Eurointervention最新文献

{"title":"Prasugrel should be preferred over ticagrelor in acute coronary syndromes: pros and cons.","authors":"Dominick J Angiolillo, Adnan Kastrati, Marco Frazzetto, Marco Valgimigli","doi":"10.4244/EIJ-E-26-00004","DOIUrl":"10.4244/EIJ-E-26-00004","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"526-529"},"PeriodicalIF":9.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943739","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: Non-culprit plaque rupture in STEMI - marker of vulnerability or actionable risk?","authors":"Jiannan Dai, Jiawei Zhao, Bo Yu","doi":"10.4244/EIJ-D-26-00287","DOIUrl":"10.4244/EIJ-D-26-00287","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"596-597"},"PeriodicalIF":9.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943751","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":"Ticagrelor versus clopidogrel in orally anticoagulated patients with acute coronary syndrome undergoing percutaneous coronary intervention.","authors":"Oskar Love Emilsson, Moman A Mohammad, Jesper van der Pals, Oscar Braun, Oskar Angerås, Tomas Jernberg, Mikael Zhou, Sacharias von Koch, David Erlinge, Sasha Koul","doi":"10.4244/EIJ-D-25-01373","DOIUrl":"10.4244/EIJ-D-25-01373","url":null,"abstract":"<p><strong>Background: </strong>In patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and who are treated with direct oral anticoagulants (DOACs), dual antithrombotic treatment without aspirin is recommended. Evidence comparing P2Y₁₂ inhibitor strategies in this setting is limited.</p><p><strong>Aims: </strong>This study aimed to compare outcomes with ticagrelor versus clopidogrel as part of dual antithrombotic treatment in ACS patients undergoing PCI.</p><p><strong>Methods: </strong>Using data from the SWEDEHEART registry, we conducted a cohort study including patients on dual antithrombotic treatment with ACS undergoing PCI between January 2014 and February 2022. Outcomes within one year were analysed using multivariate Cox regression to obtain adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for major adverse cardiovascular events (MACE; including mortality, myocardial infarction [MI], and stroke), all-cause mortality, clinically relevant bleeding, and MI.</p><p><strong>Results: </strong>A total of 3,708 patients were included (median age 76 years; 69% males; 40% ST-segment elevation myocardial infarction). At discharge, 1,170 (32%) received ticagrelor and 2,538 (68%) clopidogrel. For MACE, the unadjusted event rate was 16.7% in the ticagrelor group and 16.6% in the clopidogrel group (aHR 1.02, 95% CI: 0.84-1.23). Mortality occurred in 6.6% of patients treated with ticagrelor and 6.2% of those treated with clopidogrel (aHR 1.24, 95% CI: 0.91-1.69). Bleeding was 4.9% in the ticagrelor group compared with 3.7% in the clopidogrel group (aHR 1.53, 95% CI: 1.06-2.22). MI occurred in 10.4% of patients on ticagrelor and 11.2% of those on clopidogrel (aHR 0.90, 95% CI: 0.71-1.13).</p><p><strong>Conclusions: </strong>In ACS patients on DOACs undergoing PCI, ticagrelor was associated with an increased risk of bleeding compared with clopidogrel, with no differences in MACE, mortality, or MI.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"575-584"},"PeriodicalIF":9.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943815","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":"Letter: Non-culprit plaque rupture in STEMI - marker of vulnerability or actionable risk?","authors":"Bartosz Hudzik","doi":"10.4244/EIJ-D-26-00224","DOIUrl":"10.4244/EIJ-D-26-00224","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"594-595"},"PeriodicalIF":9.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943792","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":"Comparison of self-expanding transcatheter heart valves for aortic stenosis: the multicentre, randomised, controlled, non-inferiority DOUBLE-CHOICE trial.","authors":"Hans-Josef Feistritzer, Philipp Lauten, Tanja K Rudolph, Volker Rudolph, Tobias Geisler, Steffen Massberg, Matti Adam, Stephan Baldus, Samuel Sossalla, Michael Joner, Helge Moellmann, Alexander Wolf, Won-Keun Kim, Michael A Borger, Thilo Noack, Andreas Boening, Sabine Bleiziffer, Sven Hohenstein, Nadine Hoesler, Maria Buske, Nicolas Majunke, Niklas Lankisch, Maximilian von Roeder, Steffen Desch, Holger Thiele, Mohamed Abdel-Wahab, On Behalf Of The Double-Choice Investigators","doi":"10.4244/EIJ-D-26-00001","DOIUrl":"10.4244/EIJ-D-26-00001","url":null,"abstract":"<p><strong>Background: </strong>Although withdrawn from the market, the specific design of the ACURATE neo2 valve might influence the design of future transcatheter aortic valve platforms.</p><p><strong>Aims: </strong>We aimed to evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) using the ACURATE neo2 valve compared with the Evolut platform in selected anatomies.</p><p><strong>Methods: </strong>In this investigator-initiated, 2x2 factorial, open-label, randomised, multicentre, non-inferiority trial, patients with symptomatic, severe aortic stenosis were randomised to the ACURATE neo2 or an Evolut PRO/PRO+/FX valve. The primary endpoint was a composite of all-cause mortality, stroke, moderate/severe prosthetic valve regurgitation, and permanent pacemaker implantation at 30 days. Non-inferiority of the ACURATE neo2 to an Evolut valve was tested in the intention-to-treat population (absolute non-inferiority margin of -6%, α of 0.05).</p><p><strong>Results: </strong>At 10 sites in Germany, 835 patients were randomised. Within 30 days, the primary endpoint occurred in 60/389 patients (15.4%) in the ACURATE neo2 group and in 120/395 patients (30.4%) in the Evolut group (rate difference 15.0%, lower boundary of the 1-sided 95% confidence interval [CI]: 10.1%; p for non-inferiority<0.001, 2-sided 95% CI: 9.1-20.7; p for difference<0.001). A permanent pacemaker was implanted in 42/374 patients (11.2%) in the ACURATE neo2 group and in 101/381 patients (26.5%) in the Evolut group (p for difference <0.001). Rates of moderate/severe prosthetic valve regurgitation were low for both valves (1.3% vs 1.7%; p for difference=0.6).</p><p><strong>Conclusions: </strong>In selected anatomies, TAVI with the ACURATE neo2 was non-inferior to TAVI with an Evolut valve, with significantly lower rates of the primary endpoint, driven by lower permanent pacemaker implantation at 30 days.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"555-565"},"PeriodicalIF":9.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943822","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":"Inflammation after TAVI: an emerging therapeutic target?","authors":"Thomas Pilgrim, Ottavia Cozzi","doi":"10.4244/EIJ-D-26-00452","DOIUrl":"10.4244/EIJ-D-26-00452","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"513-515"},"PeriodicalIF":9.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943741","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":"Full-on commitment to interventional cardiology - today and in the future.","authors":"Bernard Prendergast, Emanuele Barbato, Nicolas Dumonteil, Martine Gilard, Didier Tchétché, Thomas Cuisset, Nieves Gonzalo, On Behalf Of The Pcr Board","doi":"10.4244/EIJ-E-26-00007","DOIUrl":"10.4244/EIJ-E-26-00007","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"524-525"},"PeriodicalIF":9.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943767","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":"A sledgehammer or a scalpel? Refining antithrombotic therapy in anticoagulated ACS patients.","authors":"Diana A Gorog, Konstantinos Toutouzas","doi":"10.4244/EIJ-D-26-00417","DOIUrl":"10.4244/EIJ-D-26-00417","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"521-523"},"PeriodicalIF":9.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943819","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":"Optical coherence tomography versus angiographic guidance in true unprotected left main bifurcation disease: an OCTOBER substudy.","authors":"Emil N Holck, Lene D Andreasen, Omeed Neghabat, Peep Laanmets, Lone J H Mogensen, James C Spratt, Johan Bennett, Slobodan Calic, Simon Walsh, Peter O'kane, James Cockburn, Loghman Henerah, Saqib Chowdhary, Karlis Grikis, Jacob Lønborg, Mattias Heighert, Stephan Kische, Evald H Christiansen","doi":"10.4244/EIJ-D-25-01337","DOIUrl":"10.4244/EIJ-D-25-01337","url":null,"abstract":"<p><strong>Background: </strong>Dedicated randomised studies on intravascular imaging guidance in unprotected left main coronary artery (LMCA) disease are lacking.</p><p><strong>Aims: </strong>We aimed to investigate the clinical feasibility of optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI) of true LMCA bifurcation lesions and to evaluate its prognostic impact compared with angiographic guidance.</p><p><strong>Methods: </strong>Patients with true LMCA bifurcation lesions who were randomised to either OCT or angiographic guidance in the OCTOBER Trial were included. The feasibility of OCT guidance was assessed as the proportion of patients with successful and analysable OCT pullbacks before, during, and after stenting. Clinical outcomes between the two groups were compared based on the incidence of a composite of major adverse cardiac events (MACE), comprising cardiac death, any myocardial infarction, or target lesion revascularisation.</p><p><strong>Results: </strong>In total, 227 patients were included (OCT: 111, angiography: 116). OCT guidance was successful, with 98% of cases having a pre-stenting pullback performed and 96% a final pullback, as per protocol. The proximal LMCA stent edge was analysable in 43% of patients, and in the remaining 57%, only 5% were limited by insufficient image quality. No statistically significant difference in MACE was observed between the two groups (OCT: 14.4% vs angiography: 18.4%, hazard ratio 0.78, 95% confidence interval: 0.39-1.51).</p><p><strong>Conclusions: </strong>OCT-guided PCI in true LMCA bifurcation lesions was clinically feasible, but visibility of the LMCA ostium was limited by short pullbacks, insufficient clearance, or guide catheter shadowing. OCT guidance was associated with a non-significant reduction in MACE, consistent with the effect estimate in the main trial.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"566-574"},"PeriodicalIF":9.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943827","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":"Glucocorticoids to reduce permanent pacemaker implantation after TAVI: the GLUCO-TAVI randomised trial.","authors":"Laura Fuertes-Kenneally, Fernando Torres-Mezcua, Marta Herrero-Brocal, José Antonio Quesada Rico, Raquel Ajo Ferrer, Seira Climent Ballester, Javier Pineda Rocamora, Pascual Bordes Siscar, José Valencia, Francisco Torres-Saura, Daniel Martínez López Clemente, Carlos Yago Riquelme, José Carlos López Clemente, Teresa Lozano Palencia, Carlos López-Menchero Ortiz de Salazar, Adriana Lloret Rubio, Lucía De la Hoz Marañón, José Manuel Mateo Soler, Juan Gabriel Martínez, Juan M Ruiz-Nodar","doi":"10.4244/EIJ-D-26-00032","DOIUrl":"10.4244/EIJ-D-26-00032","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing demand for transcatheter aortic valve implantation (TAVI), there is no strategy to prevent its most common complication: cardiac conduction disturbances (CCD). These disturbances often necessitate permanent pacemaker implantation (PPI), leading to high morbidity and costs. Post-TAVI CCD may be transient, resulting from inflammation.</p><p><strong>Aims: </strong>We aimed to evaluate the feasibility, safety, and preliminary efficacy of glucocorticoids in preventing PPI in patients undergoing TAVI.</p><p><strong>Methods: </strong>This pilot study followed a Prospective Randomised Open-label Blinded Endpoint (PROBE) design. One hundred TAVI patients were randomised 1:1 to standard care or methylprednisolone (7 mg/kg administered 1 hour preprocedure), followed by prednisone (15 mg every 12 hours for 5 days). Electrocardiograms and inflammatory biomarkers were assessed pre- and post-intervention, and at 1 month and 1 year. The primary efficacy endpoint was the 1-month incidence of PPI. Secondary outcomes included 1-year PPI, new left bundle branch block (LBBB), LBBB and PPI, other CCD, mortality, and procedural complications.</p><p><strong>Results: </strong>The primary efficacy outcome occurred in 16% of the control group and 8% of the intervention group, reflecting a 50% relative risk (RR) reduction in PPI (RR 0.50, 95% confidence interval [CI]: 0.16-1.55; p=0.23). There was no significant difference in 1-year PPI (RR 0.67, 95% CI: 0.26-1.73; p=0.41) or new LBBB (RR 1.12, 95% CI: 0.66-1.89; p=0.66). The intervention was safe, without differences in complications, mortality (4% vs 12%; p=0.27), or adverse events (n=3).</p><p><strong>Conclusions: </strong>Glucocorticoids in TAVI are feasible and safe. The observed numerical difference in PPI did not reach statistical significance. Large-scale trials are needed to confirm the results of this pilot study.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 10","pages":"545-554"},"PeriodicalIF":9.2,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943743","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}