Korean Circulation Journal最新文献

{"title":"Long-Term Outcomes of Aspirin vs. Clopidogrel After PCI in High-Risk Patients With Cardiovascular Comorbidities: A Post Hoc Analysis of the HOST-EXAM Extended Trial.","authors":"Huijin Lee, Jeehoon Kang, Doyeon Hwang, Kyung Woo Park, Han-Mo Yang, Hyun-Jae Kang, Jung-Kyu Han, Eun-Seok Shin, Bon-Kwon Koo, Hyo-Soo Kim","doi":"10.4070/kcj.2025.0272","DOIUrl":"10.4070/kcj.2025.0272","url":null,"abstract":"<p><strong>Background and objectives: </strong>The HOST-EXAM Extended trial demonstrated the long-term benefits of clopidogrel over aspirin monotherapy following dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). This sub-study evaluated these therapies in patients with and without previous cardiovascular disease (CVD).</p><p><strong>Methods: </strong>A total of 5,438 patients were randomized to aspirin (100 mg daily) or clopidogrel (75 mg daily) monotherapy. Previous CVD was defined as previous myocardial infarction, cerebrovascular accident, or peripheral artery disease, present in 1,137 patients; 4,301 had no CVD. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to ACS, and major bleeding (Bleeding Academic Research Consortium [BARC] type 3 or 5). Secondary endpoints included thrombotic and any bleeding events (BARC type ≥2). Median follow-up was 5.8 years.</p><p><strong>Results: </strong>The primary endpoint occurred more frequently in patients with previous CVD than in those without (18.1% vs. 13.7%, hazard ratio [HR], 1.045; 95% confidence interval [CI], 1.037-1.054; p<0.001). Regarding the treatment estimates for the primary endpoint between those with and without previous CVD, no significant interaction was observed (CVD group: HR, 0.784; 95% CI, 0.596-1.033 and non-CVD group: HR, 0.794; 95% CI, 0.675-0.934, respectively; interaction p=0.951). For thrombotic and bleeding composite endpoints, CIs were overlapping across CVD strata, indicating no clear heterogeneity.</p><p><strong>Conclusions: </strong>Clopidogrel was associated with a lower risk of the primary endpoint versus aspirin after PCI, with no evidence of effect modification by previous CVD.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"680-690"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674449","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":"Mitral Annular and Aortic Calcification in Aortic Stenosis: Risk Marker or Bystander?","authors":"Jihoon Kim","doi":"10.4070/kcj.2026.0136","DOIUrl":"10.4070/kcj.2026.0136","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"747-749"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295486","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":"Assessment of Myocardial Stiffness With New Echocardiographic Methods.","authors":"Laurine Wouters, Annette Caenen, Ahmed Youssef, Andressa Araujo Andrade Sousa, Stéphanie Bézy, Jürgen Duchenne, Jan D'hooge, Jens-Uwe Voigt","doi":"10.4070/kcj.2025.0420","DOIUrl":"10.4070/kcj.2025.0420","url":null,"abstract":"<p><p>Myocardial stiffness is a key determinant of cardiac function. So far, its assessment required invasive methods such as pressure-volume loop measurements or mechanical testing of tissue biopsies, which are both not suited for daily clinical use. However, recent advances in echocardiography offer promising non-invasive alternatives. Initial clinical studies in different pathologies are encouraging and indicate a huge potential of these new ultrasound-based techniques for evaluating myocardial stiffness. In this review, we explain the concept of myocardial stiffness, explore the most promising ultrasound techniques currently available for its evaluation, and discuss key insights from recent clinical research in the field.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"655-679"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010906","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":"Transradial Access vs. Transfemoral Access for Primary PCI in ST-Elevation Myocardial Infarction Complicated by Cardiogenic Shock: Findings from a National, Multicenter Registry and Meta-Analysis.","authors":"Minghui Zhang, Zixu Zhao, Yu Liu, Haoran Ma, Kexin Wang, Tian Liu, Wangyang Yang, Yichen Zhao, Wei Luo, Xuedong Zhao, Keyang Zheng, Chengqian Yin, Xinyong Zhang, Hai Gao, Can Zhou, Dong Zhao","doi":"10.4070/kcj.2025.0251","DOIUrl":"10.4070/kcj.2025.0251","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transradial access (TRA) is recommended for percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) due to lower mortality and bleeding risk, but evidence in STEMI with cardiogenic shock (STEMI-CS) remains limited. To evaluate the efficacy and safety of TRA versus transfemoral access (TFA) for primary PCI in STEMI-CS.</p><p><strong>Methods: </strong>Using data from a nationwide, multicenter registry, we compared TRA and TFA with multivariable-adjusted Cox regression, propensity score matching, and inverse probability treatment weighting. The primary outcome was in-hospital all-cause mortality. Other outcomes included major bleeding and major adverse cardiovascular events (MACE), defined as a composite of all-cause mortality, cardiac arrest, reinfarction, stroke, or in-stent thrombosis. A meta-analysis was conducted to compare short-term outcomes of interest during hospitalization or within 30 days of hospital discharge.</p><p><strong>Results: </strong>Among 837 eligible patients, 669 underwent TRA. Multivariable Cox regression showed that TRA was associated with a lower risk of in-hospital mortality (adjusted hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.42-0.91), MACE (adjusted HR, 0.63; 95% CI, 0.43-0.91), but a non-significantly lower risk of major bleeding (adjusted HR, 0.72; 95% CI, 0.35-1.49) compared to TFA. Meta-analysis of 65,943 patients from 17 studies confirmed lower short-term mortality (odds ratio [OR], 0.50; 95% CI, 0.43-0.57), major bleeding (OR, 0.58; 95% CI, 0.48-0.71), and MACE (OR, 0.65; 95% CI, 0.53-0.80) with TRA.</p><p><strong>Conclusions: </strong>Our findings indicate that, in STEMI-CS, TRA is associated with lower short-term all-cause mortality compared with TFA, supporting the potential advantages of TRA in this population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02306616.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"694-709"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674459","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":"Precision Prevention in CIED Infection: Interpreting the Signal Beyond the Pooled Estimate.","authors":"Hee Tae Yu","doi":"10.4070/kcj.2026.0067","DOIUrl":"10.4070/kcj.2026.0067","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"729-731"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963755","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":"Circumferential Subclavian Artery Dissection in Marfan Syndrome.","authors":"Takashi Kawanishi, Takashi Norikane, Yoichi Yamashita, Yoshihiro Nishiyama","doi":"10.4070/kcj.2026.0011","DOIUrl":"10.4070/kcj.2026.0011","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"750-751"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964238","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":"Lead aVR in ARVC: Rediscovering an Overlooked Signal.","authors":"Soonil Kwon","doi":"10.4070/kcj.2026.0292","DOIUrl":"https://doi.org/10.4070/kcj.2026.0292","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"(Pro)renin Receptor Regulates LDL-C Metabolism and Exacerbates Atherosclerosis via SREBP2/PCSK9/LDLR Pathway.","authors":"Kaiwen Sun, Wei Zhang, Wanyu Liu, Cuiping Bai, Yinong Jiang, Ying Zhang, Wei Song","doi":"10.4070/kcj.2026.0038","DOIUrl":"https://doi.org/10.4070/kcj.2026.0038","url":null,"abstract":"<p><strong>Background and objectives: </strong>The (pro)renin receptor [(P)RR] plays an important role in physiological processes through an angiotensin II (Ang-II) independent pathway. Low-density lipoprotein cholesterol (LDL-C) is a major risk factor for atherosclerotic cardiovascular disease. Its clearance depends on binding to the low-density lipoprotein receptor (LDLR), which is regulated by proprotein convertase subtilisin/kexin type 9 (PCSK9) and sterol regulatory elements binding protein 2 (SREBP2). This study aimed to explore whether (P)RR regulates LDL-C metabolism and exacerbated atherosclerosis via an Ang-II independent pathway.</p><p><strong>Methods: </strong>Apolipoprotein E-knockout mice were fed with a high-fat diet, treated with losartan and received prorenin injection for 8 weeks. Hep G2 cells were incubated with prorenin, small interfering RNA or plasmid for (P)RR, inhibitors of pathway in vitro. In the population study, individuals were divided into two groups based on their plasma renin activity (PRA). Clinical characteristics and LDL-C levels were collected and compared.</p><p><strong>Results: </strong>The mice in the prorenin group exhibited higher liver and plasma levels of LDL-C and a larger aortic plaque area. The (P)RR upregulated the mRNA and protein expression of SREBP2 and PCSK9, while downregulating LDLR expression. Silencing (P)RR or treatment with SREBP2 and/or PCSK9 inhibitor reversed the reduction in LDLR and reduced SREBP2 and PCSK9 expression. Consistent with these findings, participants with higher PRA had significantly higher plasma LDL-C levels in the population study.</p><p><strong>Conclusions: </strong>(P)RR regulates LDL-C metabolism and promotes atherosclerosis progression via the SREBP2/PCSK9/LDLR pathway. Targeting (P)RR may represent a promising approach to counteract atherosclerosis by lowering LDL-C.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Antiplatelet Therapy After Coronary Artery Bypass Grafting: Time to Reconsider Clopidogrel as the Default Monotherapy.","authors":"Jinhwan Jo, Woosik Han, Young-Hoon Jeong","doi":"10.4070/kcj.2026.0271","DOIUrl":"https://doi.org/10.4070/kcj.2026.0271","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the High-Risk Bifurcation: Beyond the RESOLVE Score.","authors":"Kyung Hoon Cho","doi":"10.4070/kcj.2026.0254","DOIUrl":"https://doi.org/10.4070/kcj.2026.0254","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}