Eurointervention最新文献

{"title":"Expanding physiology beyond the wire: will 2026 be the defining year?","authors":"Gianluca Campo, Simone Biscaglia","doi":"10.4244/EIJ-D-26-00289","DOIUrl":"10.4244/EIJ-D-26-00289","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e467-e468"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow flow and no reflow after percutaneous coronary intervention.","authors":"Salvatore Brugaletta, Luis Ortega-Paz, Josep Gómez-Lara, Claudio Laudani, Michele Strosio, Manel Sabaté","doi":"10.4244/EIJ-D-25-01346","DOIUrl":"10.4244/EIJ-D-25-01346","url":null,"abstract":"<p><p>Primary percutaneous coronary intervention is currently the standard of care for the treatment of acute ST-segment elevation myocardial infarction (STEMI). While it can restore flow in the infarcted artery in the majority of cases, some patients experience the so-called \"no-reflow\" phenomenon, which consists of abnormal myocardial reperfusion occurring after the occluded coronary artery has been opened. It is caused by microvascular obstruction (MVO), and its pathogenesis is multifactorial, including myocardial ischaemia, distal embolisation, and ischaemia-reperfusion injury, combined with individual susceptibility. Currently, there is no consensus on pharmacological or interventional strategies which can prevent or treat it. We herein discuss in detail the pathophysiology of the \"no-reflow\" phenomenon in STEMI patients, which is closely related to MVO, as well as potential pharmacological and interventional treatments tested in clinical studies.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e473-e488"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-coated balloons for the treatment of coronary artery bypass graft failure.","authors":"Alexander Marschall, Jorge F Chavez-Solsol, Nieves Gonzalo, Fernando Rivero, Pablo Salinas, Felipe Díez Del Hoyo, Hernán Mejía-Rentería, Javier Escaned, Fernando Alfonso, Fernando Macaya-Ten","doi":"10.4244/EIJ-D-25-01273","DOIUrl":"10.4244/EIJ-D-25-01273","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e508-e510"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural history of coronary plaque redistribution after drug-coated balloon angioplasty.","authors":"Magdalena M Dobrolińska, Wojciech J Skorupski, Mariusz Kruk, Damini Dey, Maksymilian P Opolski","doi":"10.4244/EIJ-D-25-01145","DOIUrl":"10.4244/EIJ-D-25-01145","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e511-e512"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracoronary imaging guidance for de novo coronary lesion treatment with drug-coated balloons.","authors":"Nicolas Amabile, Nieves Gonzalo, Antoinette Neylon, Fernando Alfonso","doi":"10.4244/EIJ-D-25-01066","DOIUrl":"10.4244/EIJ-D-25-01066","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e469-e472"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Derivation and external validation of a deep learning model to predict changes in coronary plaque burden.","authors":"Hector M García-García, Carlos A Bulant, Gustavo A Boroni, Alejandro Clausse, Thomas Engstrøm, Pedro A Lemos, Nathan A Lecaros Yap, Murat Cap, Juan F Iglesias, Robert van Geuns, Irene M Lang, David Spirk, Jonas D Häner, Konstantinos C Koskinas, Ryota Kakizaki, Yasushi Ueki, George C M Siontis, Cristos V Bourantas, Pablo J Blanco, Lorenz Räber","doi":"10.4244/EIJ-D-25-01352","DOIUrl":"10.4244/EIJ-D-25-01352","url":null,"abstract":"<p><strong>Background: </strong>Predicting the progression/regression of coronary plaque burden is challenging.</p><p><strong>Aims: </strong>We aimed to develop a deep learning model to forecast changes in percent atheroma volume (ΔPAV) using intravascular ultrasound (IVUS).</p><p><strong>Methods: </strong>We analysed data from IBIS-4 and PACMAN-AMI. Core lab measurements of plaque burden were available from IVUS pullbacks. Each model consists of a bidirectional Long Short-Term Memory (biLSTM) layer followed by two fully connected layers with one neuron each, resulting in both a classification for input progression/regression and an estimation of the ΔPAV.</p><p><strong>Results: </strong>For the derivation and validation, a total of 1,960 regions of interest (ROIs) from the IBIS-4 dataset were used. The mean±standard deviation of the model accuracy was 0.85±0.02, the Matthews correlation coefficient was 0.70±0.04, and the F1 score was 0.85±0.02 for both progression and regression classes. In the testing (external validation) process with the PACMAN-AMI dataset, 5,283 ROIs were utilised. The mean ΔPAV was -0.31±5.63, for which 2,665 featured regression with a mean ΔPAV of -4.57±3.73, and 2,618 presented progression with a mean ΔPAV of 4.02±3.55, representing 49.6% of plaque progression prevalence. The predictive performance across the 100 trained models in the testing dataset showed an accuracy of 0.84, a Matthews correlation coefficient of 0.68, and an F1 score for the progression and regression classes of 0.84.</p><p><strong>Conclusions: </strong>This is the first deep learning model capable of detecting changes in plaque progression by analysing the rate of plaque burden change between adjacent frames.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e499-e507"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative flow ratio versus fractional flow reserve: 2-year follow-up of the FAVOR III Europe trial.","authors":"Birgitte K Andersen, Niels R Holm, Martin Sejr-Hansen, Andrea Erriquez, Truls Råmunddal, Barbara E Stähli, Vincenzo Guiducci, Lone J H Mogensen, Jelmer Westra, Javier Escaned, Evald H Christiansen, On Behalf Of The Favor Iii Europe Investigators","doi":"10.4244/EIJ-D-25-01255","DOIUrl":"10.4244/EIJ-D-25-01255","url":null,"abstract":"<p><strong>Background: </strong>Quantitative flow ratio (QFR) is an angiography-based method for estimating fractional flow reserve (FFR). The FAVOR III Europe trial showed that QFR guidance did not meet non-inferiority to FFR guidance, as measured by a composite endpoint of all-cause death, myocardial infarction, and unplanned revascularisation at 12 months.</p><p><strong>Aims: </strong>We sought to report the 2-year outcomes of the QFR-guided diagnostic strategy and the FFR-guided strategy as applied in the FAVOR III Europe trial.</p><p><strong>Methods: </strong>FAVOR III Europe was a multicentre, randomised, open-label, non-inferiority trial. A total of 2,000 patients from 34 European medical centres were randomised to undergo QFR- or FFR-guided revascularisation of intermediate coronary artery stenoses. Endpoints assessed at the 2-year follow-up included the rates of major adverse cardiac events (MACE) and its individual components of all-cause death, myocardial infarction, and unplanned revascularisation. The rates of MACE were compared for superiority by unadjusted Cox regression analysis. The outcomes from 1 to 2 years were explored in a landmark analysis.</p><p><strong>Results: </strong>At 2 years, the rates of MACE were 9.7% in the QFR group and 7.4% in the FFR group (hazard ratio [HR] 1.34, 95% confidence interval [CI]: 0.98-1.81; p=0.064). In the landmark analysis, the rates of MACE between 1 and 2 years were 3.2% in the QFR group and 3.2% in the FFR group (HR 0.97, 95% CI: 0.58-1.62; p=0.92).</p><p><strong>Conclusions: </strong>The excess risks associated with QFR-guided revascularisation compared with FFR were confined to the first year. From 1 to 2 years, the rates of MACE developed similarly in the QFR and the FFR groups.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 9","pages":"e489-e498"},"PeriodicalIF":9.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of renal function on edoxaban antithrombotic therapy in patients with atrial fibrillation and stable coronary artery disease: a prespecified analysis of the EPIC-CAD trial.","authors":"Joong Min Lee, Min Soo Cho, Do-Yoon Kang, Jung-Min Ahn, Yong-Seog Oh, Chang Hoon Lee, Eue-Keun Choi, Ji Hyun Lee, Chang Hee Kwon, Gyung-Min Park, Hyung Oh Choi, Kyoung-Ha Park, Kyoung-Min Park, Jongmin Hwang, Ki-Dong Yoo, Young-Rak Cho, Ji Hyun Kim, Ki Won Hwang, Eun-Sun Jin, Osung Kwon, Ki-Hun Kim, Seung-Jung Park, Gi-Byoung Nam, Duk-Woo Park","doi":"10.4244/EIJ-D-25-01274","DOIUrl":"10.4244/EIJ-D-25-01274","url":null,"abstract":"<p><strong>Background: </strong>Renal function is a critical factor of ischaemic and bleeding risks in patients with atrial fibrillation (AF) receiving antithrombotic therapy.</p><p><strong>Aims: </strong>This study aimed to evaluate the impact of renal dysfunction in patients with AF and stable coronary artery disease (CAD) undergoing antithrombotic therapy.</p><p><strong>Methods: </strong>The Edoxaban Versus Edoxaban With antiPlatelet Agent In Patients With Atrial Fibrillation and Chronic Stable Coronary Artery Disease (EPIC-CAD) trial randomised patients to edoxaban monotherapy or dual antithrombotic therapy (edoxaban plus a single antiplatelet agent). In this prespecified analysis, patients were stratified by creatinine clearance into low (<50 mL/min) or high (≥50 mL/min) groups according to edoxaban dose-reduction criteria. The primary endpoint was net adverse clinical events (NACE: death from any cause, myocardial infarction, stroke, systemic embolism, urgent revascularisation, or major/clinically relevant non-major bleeding) at 12 months.</p><p><strong>Results: </strong>Of 1,040 randomised patients, 252 (24.2%) had low creatinine clearance; these patients were older and had more comorbidities compared with the 788 patients (75.8%) with high creatinine clearance. Patients with low creatinine clearance experienced higher risks of NACE (hazard ratio [HR] 1.72, 95% confidence interval [CI]: 1.19-2.49; p=0.004), ischaemic events (HR 2.70, 95% CI: 1.09-6.70; p=0.032), and bleeding (HR 1.54, 95% CI: 1.01-2.34; p=0.046). At 12 months, edoxaban monotherapy reduced NACE compared with dual therapy in both the low (12.1% vs 21.7%, HR 0.52, 95% CI: 0.28-0.98; p=0.042) and high creatinine clearance groups (5.2% vs 14.5%, HR 0.40, 95% CI: 0.25-0.65; p<0.001), with no interaction (p for interaction=0.53).</p><p><strong>Conclusions: </strong>In patients with AF and stable CAD, edoxaban monotherapy led to a lower risk of primary NACE than dual antithrombotic therapy, regardless of renal function. (ClinicalTrials.gov: NCT03718559).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 8","pages":"e432-e443"},"PeriodicalIF":9.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Transcatheter paravalvular leak closure - insights on selection criteria, imaging, and comparative outcomes.","authors":"Sebastien Hascoet, Grégoire Albenque, Grzegorz Smolka, Benoît Gérardin","doi":"10.4244/EIJ-D-26-00147","DOIUrl":"10.4244/EIJ-D-26-00147","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 8","pages":"e465-e466"},"PeriodicalIF":9.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No antithrombotic therapy versus single antiplatelet therapy after percutaneous left atrial appendage closure in non-valvular atrial fibrillation: rationale and design of the multicentre, randomised, non-inferiority NAPT-LAAC trial.","authors":"Toshiaki Otsuka, Masanori Yamamoto, Masahiko Asami, Toru Naganuma, Yohei Ohno, Tomoyuki Tani, Gaku Nakazawa, Masaki Izumo, Mike Saji, Daisuke Hachinohe, Hiroshi Ueno, Atsushi Sugiura, Tetsuro Shimura, Shinya Okazaki, Takao Morikawa, Yuki Izumi, Masaki Nakashima, Shunsuke Kubo, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida, On Behalf Of The Ocean-Laac Investigators","doi":"10.4244/EIJ-D-25-01307","DOIUrl":"10.4244/EIJ-D-25-01307","url":null,"abstract":"<p><p>The current standard regimen for antithrombotic therapy after percutaneous left atrial appendage closure (LAAC) in patients with non-valvular atrial fibrillation (NVAF) recommends long-term use of antiplatelet agents. However, this recommendation is not supported by sufficient clinical evidence. Since LAAC is a treatment option for managing patients at high risk of bleeding, it is necessary to clarify whether long-term antiplatelet therapy is truly required after LAAC. The Non-Antithrombotic Versus. Single antiPlatelet Therapy Following Left Atrial Appendage Closure (NAPT-LAAC) trial, a prospective, randomised, controlled, open-label, blinded-endpoint multicentre study, will be conducted in Japan. It was designed to evaluate whether non-antithrombotic therapy is non-inferior to antiplatelet monotherapy after 45 days of oral anticoagulant (OAC) monotherapy following LAAC, with respect to the incidence of thrombotic and bleeding composite events in patients with NVAF and high bleeding risk. Patients with NVAF with a CHA₂DS₂-VA score ≥2 and who successfully undergo LAAC are eligible for inclusion. A total of 500 patients undergoing LAAC will be randomised (1:1) to aspirin monotherapy versus non-antithrombotic therapy for the 45 days following OAC monotherapy. The primary outcome is a composite of all-cause mortality, myocardial infarction, stroke, systemic embolism, major bleeding, and clinically relevant non-fatal bleeding during a maximum of 4 years of follow-up. Major bleeding or clinically relevant non-fatal bleeding is defined as Type 2, 3, or 5 bleeding, according to the Bleeding Academic Research Consortium definition. The NAPT-LAAC trial will determine the probable non-inferiority of long-term non-antithrombotic therapy to aspirin monotherapy in patients with NVAF who undergo LAAC. (ClinicalTrials.gov: NCT07125417; jRCTs031250110).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 8","pages":"e455-e462"},"PeriodicalIF":9.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}