International journal of cardiology最新文献

{"title":"Redefining risk in diastolic function: mortality-based thresholds along a physiologic continuum","authors":"Mattia Alberti","doi":"10.1016/j.ijcard.2026.134201","DOIUrl":"10.1016/j.ijcard.2026.134201","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134201"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of common risk factors with major adverse cardiac events and mortality in patients with MINOCA: A systematic review and meta-analysis","authors":"Sotirios Chiotis ,&nbsp;Georgios Giannopoulos ,&nbsp;Aristi Boulmpou ,&nbsp;Aikaterini Zgouridou ,&nbsp;Leonidas Koliastasis ,&nbsp;Ioannis Efthymiou ,&nbsp;Aikaterini Vassilikou ,&nbsp;Prokopios Mamolis ,&nbsp;Dimitrios Vrachatis ,&nbsp;Efstathios Pagkourelias ,&nbsp;Stergios Tzikas ,&nbsp;Ioannis Doundoulakis ,&nbsp;Christodoulos Papadopoulos ,&nbsp;Vassileios P. Vassilikos","doi":"10.1016/j.ijcard.2026.134225","DOIUrl":"10.1016/j.ijcard.2026.134225","url":null,"abstract":"<div><h3>Background</h3><div>Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous condition with variable outcomes. The prognostic value of common clinical risk factors for major adverse cardiac events (MACEs) and all-cause mortality remains unclear. This study systematically evaluates associations between traditional risk factors and adverse outcomes in MINOCA.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted to assess pooled hazard ratios (HRs) for clinical variables associated with MACEs and all-cause mortality. Eligible studies reporting HRs with at least 6 months of follow-up were included. Random-effects models were used to derive pooled estimates.</div></div><div><h3>Results</h3><div>Eleven studies including 12,081 patients were analyzed. Over a mean follow-up of 49.2 months, pooled MACEs incidence was 17% (95% CI: 11–26%) and all-cause mortality was 10% (95% CI: 8–14%). Older age increased the risk of MACEs (HR: 1.02; 95% CI: 1.01–1.04), while higher BMI was protective (HR: 0.92; 95% CI: 0.86–0.99). For all-cause mortality, significant predictors included age (HR: 1.04 per year), diabetes (HR: 1.33; 95% CI: 1.07–1.64), creatinine (HR: 1.01; 95% CI: 1.0009–1.02), and STEMI-pattern presentation (HR: 2.85; 95% CI: 1.09–7.44). Higher BMI (HR: 0.89; 95% CI: 0.82–0.98) and dyslipidemia (HR: 0.83; 95% CI: 0.76–0.90) were associated with lower mortality.</div></div><div><h3>Conclusion</h3><div>Only select clinical variables predict outcomes in MINOCA, while many traditional MI risk factors do not. These findings highlight the need for MINOCA-specific risk models and targeted management strategies.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134225"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary inflammation: Identification, clinical impact and possible therapeutical solutions","authors":"Francesco Prati ,&nbsp;Flavio Giuseppe Biccirè ,&nbsp;Maria Teresa Mallus ,&nbsp;Flavio Mastroianni ,&nbsp;Laura Gatto ,&nbsp;Michela Ferrari ,&nbsp;Eloisa Arbustini","doi":"10.1016/j.ijcard.2026.134229","DOIUrl":"10.1016/j.ijcard.2026.134229","url":null,"abstract":"<div><div>Coronary inflammation is now widely recognized as a key driver of atherosclerotic plaque initiation, progression, and destabilization. Histopathological studies and advanced imaging have demonstrated the central role of local inflammation, including extensive macrophage infiltration, cytokine activation, and perivascular adipose tissue, in promoting plaque vulnerability and acute coronary syndromes. Among systemic biomarkers, high-sensitivity C-reactive protein remains the most widely used, although its limited specificity underscores the need for more targeted inflammatory markers such as interleukin-6. Invasive intracoronary imaging with optical coherence tomography can visualize macrophage accumulation and quantify local inflammatory burden. Hybrid molecular imaging with OCT-NIRF, novel PET tracers and peri-coronary adipose tissue attenuation can provide emerging opportunities to further characterize vascular inflammation and residual risk. Anti-inflammatory therapies represent a major opportunity to improve outcomes beyond lipid lowering. Among patients with coronary artery disease, the use of colchicine has demonstrated significant risk reduction in adverse events, though with mixed results. Important randomized trials are underway to investigate the efficacy of novel monoclonal antibodies targeting interleukin pathways. In addition, GLP-1 receptor agonists, SGLT2 inhibitors, and PCSK9 inhibitors have been described to exhibit favourable vascular anti-inflammatory effects in experimental and in-vivo studies. In this comprehensive review, we provide an updated reappraisal of the available evidence unravelling how accurate identification of high-risk patients through multimodal imaging and biomarker profiling, combined with selective anti-inflammatory therapy, can represent a promising strategy for further reducing residual cardiovascular risk.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134229"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel insights into myocardial synchrony: A CMR-based approach for improving the detection of coronary artery disease at rest","authors":"Minghui Hua ,&nbsp;Rong Liang ,&nbsp;Weizhi Nie ,&nbsp;Li Zhou ,&nbsp;Yimeng Zhang ,&nbsp;Ziyu Yan ,&nbsp;Keyi Cui ,&nbsp;Yufan Gao ,&nbsp;Boxin Li ,&nbsp;Jiwei Sun ,&nbsp;Wenjiao Wang ,&nbsp;Anhong Yu ,&nbsp;Yafang Zheng ,&nbsp;Xi Liu ,&nbsp;Feng Wang ,&nbsp;Zhen Xing ,&nbsp;Shuo Liang ,&nbsp;Jun Lv ,&nbsp;Yanhe Ma ,&nbsp;Ximing Li ,&nbsp;Hong Zhang","doi":"10.1016/j.ijcard.2026.134221","DOIUrl":"10.1016/j.ijcard.2026.134221","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to develop a novel cardiac magnetic resonance (CMR)-based method for quantifying myocardial synchrony and evaluate its diagnostic value in detecting myocardial dysfunction of coronary artery disease (CAD).</div></div><div><h3>Methods</h3><div>Consecutive participants with anatomically/angiographically obstructive CAD (<em>n</em> = 112) and healthy participants (<em>n</em> = 87) undergoing CMR imaging were prospectively enrolled. Myocardial strain was analyzed using feature-tracking, and myocardial synchrony was quantified via Pearson correlation coefficients of segmental strain time series across the cardiac cycle. Machine learning models (strain-only, synchrony-only, combined) were developed and validated in an independent external cohort.</div></div><div><h3>Results</h3><div>Healthy participants exhibited high left ventricular myocardial synchrony (radial: 0.91 [IQR: 0.88, 0.93]; circumferential: 0.90 ± 0.04; longitudinal: 0.97 ± 0.02), significantly reduced in participants with CAD (radial: 0.84 [IQR: 0.75, 0.89]; circumferential: 0.81 ± 0.12; longitudinal: 0.90 ± 0.08), including those with preserved left ventricular ejection fraction (LVEF ≥50%) (radial: 0.86 [IQR: 0.82, 0.90]; circumferential: 0.86 ± 0.07; longitudinal: 0.91 ± 0.07), all <em>p</em> &lt; 0.001. In model analysis, the combined model significantly outperformed individual models (AUC: 0.94 [95% CI: 0.89–1.00] vs. 0.84 [0.75–0.94] for strain model, <em>p</em> = 0.037; vs. 0.79 [0.68–0.90] for synchrony model, <em>p</em> = 0.001). Superiority persisted in CAD with preserved LVEF (AUC: 0.91 [95% CI: 0.83–1.00]) and external validation (AUC: 0.93 [95% CI: 0.84–1.00]).</div></div><div><h3>Conclusions</h3><div>This CMR-derived approach demonstrated the high degree of left ventricular synchrony in healthy populations and significant dyssynchrony in CAD, even in those with preserved LVEF. Integrating myocardial synchrony with strain significantly enhanced CAD myocardial dysfunction detection relative to strain alone, with robust diagnostic performance maintained in CAD with preserved LVEF.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134221"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase III cardiac rehabilitation improves left ventricular ejection fraction in patients with coronary artery disease and mildly reduced ejection fraction after percutaneous coronary intervention","authors":"Mei-Lian Cai ,&nbsp;Wu-Xiang Shi ,&nbsp;Jing Li ,&nbsp;Tao Li ,&nbsp;Wei Zhang ,&nbsp;Chuang-Biao Lin ,&nbsp;Xin-Yun Wang ,&nbsp;Yu-Ting Huang ,&nbsp;Xin-Min Qing","doi":"10.1016/j.ijcard.2026.134219","DOIUrl":"10.1016/j.ijcard.2026.134219","url":null,"abstract":"<div><h3>Background</h3><div>Exercise-based cardiac rehabilitation (ExCR) is standard for secondary prevention in coronary artery disease (CAD), yet its efficacy in patients with heart failure with mildly reduced ejection fraction (HFmrEF) after percutaneous coronary intervention (PCI) remains unclear.</div></div><div><h3>Methods</h3><div>In this single-center RCT, 120 stable CAD patients with HFmrEF (LVEF 40–49%) post-PCI were randomized 1:1 to receive either guideline-directed medical therapy (GDMT) plus a 52-week structured ExCR program (intervention) or GDMT alone (control). Primary outcomes—LDL-C, TG, LVEF, and LVEDD—were assessed at 4, 12, 24, and 52 weeks. Linear Mixed Models analyzed longitudinal intervention effects.</div></div><div><h3>Results</h3><div>A significant Group × Time interaction was observed for LVEF (<em>p</em> = .032), indicating superior recovery in the ExCR group. At 52 weeks, the ExCR group showed greater improvement in LVEF (+5.0% vs. +4.0%, <em>p</em> = .023) and greater reduction in LDL-C (−1.43 mmol/L vs. –1.04 mmol/L, <em>p</em> = .030) versus control. No between-group differences were found in TG or LVEDD.</div></div><div><h3>Conclusions</h3><div>A 52-week structured ExCR program significantly enhances cardiac recovery and lipid control in HFmrEF patients post-PCI, providing incremental benefits beyond GDMT alone. Sustained ExCR should be considered essential in comprehensive management for this population.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134219"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic inflammatory indices, cardiac conduction disorders, and atrial fibrillation: Phenotype-specific associations and incremental discrimination in the China National Health Survey (CNHS)","authors":"Zichao Wang ,&nbsp;Yaoda Hu ,&nbsp;Huijing He ,&nbsp;Ji Tu ,&nbsp;Zhiming Lu ,&nbsp;Weihao Wang ,&nbsp;Haibo Huang ,&nbsp;Zhili Chen ,&nbsp;Da Xu ,&nbsp;Qing Wang ,&nbsp;Zhujie Ran ,&nbsp;Mengwei Zhang ,&nbsp;Guangliang Shan","doi":"10.1016/j.ijcard.2026.134224","DOIUrl":"10.1016/j.ijcard.2026.134224","url":null,"abstract":"<div><h3>Background</h3><div>Systemic inflammation may influence cardiac electrophysiology, but evidence on phenotype-specific links with ECG-defined conduction disorders and atrial fibrillation (AF) in China is limited.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional analysis of 10,303 adults in the China National Health Survey. Nine inflammatory markers (neutrophils, lymphocytes, monocytes, platelets, hsCRP, NLR, SII, SIRI and PIV; log-transformed and standardized) were related to ECG-defined right bundle branch block (RBBB), intraventricular conduction delay (IVCD), left bundle branch block (LBBB), left anterior fascicular block (LAFB), atrioventricular block (AVB) and AF. Associations were estimated with Firth-penalised logistic regression with multivariable adjustment and false discovery rate control. Incremental discrimination beyond covariates was assessed by 10-fold cross-validated area under the curve (AUC).</div></div><div><h3>Results</h3><div>LBBB showed the strongest pattern: lymphocytes were inversely associated (odds ratio [OR] 0.65, 95% CI 0.50–0.84), while neutrophils (OR 5.39, 4.05–7.29), SIRI (OR 4.24, 3.34–5.44), and SII (OR 6.93, 5.17–9.52) were positively associated. LAFB and AF displayed similar signals (LAFB: lymphocytes OR 0.68, 0.55–0.86; NLR OR 1.66, 1.34–2.05; AF: monocytes OR 2.30, 1.79–2.94; SIRI OR 2.42, 1.92–3.03). RBBB showed modest links (NLR OR 1.15, 1.03–1.27); IVCD and AVB were largely null. Composite indices improved discrimination beyond covariates: SIRI yielded ΔAUC +0.163 for LBBB (final AUC 0.923), +0.098 for AF, and +0.041 for LAFB; gains for RBBB/IVCD/AVB were negligible. Sex interactions were significant: neutrophil and SIRI effects were stronger in men with LBBB (P-interaction 0.032/0.038), while lymphocytes were more protective in women with AF (OR 0.51, 0.36–0.73; P-interaction 0.001).</div></div><div><h3>Conclusions</h3><div>Systemic inflammation showed phenotype-specific associations with ECG-defined conduction disorders and atrial fibrillation. Low-cost composite indices—especially SIRI—substantially improved discrimination of prevalent LBBB, LAFB, and AF beyond clinical covariates; prospective studies are needed to clarify temporality, validate thresholds, and assess clinical utility.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134224"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telomere length in patients with Marfan Syndrome","authors":"Tijs K. Tournoy ,&nbsp;Simon D'hulst ,&nbsp;Anthony Demolder ,&nbsp;Robbe Derudder ,&nbsp;Dries S. Martens ,&nbsp;Laura Muiño Mosquera ,&nbsp;Paul Coucke ,&nbsp;Julie De Backer","doi":"10.1016/j.ijcard.2026.134234","DOIUrl":"10.1016/j.ijcard.2026.134234","url":null,"abstract":"<div><h3>Background</h3><div>Marfan syndrome (MFS) is a multisystemic heritable thoracic aortic disease entity characterized by progressive aortic dilatation and life-threatening cardiovascular complications. Chronic inflammation and oxidative stress are increasingly recognized in its pathophysiology, and are important drivers of telomere shortening, a hallmark of biological aging. We hypothesized that adults with MFS have shorter telomere length (TL) compared to healthy controls.</div></div><div><h3>Methods</h3><div>Relative average leukocyte TL was measured in 59 adults with molecularly confirmed MFS (median age 38 years, 29 females) and 59 age- and sex-matched healthy controls. TL was determined by a singleplex qPCR assay.</div></div><div><h3>Results</h3><div>Patients with MFS had shorter TL compared to healthy controls (0.99 ± 0.19 vs. 1.07 ± 0.21, <em>p</em> = 0.033). In univariate analysis, we found that major adverse cardiovascular events (defined as aortic dissection, arrhythmia or heart failure) were associated with shorter TL (β = −0.168, 95%CI -0.291; −0.013, <em>p</em> = 0.008). No other clinical or genetic variables showed significant associations in either the raw or age- and sex–adjusted TL analyses.</div></div><div><h3>Conclusion</h3><div>Adults with MFS have shorter leukocyte TL, and an association was found between shorter TL and severe cardiovascular events. These findings suggest a role for accelerated aging mechanisms in the pathophysiology of the disease.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134234"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary CT angiography in master athletes: Redefining primary prevention of ischemic heart disease beyond the Italian 2023 COCIS guidelines","authors":"Giuseppe Mascia ,&nbsp;Michela Cammarano ,&nbsp;Vincenzo Palmieri ,&nbsp;Riccardo Monti ,&nbsp;Roberta Della Bona ,&nbsp;Rocco Vergallo ,&nbsp;Daniele Andreini ,&nbsp;Paolo Zeppilli ,&nbsp;Italo Porto","doi":"10.1016/j.ijcard.2026.134214","DOIUrl":"10.1016/j.ijcard.2026.134214","url":null,"abstract":"<div><h3>Background</h3><div>In adults over 35 years of age, ischemic heart disease (IHD) is the predominant cause of exercise-related acute coronary events and sudden cardiac death. Master athletes, despite high levels of fitness, are not immune to coronary atherosclerosis, which often remains clinically silent until precipitated by exertional stress. Recent data challenge the assumption that long-term endurance training offers protection against coronary artery disease (CAD), revealing a non-negligible prevalence of subclinical atheroma even in asymptomatic athletes.</div></div><div><h3>Objective</h3><div>To examine the evolving role of coronary computed tomography angiography (CCTA) in the primary prevention of IHD in master athletes, with a focus on risk stratification, plaque characterization, and integration into sports eligibility assessment.</div></div><div><h3>Content</h3><div>Technological advances have enhanced the diagnostic performance of CCTA, allowing not only the detection of obstructive disease but also the identification of high-risk plaque features, such as low-attenuation fibro-lipid core, positive remodelling, and microcalcifications. In selected older athletes with elevated risk profiles or equivocal stress tests, CCTA provides valuable anatomical information that often eludes functional testing alone. Italian guidelines (COCIS 2023) include CCTA in the evaluation of intermediate-to-high-risk master athletes, emphasizing a risk-adapted approach rather than blanket screening.</div></div><div><h3>Conclusions</h3><div>CCTA may refine cardiovascular risk assessment in master athletes by detecting subclinical but clinically relevant CAD, potentially improving long-term outcomes and guiding individualized recommendations for sports participation. While broader implementation must consider cost, radiation exposure, and the risk of overdiagnosis, selective use of CCTA appears justified in targeted high-risk populations. Prospective studies are needed to validate this strategy and define its role within comprehensive athlete evaluation frameworks.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134214"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When opening the artery is not enough: Diastolic remodeling and CTO revascularization after STEMI","authors":"Sant Kumar ,&nbsp;Lorenzo Azzalini","doi":"10.1016/j.ijcard.2026.134220","DOIUrl":"10.1016/j.ijcard.2026.134220","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"450 ","pages":"Article 134220"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right versus left distal radial access for coronary procedures in a large prospective multicenter registry: Insight from the KODRA registry","authors":"Chan Joon Kim ,&nbsp;Seonghyeon Bu ,&nbsp;Jun-Won Lee ,&nbsp;Tae-Hyun Yang ,&nbsp;Jeong-Sook Seo ,&nbsp;Yongcheol Kim ,&nbsp;Bong-Ki Lee ,&nbsp;Sang-Yong Yoo ,&nbsp;Sang Yeub Lee ,&nbsp;Sung Woo Cho ,&nbsp;Jin Sup Park ,&nbsp;Jung Ho Heo ,&nbsp;Do Hoi Kim ,&nbsp;Jin Bae Lee ,&nbsp;Dong-Kie Kim ,&nbsp;Jino Park ,&nbsp;Jun Ho Bae ,&nbsp;Sung-Yun Lee ,&nbsp;Seung-Hwan Lee ,&nbsp;Han-Young Jin","doi":"10.1016/j.ijcard.2026.134193","DOIUrl":"10.1016/j.ijcard.2026.134193","url":null,"abstract":"<div><h3>Background</h3><div>Distal radial access (DRA) can be performed from either the right or left distal radial artery. However, comparative data between these two access routes remain limited.</div></div><div><h3>Methods</h3><div>Using data from the KODRA registry, we compared procedural outcomes between right (RDRA) and left DRA (LDRA). The primary endpoint was access-site crossover after successful puncture. Secondary endpoints included successful coronary angiography (CAG) via the initial access site, puncture success, overall access-site crossover, DRA-related bleeding, and procedure-related times.</div></div><div><h3>Results</h3><div>Among 4977 patients, RDRA showed a higher rate of access-site crossover (1.7% vs. 0.7%, <em>p</em> &lt; 0.001). Rates of successful CAG (92.5% vs. 93.8%, <em>p</em> = 0.087), puncture success (94.2% vs. 94.5%, <em>p</em> = 0.670), overall access-site crossover (7.5% vs. 6.2%, <em>p</em> = 0.068), and DRA-related bleeding (3.0% vs. 3.4%, <em>p</em> = 0.446) were comparable between groups. The times for arterial puncture and CAG were significantly shorter with RDRA than with LDRA (88.2 ± 115.4 s vs. 107.9 ± 123.2 s; 8.6 ± 6.7 min vs. 10.9 ± 8.3 min; both <em>p</em> &lt; 0.001), although procedural times were shorter when procedures were performed on the operators' preferred access side. In multivariable analysis, RDRA independently predicted access-site crossover after successful puncture (OR 2.156, 95% CI 1.184–3.926).</div></div><div><h3>Conclusions</h3><div>Compared with LDRA, RDRA was associated with a higher risk of access-site crossover, whereas success rates of CAG and puncture, overall access-site crossover, and DRA-related bleeding were comparable. The shorter procedural times with RDRA were largely influenced by the operator's access-side preference.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"449 ","pages":"Article 134193"},"PeriodicalIF":3.2,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146062746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}