AI-QCT ISCHEMIA -augmented CCTA, with 60 undergoing concurrent SPECT and 16 having invasive coronary angiograms. Eight studies were excluded from analysis due to incomplete data or coronary anomalies.</p><p><strong>Results: </strong> A total of 175 patients (95%) had CCTA performed, deemed acceptable for AI-QCT ISCHEMIA interpretation. Compared to invasive angiography, AI-QCT ISCHEMIA -driven CCTA showed a sensitivity of 75% and specificity of 70% for predicting coronary ischemia, versus 70% and 53%, respectively for SPECT. The negative predictive value was high for female patients when using AI-QCT ISCHEMIA compared to SPECT (91% vs. 68%, P  = 0.042). Area under the receiver operating characteristic curves were similar between both modalities (0.81 for AI-CCTA, 0.75 for SPECT, P  = 0.526). When comparing both modalities, the correlation coefficient was r  = 0.71 ( P  < 0.04).</p><p><strong>Conclusion: </strong>AI-powered CCTA is a viable alternative to SPECT for detecting myocardial ischemia in patients with low- to intermediate-risk coronary artery disease, with significant positive and negative correlation in results. For patients who underwent confirmatory invasive angiography, the results of AI-CCTA and SPECT imaging were comparable. Future research focusing on prospective studies involving larger and more diverse patient populations is warranted to further investigate the benefits offered by AI-driven CCTA.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"390-395"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853490","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}

{"title":"Hypertrophic cardiomyopathy diagnosed by coronary computed tomography angiography: a case report.","authors":"Mason Condello, Srikanth Krishnan, Matthew J Budoff","doi":"10.1097/MCA.0000000000001435","DOIUrl":"10.1097/MCA.0000000000001435","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"446-447"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794988","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":"Causes of mortality following PCI: the University of New Mexico hospital experience.","authors":"Yusra Azhar, Kenneth M Zabel, James C Blankenship","doi":"10.1097/MCA.0000000000001486","DOIUrl":"10.1097/MCA.0000000000001486","url":null,"abstract":"<p><strong>Background: </strong>Mortality after percutaneous coronary intervention (PCI) remains a problem. Clinical databases such as the American College of Cardiology National Cardiovascular Data CathPCI Registry do not contain enough information to determine the specific cause of death after PCI, and thus are not able to identify opportunities for improvement (OFIs) that might have prevented the death of specific patients. We reviewed cases of death after coronary intervention to identify specific OFIs.</p><p><strong>Methods: </strong>The University of New Mexico electronic medical record system was used to identify PCI patients who died before discharge from 1 January 2019 to 30 June 2021. Electronic medical records for each patient were reviewed by two physicians to identify presentation before PCI, procedural success of PCI, complications of PCI, contribution of PCI complications to death, and causes of death after PCI.</p><p><strong>Results: </strong>During the study period, 48 of 894 PCI patients died before discharge. Presentation was ST elevation myocardial infarction in 23 (48%) and out of hospital cardiac arrest in 17 (35%). PCI success rate was 90%. Causes of death were most frequently cardiac (80%), septic shock (4%), mixed cardiogenic and septic shock (4%), COVID (8%), and anoxic brain injury (4%).</p><p><strong>Conclusion: </strong>All post-PCI deaths in this series occurred in acutely unstable patients, with cardiac comorbidities and myocardial infarction or cardiac arrest prior to catheterization. PCI reduced culprit stenosis to ≤50% in 96% of cases with an overall procedural success rate of 90% and only one major complication. No deaths were clearly related to operator error.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"384-389"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845922","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":"Comparison of long-term outcomes of minimally invasive coronary artery bypass grafting and percutaneous coronary intervention for left main disease.","authors":"Ahmet Güner, Cemil Can, Fatih Furkan Bedir, Ünal Aydin, Ersin Kadiroğullari, Cemalettin Akman, Ezgi Gültekin Güner, Emre Aydin, Berkay Serter, Ahmet Yaşar Çizgici, İbrahim Faruk Aktürk, Taner İyigün, Timuçin Aksu, Abdullah Doğan, Merve Aydin, Aybüke Şimşek, Fatih Uzun","doi":"10.1097/MCA.0000000000001504","DOIUrl":"10.1097/MCA.0000000000001504","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive coronary artery bypass grafting (MICS-CABG) is frequently used for coronary revascularization, but the comparison of long-term clinical results with percutaneous coronary intervention (PCI) in left main disease (LMDs) remains unclear. The present study sought to determine the long-term outcomes of MICS-CABG and PCI in patients with LMDs.</p><p><strong>Methods: </strong>A total of 551 consecutive patients [man: 457 (82.9%), mean age: 60.70 ± 9.54 years] who underwent PCI or MICS-CABG for LMDs were included. The primary endpoint was defined as the all-cause death during follow-up. The secondary endpoint defined as the major cardiovascular and cerebral events (MACCE) included cardiac death, myocardial infarction, target vessel revascularization, stroke, and stent thrombosis or graft occlusion. Inverse probability weighting (IPW) was performed to reduce treatment selection bias. This is the first report comparing the long-term outcomes of MICS-CABG and PCI in patients with LMDs.</p><p><strong>Results: </strong>The initial revascularization strategy was MICS-CABG in 269 (48.8%) cases and PCI in 282 (51.2%) patients. The SYNTAX scores (31.25 ± 4.63 vs. 26.05 ± 5.9, P  < 0.001) were notably higher in the MICS-CABG group than in the PCI group. The incidence of long-term mortality (11 vs. 5.6%, P  = 0.022) and MACCE (22 vs. 15.2%, P  = 0.042) were notably higher in the PCI group than in the MICS-CABG group. The long-term mortality [adjusted HR (IPW) = 6.38 (95% CI, 3.00-13.57), P  < 0.001] and MACCE [adjusted HR (IPW) = 4.51 (95% CI, 2.90-7.03), P  < 0.001] in the overall population significantly differed between the PCI group and the MICS-CABG group.</p><p><strong>Conclusion: </strong>The present study suggests that MICS-CABG for LMDs was associated with lower long-term mortality and MACCE rates than PCI.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"406-415"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001630","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":"Validation of a deep learning model for computed tomography-derived fractional flow reserve.","authors":"Vincent Pham, Fabien Picard, Sebastien Monnot, Pierre Garrigoux, Arnaud Jegou, Grégoire Dambrin, Jean-François Paul","doi":"10.1097/MCA.0000000000001508","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001508","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":"36 5","pages":"434-436"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495056","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 impact of the Naples prognostic score in long-term outcomes after percutaneous coronary intervention for chronic total occlusions.","authors":"Cihan Dündar, Ali Cevat Tanalp, Aysel Yağmur, Muhammet Buğra Karaaslan","doi":"10.1097/MCA.0000000000001512","DOIUrl":"10.1097/MCA.0000000000001512","url":null,"abstract":"<p><strong>Background: </strong>Chronic total occlusions (CTOs) of coronary arteries present a significant challenge in cardiology, with long-term outcomes following percutaneous coronary intervention (PCI) for CTOs remaining variable and unpredictable. The Naples prognostic score (NPS), which incorporates markers of nutritional status and systemic inflammation, has shown potential in predicting outcomes in various cardiovascular settings. This study evaluates the NPS as a predictor of long-term outcomes after PCI for CTOs.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 287 patients who underwent coronary angiography. Patients were categorized into non-CTO-PCI and CTO-PCI groups. Patients were further stratified based on survival status. Cox regression and Kaplan-Meier survival analyses were used to evaluate the association between NPS and long-term outcomes.</p><p><strong>Results: </strong>The mean age of the study population was 63.5 ± 10.6 years, with 28.6% being female. The NPS was significantly higher in the CTO-PCI group compared to the non-CTO-PCI group ( P  = 0.004) and was also elevated in the non-survival group ( P  = 0.004). Multivariable Cox regression analysis identified NPS as an independent predictor of mortality ( P  = 0.015). Kaplan-Meier analysis demonstrated significantly higher mortality in patients with an elevated NPS ( P  = 0.009).</p><p><strong>Conclusion: </strong>The NPS is a valuable independent predictor of long-term mortality in patients undergoing CTO-PCI. Incorporating NPS into existing risk stratification models could improve predictive accuracy and guide individualized patient management. Further prospective studies are warranted to validate these findings and explore interventions targeting inflammation and nutrition in this high-risk population.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"422-427"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254844","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":"10.1097/MCA.0000000000001452","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"448-449"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","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":"Risk factors that predict for presence of clinically significant, noncalcified plaque in younger adults.","authors":"Aditya Mehta, Felix Thomas, Venkat Manubolu, April Kinninger, Matthew Budoff, Sion K Roy","doi":"10.1097/MCA.0000000000001495","DOIUrl":"10.1097/MCA.0000000000001495","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery calcium (CAC) scoring may be a useful tool for assessing cardiovascular disease in young adults, particularly in those with risk factors such as hypertension, dyslipidemia, or smoking. In this study, we aimed to address the risk factors for developing noncalcified plaque in young adults by assessing total plaque burden.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted among 1026 consecutive patients aged 18-45 years who underwent CAC scoring and coronary computed tomography (CT) angiograms for clinical indications. CAC scores and total plaque scores (TPS) were calculated using standard scoring protocols. Multiple logistic regression analysis was conducted to identify independent risk factors of significant, noncalcified plaque in subjects where CAC = 0.</p><p><strong>Results: </strong>This single-center retrospective cohort study included 1026 patients aged 18-45 years who underwent CAC scoring and coronary CT angiograms for clinical indications. The mean age of the population was 38.8 years old. Sixty-three patients had a CAC score of 0 and a TPS >0. Of the patients with noncalcified plaque burden, 15% had a stenosis >50%, and 10% had a stenosis >70%. The odds of a subject having noncalcified plaque presence and CAC absent were significantly associated with being Hispanic, having diabetes, and having hyperlipidemia.</p><p><strong>Conclusion: </strong>In young adults aged 18-45 years old, we found diabetes, hyperlipidemia, and being of Hispanic origin to be significantly associated with noncalcified plaque burden.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"416-421"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064207","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":"Selective C-reactive protein apheresis in acute myocardial infarction: rationale and design of a prospective international randomized controlled trial.","authors":"Jan Torzewski, Stephan Mattecka, Benjamin Mayer, Gregg W Stone, Ahmed Sheriff","doi":"10.1097/MCA.0000000000001521","DOIUrl":"10.1097/MCA.0000000000001521","url":null,"abstract":"<p><strong>Background: </strong>C-reactive protein (CRP) has long been identified as a potential therapeutic target to improve outcomes in acute myocardial infarction (AMI). Recently, CRP apheresis has shown promising results from first-in-human case reports, registries, and pilot trials in patients with COVID-19, acute ST-segment elevation myocardial infarction, cardiogenic shock, and non-ST-segment elevation acute coronary syndromes.</p><p><strong>Methods and results: </strong>Herein we describe the perspective for a pivotal, international, randomized controlled trial investigating CRP apheresis in AMI. We herein propose the rationale, design, endpoints, and statistical methodology of this study.</p><p><strong>Conclusion: </strong>The goal is to demonstrate the safety and efficacy of CRP apheresis in AMI in reducing the combined primary clinical endpoint of cardiovascular mortality or rehospitalization for heart failure.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"428-433"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729273","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}

{"title":"A case of balanced ischemia: how coronary computed tomography angiography can help.","authors":"Matthew K Campbell, Suraj Dahal, Alexander Mink, Shaimaa A Fadl, Phillip B Duncan","doi":"10.1097/MCA.0000000000001487","DOIUrl":"10.1097/MCA.0000000000001487","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":"450-452"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853488","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}