Eurointervention最新文献

{"title":"Letter: How firmly can single-vessel physiology anchor endotypeguided therapy in angina with non-obstructive coronary arteries?","authors":"Murat Sezer, Ahmet Tas, Jan J Piek","doi":"10.4244/EIJ-D-26-00948","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00948","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1070-e1071"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118489","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":"Combined ischaemia and vulnerable plaque percutaneous coronary intervention to reduce cardiovascular events: design and rationale of the COMBINE-INTERVENE Trial.","authors":"Elvin Kedhi, Wojtek Wojakowski, David Erlinge, Takashi Akasaka, Tomasz Roleder, James Muller, Krzysztof P Malinowski, Adrian Wlodarczak, Szymon Wlodarczak, Rajesh Vijayvergiya, Tejas Patel, Marco Spaziano, Elie Akl, Raul Moreno, Salvatore Brugaletta, Amin A Nuruddin, Tieng Ping Tsao, Stanislav Bartus, Michael Maeng, Theodora Benedek, Marin Postu, Eric Van Belle, Francesco Burzotta, Adam Brown, Natalia Pinilla-Echeverri, Francesco Prati, Giuseppe De Luca, Ulf Landmesser, Rohit M Oemrawsingh, Fernando Alfonso","doi":"10.4244/EIJ-D-26-00702","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00702","url":null,"abstract":"<p><p>Fractional flow reserve (FFR) assessment represents the most widely used revascularisation strategy of the last two decades. However, many FFR (+) lesions, particularly those in the grey zone, can be safely treated medically, while other lesions carrying vulnerable plaque (VP) features can cause future events despite the absence of ischaemia. Optical coherence tomography (OCT) can identify lesions with VP morphology. The objective of this study is to determine whether a combined revascularisation strategy - targeting only severely ischaemic lesions (FFR ≤0.75) and extending treatment to OCT-assessed VP, even in the absence of ischaemia (FFR>0.80) - could reduce future adverse events compared with the current revascularisation practice based exclusively on the presence of ischaemia (FFR ≤0.80). The COMBINE-INTERVENE Trial is a global, prospective, randomised, single-blinded, sham-controlled, superiority trial. A total of 1,223 all-comer patients with multivessel disease (≥2 lesions with a diameter of stenosis ≥50%) will be randomised 1:1 to revascularisation if the FFR is ≤0.75 or a VP is present (experimental arm) versus FFR ≤0.80 in the comparative arm. The primary endpoint is a composite of cardiac death, any myocardial infarction, or any clinically driven revascularisation within 24 months. The trial has already completed enrolment in 50 centres worldwide. COMBINE-INTERVENE is the first trial evaluating the impact of a revascularisation strategy that targets lesions that are either severely ischaemic or carry an OCT-assessed VP versus revascularisation based on ischaemia alone. The trial is powered for superiority. (ClinicalTrials.gov: NCT05333068).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Unresolved mechanistic and safety questions from the GLUCO-TAVI trial.","authors":"Laura Fuertes-Kenneally, Fernando Torres-Mezcua, Marta Herrero-Brocal, Juan M Ruiz-Nodar","doi":"10.4244/EIJ-D-26-00723","DOIUrl":"10.4244/EIJ-D-26-00723","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e1017-e1018"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013271","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":"Clinical outcomes of FFR-guided revascularisation of non-culprit lesions in NSTE-ACS.","authors":"Luca Paolucci, Bernard De Bruyne, Gilles Rioufol, Joo-Yong Hahn, Shao-Liang Chen, Bon-Kwon Koo, Pim A L Tonino, Marcel van 't Veer, Pascal Motreff, Denis Angoulvant, Joo Myung Lee, Doyeon Hwang, Seokhun Yang, Nico H J Pijls, Emanuele Barbato, Fabio Mangiacapra, On Behalf Of The Prime Collaboration","doi":"10.4244/EIJ-D-26-00055","DOIUrl":"10.4244/EIJ-D-26-00055","url":null,"abstract":"<p><strong>Background: </strong>The role of fractional flow reserve (FFR)-guided revascularisation in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) is unclear.</p><p><strong>Aims: </strong>We sought to compare the outcomes of FFR-guided and angiography-guided revascularisation in patients with NSTE-ACS and chronic coronary syndrome (CCS).</p><p><strong>Methods: </strong>Individual patient data from five randomised clinical trials comparing FFR- and angiography-guided percutaneous coronary intervention (PCI) were pooled and stratified according to the coronary syndrome subtype. The primary outcome was major adverse cardiovascular events (MACE) at 1 year.</p><p><strong>Results: </strong>Overall, 2,493 patients were considered, including 1,316 (52.8%) with CCS and 1,177 (47.2%) with NSTE-ACS. The relationship between an FFR-guided strategy and the risk of MACE at 1 year was similar across the two groups (CCS: hazard ratio [HR] 0.78, 95% confidence interval [CI]: 0.58-1.05; NSTE-ACS: HR 0.86, 95% CI: 0.63-1.18; p-value for interaction [p-int]=0.792). Similar findings were found for all-cause death (p-int=0.459), myocardial infarction (p-int=0.996) and repeat revascularisation (p-int=0.290). These results were confirmed through an extended exploratory analysis at 5 years of follow-up. In patients with NSTE-ACS randomised to FFR-guided revascularisation, the number of deferred lesions was not associated with an increased risk of MACE.</p><p><strong>Conclusions: </strong>FFR-guided revascularisation is associated with a similar clinical benefit in NSTE-ACS and CCS settings. An FFR-guided strategy should be considered to safely reduce unnecessary PCI in patients with NSTE-ACS.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e970-e977"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013338","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":"Cardiogenic shock after cardiac arrest: phenotype before escalation.","authors":"Amir Lotfi, Sophia Airhart","doi":"10.4244/EIJ-D-26-00878","DOIUrl":"10.4244/EIJ-D-26-00878","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e968-e969"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013255","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":"Intentional fenestration of an intracoronary membrane-like structure with excimer laser.","authors":"Kiwamu Sudo, Masakazu Yasuda, Tomohiro Yamasaki, Mutsumi Iwamoto, Atsunori Okamura","doi":"10.4244/EIJ-D-25-01059","DOIUrl":"10.4244/EIJ-D-25-01059","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e1013-e1014"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013304","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: Unresolved mechanistic and safety questions from the GLUCO-TAVI trial.","authors":"Panayotis K Vlachakis, Maria Drakopoulou, Konstantinos Toutouzas","doi":"10.4244/EIJ-D-26-00693","DOIUrl":"10.4244/EIJ-D-26-00693","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e1015-e1016"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013295","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":"Breaking up with aspirin: it's not all about sex; patient factors matter too.","authors":"Jolanta M Siller-Matula, Christof Skos","doi":"10.4244/EIJ-D-26-01008","DOIUrl":"10.4244/EIJ-D-26-01008","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e964-e967"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013318","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":"Fractional flow reserve in non-ST-segment elevation acute coronary syndrome.","authors":"William F Fearon, Tara Gedeon","doi":"10.4244/EIJ-D-26-00956","DOIUrl":"10.4244/EIJ-D-26-00956","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e962-e963"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013335","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":"Clopidogrel monotherapy versus aspirin monotherapy in females and males after percutaneous coronary intervention: a sex-stratified analysis of the SMART-CHOICE 3 trial.","authors":"Woochan Kwon, Ki Hong Choi, Yong Hwan Park, Jin-Ok Jeong, Chan Joon Kim, Kyeong Ho Yun, Han Cheol Lee, Kiyuk Chang, Mahn-Won Park, Jang-Whan Bae, Joon-Hyung Doh, Byung Ryul Cho, Hee-Yeol Kim, Weon Kim, Ung Kim, Seung-Woon Rha, Young Joon Hong, Hyun-Jong Lee, Sung Gyun Ahn, Doo-Il Kim, Jang Hyun Cho, Sung Ho Her, Doo Soo Jeon, Seung Hwan Han, Jin-Bae Lee, Cheol Whan Lee, Danbee Kang, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Soo-Youn Lee, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Young Bin Song, Jong-Young Lee, Joo-Yong Hahn, On Behalf Of The Smart-Choice Investigators","doi":"10.4244/EIJ-D-26-00332","DOIUrl":"10.4244/EIJ-D-26-00332","url":null,"abstract":"<p><strong>Background: </strong>Clopidogrel has emerged as a promising alternative to aspirin monotherapy for maintenance therapy after percutaneous coronary intervention (PCI); however, the optimal antiplatelet strategy according to sex remains controversial.</p><p><strong>Aims: </strong>We aimed to investigate whether the treatment effect of antiplatelet therapy differs according to sex.</p><p><strong>Methods: </strong>This study was a prespecified substudy of the SMART-CHOICE 3 trial. Patients at high risk of recurrent ischaemic events who had completed the standard duration of dual antiplatelet therapy after PCI were randomly assigned to receive clopidogrel or aspirin monotherapy. The primary endpoint was a composite of all-cause death, myocardial infarction, or stroke.</p><p><strong>Results: </strong>A total of 5,506 patients, including 1,002 females and 4,504 males, were enrolled in South Korea. Females had a higher risk profile than males; however, the incidence of the primary endpoint did not differ significantly between females and males (6.7% vs 5.2%, adjusted hazard ratio [HR] 0.89, 95% confidence interval [CI]: 0.62-1.28; p=0.537). Clopidogrel, compared with aspirin, significantly reduced the primary endpoint in females (4.3% vs 9.4%, adjusted HR 0.45, 95% CI: 0.24-0.85; p=0.014) but not in males (4.4% vs 6.0%, adjusted HR 0.77, 95% CI: 0.56-1.07; p=0.116). There was no significant interaction between sex and the antiplatelet therapy (p for interaction=0.288).</p><p><strong>Conclusions: </strong>In patients with remote PCI and a high risk of recurrent ischaemic events, clopidogrel monotherapy showed a directionally consistent reduction in the composite endpoint of all-cause death, myocardial infarction, or stroke compared with aspirin in both females and males. No significant sex-by-treatment interaction was observed, supporting the consistency of the treatment effect across sexes.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e990-e1000"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013252","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}