Frontiers in Cardiovascular Medicine最新文献

{"title":"Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction.","authors":"Min-Wook Bae, Seong-Guen Moon, Kyung-Tae Jung, Won-Ho Kim, Sang-Hyun Park, Jihun Ahn, Jin-Yong Hwang, Seok Kyu Oh, Seung Ho Hur, Myung Ho Jung, Kyu-Sun Lee","doi":"10.3389/fcvm.2025.1530006","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1530006","url":null,"abstract":"<p><strong>Background: </strong>The prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.</p><p><strong>Methods: </strong>This study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. LVEF and WMSI were assessed via echocardiography at baseline and one-year post-PCI. The primary outcome was major cardiovascular adverse events (MACE), a composite of all-cause death, recurrent myocardial infarction (MI), and rehospitalization for heart failure at three years.</p><p><strong>Results: </strong>Among 3,510 AMI patients, 1,561 (44.5%) showed improvement in both LVEF and WMSI at one year after PCI, 1,150 (32.8%) experienced improvement in either LVEF or WMSI, while 799 (22.8%) had deterioration in both. The incidence of MACE was significantly lower in patients with improvement in both LVEF and WMSI (7.8% vs. 12.5% vs. 17.1%, <i>P</i> < 0.001). These patients also exhibited the highest rate of LV reverse remodeling and the lowest rate of adverse remodeling. Both the random forest and logistic regression models identified changes in LVEF and WMSI as significant predictors of MACE and LV remodeling.</p><p><strong>Conclusion: </strong>In AMI patients, improvement in both LVEF and WMSI post-PCI was associated with a lower risk of MACE and a higher likelihood of LV reverse remodeling. These findings highlight the prognostic value of LVEF and WMSI changes in guiding long-term management strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1530006"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between neutrophil percentage-to-albumin ratio and cardiovascular disease: evidence from a cross-sectional study.","authors":"Xinfu Huang, Yuqing Zhang, Wanting Hao, Xue Wu, Peng Yang","doi":"10.3389/fcvm.2025.1557507","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1557507","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a leading cause of death and disability worldwide. Available studies suggest that inflammation and nutritional status play a key role in the development of CVD. As a new combined indicator of inflammation and nutritional status, the neutrophil percentage-to-albumin ratio (NPAR) may be important in CVD prediction.</p><p><strong>Objective: </strong>This study investigated the association between NPAR and CVDs such as heart failure, coronary heart disease, angina pectoris, and stroke. It aimed to confirm the validity of NPAR as a potential biomarker of CVD using data from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>This study used a cross-sectional study design that analyzed the neutrophil percentage, albumin levels, and CVD diagnostic information of 12,165 adults. Multifactorial logistic regression modeling was employed to explore the association between NPAR and CVDs such as heart failure, coronary heart disease, angina pectoris, and stroke, while the nonlinear relationships were examined via restricted cubic spline. In addition, subgroup analyses were performed to assess the effect of age, sex, and race on the association between NPAR and CVD.</p><p><strong>Results: </strong>Our findings suggested that higher NPAR levels were significantly associated with an increased odds of CVD events. Specifically, each NPAR unit increase was associated with a 3% higher odds of a CVD event (OR = 1.03, 95% CI: 1.01-1.06). Individuals in the highest NPAR quartile displayed a significantly higher odds of heart failure (OR = 1.66, 95% CI: 1.18-2.34, <i>p</i> = 0.0035)and stroke (OR = 1.74, 95% CI: 1.28-2.36, <i>p</i> = 0.0004) than those in the lowest quartile. Subgroup analyses showed a more pronounced association between NPAR and CVD in women (OR = 1.04, 95% CI: 1.00-1.08, <i>p</i> = 0.0499), hypertensive patients (OR = 1.04, 95% CI: 1.01-1.07, <i>p</i> = 0.0154), and diabetic patients (OR = 1.05, 95% CI: 1.01-1.09, <i>p</i> = 0.0178).</p><p><strong>Conclusion: </strong>The study demonstrated that as a comprehensive indicator of inflammation and nutritional status, NPAR could effectively predict CVD occurrence. Although the clinical application value of NPAR requires further validation, it shows promise as a novel biomarker for early CVD screening and prevention.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1557507"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid annuloplasty in ischemic cardiomyopathy patients undergoing restrictive mitral annuloplasty.","authors":"Yusuke Misumi, Satoshi Kainuma, Daisuke Yoshioka, Takuji Kawamura, Ai Kawamura, Shin Yajima, Shunsuke Saito, Takashi Yamauchi, Masaki Taira, Kazuo Shimamura, Shigeru Miyagawa","doi":"10.3389/fcvm.2025.1542619","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1542619","url":null,"abstract":"<p><strong>Background: </strong>We elucidated the impact of concomitant tricuspid annuloplasty (TAP) on postoperative tricuspid regurgitation (TR), pulmonary hypertension (PH) and survival in patients with ischemic cardiomyopathy undergoing restrictive mitral annuloplasty (RMA).</p><p><strong>Methods: </strong>This study included 234 patients with ischemic cardiomyopathy (LV ejection fraction ≤40%) who underwent RMA. Of them, 114 (49%) underwent concomitant TAP for secondary TR. The primary endpoint was freedom from significant recurrence (i.e., moderate or greater) and progression (≥2+ grades) in TR. The secondary endpoints were postoperative pulmonary artery systolic pressure (sPAP) and overall survival.</p><p><strong>Results: </strong>The 30-day mortality was not different (0.9% vs. 0.8%, <i>P</i> = 0.97), despite higher EuroSCORE II score (median, 9.3% vs. 7.2%, <i>P</i> = 0.016) for TAP group. At baseline, TAP group had higher TR grades (2.4 ± 0.8 vs. 1.4 ± 0.6, <i>P</i> < 0.001) and sPAP (51 ± 16 vs. 44 ± 12 mmHg, <i>P</i> < 0.001). At 5-year post-surgery, RMA with TAP demonstrated higher freedom from recurrence or progression of TR (91 ± 3% vs. 81 ± 4%, log-rank <i>P</i> = 0.036), yielding nearly identical sPAP (42 ± 18 vs. 40 ± 16 mmHg, <i>P</i> = 0.54). Multivariable analysis demonstrated concomitant TAP was independently associated with freedom from significant recurrence in TR. Overall survival were not different between the groups (<i>P</i> = 0.74).</p><p><strong>Conclusions: </strong>In patients with ischemic cardiomyopathy, concomitant TAP did not increase operative mortality and better reduced TR, resulting in comparable PH severity and long-term survival, compared to RMA alone.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1542619"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between time-varying weighted hemoglobin and all-cause mortality in patients with acute myocardial infarction-related cardiogenic shock.","authors":"Xia Liu, Tianbo Gong, Yongpeng Zhang","doi":"10.3389/fcvm.2025.1516100","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1516100","url":null,"abstract":"<p><strong>Background and aims: </strong>Anemia has been implicated in prognosis across ischemic heart diseases. This study aimed to investigate the association between time-weighted average hemoglobin (TWA-Hb) and all-cause mortality in patients with acute myocardial infarction-related cardiogenic shock (AMI-CS).</p><p><strong>Methods and results: </strong>We conducted a retrospective analysis of 765 patients diagnosed with AMI-CS using data from the MIMIC-IV database (2008-2019). Kaplan-Meier survival analysis demonstrated that lower TWA-Hb levels were associated with higher cumulative mortality rates at 28 days, 90 days, 6 months, and 1 year (log-rank <i>P</i> = 0.002, 0.006, 0.048, and 0.005, respectively). Landmark analyses further revealed a sustained increase in mortality risk associated with lower TWA-Hb during the 28-day to 1-year follow-up period. Multivariable Cox regression analysis identified low TWA-Hb as an independent predictor of mortality risk at 90 days (<i>P</i> = 0.026), 6 months (<i>P</i> = 0.023), and 1 year (<i>P</i> = 0.021). Each one-unit increase in TWA-Hb was associated with a 0.93-, 0.76- and 0.71-fold decrease in the risk of 90-day, 6-month, and 1-year mortality, correspondingly. Subgroup analyses stratified by age, BMI, and comorbidities consistently supported these findings (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Low TWA-Hb is associated with long-term mortality in patients with AMI-CS. These findings imply that the application of this indicator in clinical practice could improve long-term risk stratification.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1516100"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the role of the atherogenic index of plasma as a mediator between body roundness Index and cardiovascular events in older adults: a NHANES-based study.","authors":"Kangming Li, Shizhong Chen, Yanan Hu, Chunmei Qi","doi":"10.3389/fcvm.2025.1506603","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1506603","url":null,"abstract":"<p><strong>Background: </strong>The rising incidence of cardiovascular diseases (CVD) in the elderly highlights the need for effective preventive strategies. Recent studies suggest that obesity, through metabolic factors, contributes to the development of CVD. This study aims to explore how body roundness index (BRI) levels affect the occurrence of CVD using data from the National Health and Nutrition Examination Survey (NHANES) (2003-2016), to better understand the role of obesity in CVD prevention and management.</p><p><strong>Methods: </strong>The study analyzed data from 3,584 NHANES participants over seven cycles (2003-2016), dividing them into three groups (T1, T2, T3) based on BRI values. Univariate and multivariate regression analyses were used to assess the association between BRI and atherogenic index of plasma (AIP) levels with the occurrence of CVD. The mediating effect of AIP on BRI and CVD was also analyzed.</p><p><strong>Results: </strong>Compared to the lowest tertile of BRI, participants with higher BRI levels had a higher proportion of females, smokers, drinkers, and individuals with lower educational attainment. Poverty-income ratio (PIR) and AIP levels were significantly higher, and the prevalence of CVD was also higher. BRI and AIP were both independent risk factors for CVD, with AIP having a significant mediating effect between BRI and CVD.</p><p><strong>Conclusion: </strong>BRI levels significantly impact the occurrence of CVD through AIP mediation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1506603"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Inflammaging and immunosenescence: role in aging-associated cardiovascular diseases.","authors":"Tlili Barhoumi, Rihab Bouchareb, Fayhan Alroqi, Adel Nefzi, Stephen Todryk","doi":"10.3389/fcvm.2025.1616623","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1616623","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1616623"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Optimizing cardiovascular imaging for unusual clinical scenarios: a case-based approach.","authors":"Antonios Karanasos, Grigorios Korosoglou","doi":"10.3389/fcvm.2025.1615228","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1615228","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1615228"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Moderate-to-severe paravalvular leak regurgitation after recurrent prosthetic valve endocarditis in a patient with a double-chambered right ventricle associated with a restricted membranous ventricular septal defect.","authors":"Cosimo Sacra, Antonio Totaro, Giuseppe Triggiani, Andrea Romano, Pasquale Astore, Chiara Galluccio, Eustaquio Maria Onorato","doi":"10.3389/fcvm.2025.1558686","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1558686","url":null,"abstract":"<p><strong>Background: </strong>Managing aortic paravalvular leak (PVL) regurgitation following multiple surgical aortic valve replacements (SAVRs) due to recurrent infective endocarditis (IE) presents significant clinical challenges.</p><p><strong>Case summary: </strong>A 46-year-old woman with a history of severe aortic regurgitation and an asymptomatic membranous ventricular septal defect underwent SAVR with a bioprosthetic aortic valve (Perimount 23 mm) in 2005. Concomitantly, a double-chambered right ventricle was diagnosed. Ten years later, due to recurrent IE, another bioprosthetic valve replaced the previous valve (Magna Ease #25). In 2018, she developed sepsis from <i>Bordetella hinzii</i> endocarditis, leading to a third SAVR in 2019, this time with a mechanical aortic valve (On-X® #23). In 2024, two-dimensional transesophageal echocardiography (TEE) revealed moderate-to-severe PVL regurgitation near the right coronary cusp. After a multidisciplinary evaluation, transcatheter PVL closure was planned. Under general anesthesia and TEE/angio-fluoroscopic guidance, the PVL was successfully crossed via the right femoral artery, and a 10 mm × 4 mm Occlutech paravalvular leak device was deployed. Post-procedural imaging confirmed effective PVL closure with a trace-mild residual leak.</p><p><strong>Discussion: </strong>This case highlights the feasibility of transcatheter PVL closure as a less invasive alternative for patients with multiple prior SAVRs and high surgical risk. Advanced imaging techniques were crucial in procedural success, ensuring precise device placement. A multidisciplinary heart team approach is essential for optimizing outcomes in complex valve pathology. Long-term follow-up is necessary to monitor the durability of the closure and potential complications.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1558686"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioinformatics analysis of JUP in patients with acute myocardial infarction and its potential application in clinical prognostic evaluation.","authors":"Xinyue Deng, Ailing Shen, Leiying Jiang","doi":"10.3389/fcvm.2025.1531309","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1531309","url":null,"abstract":"<p><strong>Background: </strong>Junctional Plakoglobin (JUP) is a critical protein involved in intercellular junctions, playing a significant role in maintaining the structure and function of myocardial cells. However, the expression of JUP in acute myocardial infarction (AMI) and its potential applications in prognostic evaluation of patients remain underexplored. This study aims to investigate the expression levels of JUP in AMI patients and its association with clinical prognosis through bioinformatics analysis.</p><p><strong>Methods: </strong>A total of 164 patients with acute myocardial infarction admitted from January 2022 to January 2024 were selected as the study subjects. They were divided into an MACE group and a non-MACE group based on the occurrence of adverse prognostic events. Clinical data and myocardial tissue samples from patients post-percutaneous coronary intervention (PCI) were collected. The expression levels of JUP in myocardial tissue were assessed using quantitative real-time PCR (qPCR), and the functional role of the JUP gene in the prognosis of acute myocardial infarction was analyzed. The impact of JUP expression levels on the prognosis of AMI patients was evaluated using Kaplan-Meier method and Cox Proportional Hazards Model.</p><p><strong>Results: </strong>The expression level of JUP in the MACE group was significantly lower than that in the Non-MACE group (<i>P</i> < 0.05). The results of the Cox Proportional Hazards Model further indicated that TnI levels (HR = 12.512, 95% CI: 1.622-96.507, <i>P</i> < 0.05), multi-vessel disease (HR = 0.300, 95% CI: 0.108-0.834, <i>P</i> < 0.05), and myocardial JUP levels (HR = 0.234, 95% CI: 0.065-0.846, <i>P</i> < 0.05) were independent predictive factors for post-PCI outcomes in patients with acute myocardial infarction. Kaplan-Meier method revealed a significant association between low JUP expression and adverse prognosis in AMI patients (<i>P</i> < 0.05). ROC curve showed that multi-vessel disease (AUC = 0.6548, Sensitivity = 64.29%, Specificity = 66.67%), TnI (AUC = 0.8316, Sensitivity = 40.71%, Specificity = 91.67%), and myocardial JUP (AUC = 0.8299, Sensitivity = 75.00%, Specificity = 84.29%) could all predict the risk of major adverse cardiac events (MACE) after PCI in AMI patients.</p><p><strong>Conclusion: </strong>The expression level of JUP is decreased in patients with acute myocardial infarction and is closely associated with adverse prognostic outcomes. JUP may serve as a potential biomarker for assessing prognosis in AMI patients, providing new insights for the development of personalized treatment strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1531309"},"PeriodicalIF":2.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study.","authors":"Giacomo Maria Cioffi, Pablo Lamelas, Mariam Shenouda, Jamie Halperin, Francesca Goffredo, Brian Patrick McGrath, Norman Said Vega Servin, Shamir R Mehta, Sanjit S Jolly, J D Schwalm, Madhu K Natarajan, Nicholas Valettas, James L Velianou, Michael B Tsang, Natalia Pinilla-Echeverri, Matthew G Sibbald, Tej N Sheth","doi":"10.3389/fcvm.2025.1565676","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1565676","url":null,"abstract":"<p><strong>Background: </strong>Stent failure (SF) is a complication of percutaneous coronary intervention (PCI).</p><p><strong>Objectives: </strong>This study aimed to assess the relationship of the optical coherence tomography (OCT) determined cause of SF with time since stent implantation, treatment, and outcome.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent an OCT evaluation for SF from January 2013 to July 2023. In-stent findings were evaluated on OCT including tissue proliferation, tissue type, underexpansion, thrombus, and multiple stent layers. The relationship between time to presentation, treatment, and outcome was assessed.</p><p><strong>Results: </strong>Of the 309 patients who underwent an OCT-guided PCI for SF, tissue proliferation was present in 228 (74%) and absent in 81 (26%). Among patients with tissue proliferation, OCT commonly showed lipidic neointima (<i>n</i> = 122, 54%), thrombus (<i>n</i> = 81, 36%), and underexpansion (<i>n</i> = 71, 31%). In patients without tissue proliferation, OCT commonly identified underexpansion (<i>n</i> = 58, 72%), thrombus (<i>n</i> = 55, 68%), and uncovered struts (<i>n</i> = 37, 46%). The mean time to SF was 6.89 ± 5.88 years with tissue proliferation and 2.98 ± 3.75 years without (<i>p</i> < 0.001). Patients with tissue proliferation were more likely to be treated with repeat stenting (78% vs. 60%, <i>p</i> < 0.001). Lipidic neointimal tissue and >1 layer of stent were predictors of target SF recurrence during a median 3 years of follow-up.</p><p><strong>Conclusion: </strong>In a large series of OCT-guided treatments of SF, tissue proliferation was more common, occurred later after stent implantation, and was more likely to be treated with repeat stenting than no-tissue proliferation. Lipidic neointimal tissue and >1 layer of stent were significant predictors of target SF during follow-up.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1565676"},"PeriodicalIF":2.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}